URQ Pain

by Elizabeth
(Chicago, Illinois)

First of all, thank you so much for having this online. I haven't had health insurance for almost a year now and no money to really do anything for my problem. Alright, this may be a little long, but I will try to get to the point. I am female, 19 (almost 20), 5'8", 158lbs.

In May, I started feeling pain in my URQ (upper right quadrant) of my abdomen. I thought this was just a cramp or something, so I walked around, which did nothing. A few days later, it got worse. I did some research online from a symptom checker. My symptoms (then and now) were slight fever (sometimes over 100), diarrhea, very severe pain in my URQ, any food affected that area and there was pain, nausea and vomiting. The first thing that came up was gallbladder stones. So I went to my doctor, which I was told to get an ultrasound. All normal. Then one night it got so bad that my parents took me to the ER because I was up all night in such agonizing pain. They did an ultrasound, normal, and a CT scan, normal. They said that I should get a HIDA scan. I did that too, and it was normal, despite the horrible pain I got from that test.

Anyways, 6 months later, I am still in a lot of pain. I have lost almost 30lbs because of this pain because I'm afraid to eat anything, because the pain comes from really any food, especially fatty food. The 2 doctors I've seen told me that they think that it's my gallbladder, despite the fact of all the tests being normal. The 2nd doctor told me to go to a GI doctor to get an endoscopy/colonoscopy to see if it's possibly IBS.

But my question is, this pain that I'm feeling has all the symptoms of my gallbladder being bad, but with the tests all being normal, is it still possible for it to be my gallbladder? What do you think it is and what do you think I should do? I have been given Vicodin for the pain, it helps takes the edge off, but nothing works in aiding the pain. What should I do? I have no insurance and no money to really do more tests… I just really need this pain to go away so I can get on with my life.

Thank you very much,
Liz.

Your RUQ Pain

Liz, thanks for getting in touch and sorry to hear about your pains. I agree with the 2 doctors that have seen you that the pains sound like gallbladder pain. You can get a condition called acalculus cholecystitis, a condition where you can get all the symptoms of an inflamed gallbladder, but without gallstones being evident. Sometimes the gallbladder can look enlarged or thick walled, but not always. The treatment for this is antibiotics at the onset of symptoms and then cholecystectomy or removal of the gallbladder.

There are other causes for your symptoms, including infection within the bile duct system, pancreatitis and inflammatory bowel disease, particularly Crohns disease of the small bowel. Urinary tract abnormalities such as kidney stones and infections can cause these symptoms, but I would have expected the CT to have picked up all these conditions.

Pelvic inflammatory disease or PID can sometimes present in this way, particularly Chlamydia causing something called Fitz-Hugh-Curtis syndrome. Its worth getting this checked if you are sexually active.

Finally, there is a condition called Sphincter of Oddi dysfunction that might account for your symptoms. This gives gallbladder symptoms, but normal findings. The only thing against this is the factor you have had a fever, not normally associated with this condition.

I appreciate the issue of finance, but you might like to consider antibiotics if you experience this again at the very least. Hope this helps and good luck.