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What Causes Pain On The Upper Quadrant?
I am a 38 yo male. I have right upper quadrant pain, it has been going on since early November. It occurs after eating, it is usually worse in the evening. I have had two abdominal ultrasounds, both which showed no gallstone, some gall bladder wall thickening. I had a HIDA scan, which was normal. Abdominal/pelvic CT was also normal. My labs have been normal, except for a elevated liver enzyme AST, at one time during early December. The pain is pretty significant, and I have symptoms almost every day, at times I have nausea and vomiting. My primary care doctor said he's seen other patients with similar symptoms and negative diagnostic tests, that once their gallbladder is removed, symptoms improve. The surgeon is a bit hesitant to do the lap choly, but I am completely frustrated and I am losing weight from not eating. My primary care doc suggested and upper GI evaluation endoscopy, to rule out ulcers. What do you think? Should my gall bladder come out?
Tue, 7 Nov 2017
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Since all the relevant investigations like Ultrasound, blood and urine, CT scan and HIDA scan are normal the most probable cause I can think of is Irritable bowel syndrome, IBS as it is called.
In this regards you also have a specific history of increase in pain in the evening indicating the day-to-day work tensions, stress and anxiety are taking the toll and is one of the most important reasons of IBS.
Hence I would advise you the following in such a situation:
Consult a Gastroenterologist for clinical evaluation, examination and any further investigations like colonoscopy, upper GI Endoscopy and whatever is will be advised by your Doctor.
Laparoscopic Cholecystectomy may not help you unless there is proper evidence of a specific cause related to the gall bladder.
Thanks for your query.
Noted the history and understood the concerns.
Since all the relevant investigations like Ultrasound, blood and urine, CT scan and HIDA scan are normal the most probable cause I can think of is Irritable bowel syndrome, IBS as it is called.
In this regards you also have a specific history of increase in pain in the evening indicating the day-to-day work tensions, stress and anxiety are taking the toll and is one of the most important reasons of IBS.
Hence I would advise you the following in such a situation:
Consult a Gastroenterologist for clinical evaluation, examination and any further investigations like colonoscopy, upper GI Endoscopy and whatever is will be advised by your Doctor.
Laparoscopic Cholecystectomy may not help you unless there is proper evidence of a specific cause related to the gall bladder.
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