Right Upper Abdomen Pain: Causes and Insights - Gastroenterology and Hepatology

Q: Right Upper Abdomen Pain: Causes and Insights

Hello： (1) If there are questions regarding the report, physicians from different specialties may not provide much explanation for parts they do not understand. <br>It is advisable to consult the physician who originally arranged the examination or a specialist in that field. <br

Right upper quadrant issues?

Hello Dr.
Tsai,
In recent days, I have been experiencing intermittent sharp pain in my upper right abdomen near the last rib, which feels similar to nerve pain.
The pain is horizontal and approximately ten centimeters in length.
It diminishes or even disappears when I apply pressure.
The episodes occur unpredictably, lasting no more than five seconds at most.
I do not have nausea or diarrhea, and my bowel movements are normal.
I am unsure what might be causing this.
I would appreciate your insights.
Thank you.
Additionally, last month I experienced a sensation of constriction or squeezing in the center of my chest (at heart level).
The pulmonologist suspected it might be an esophageal issue and arranged for an endoscopy.
However, due to a business trip, I was unable to return for a follow-up appointment.
I would like to know if I can wait until my next cardiology appointment to have the cardiologist explain the report.
I ask this because I believe that reports from the same hospital usually come with explanations, and even if they are from different departments, they can still provide clarification to the patient, correct? Thank you again for your help, Dr.
Tsai.

Mr. Zhang, 50~59 year old female. Ask Date: 2016/04/04

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: (1) If there are questions regarding the report, physicians from different specialties may not provide much explanation for parts they do not understand.
It is advisable to consult the physician who originally arranged the examination or a specialist in that field.
(2) The organs located under the right upper rib cage are complex, including the liver, gallbladder, stomach, duodenum, right lower lung lobe, and hepatic flexure of the colon.
It is recommended to consult a gastroenterologist for differential diagnosis.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/04/04

More Info

Understanding right upper abdomen pain can be quite complex, as there are numerous potential causes for discomfort in this area. Based on your description of the pain being localized near the last rib, intermittent, and relieved by pressure, several possibilities can be considered.

1. Musculoskeletal Issues: Given that the pain is relieved by pressure, it is possible that the discomfort is related to musculoskeletal issues. This could include muscle strain or irritation of the intercostal muscles, which are located between the ribs. Activities that involve twisting or heavy lifting can lead to such strains, resulting in sharp, localized pain.

2. Nerve Irritation: The description of the pain as "nerve-like" could suggest a condition known as intercostal neuralgia, which occurs when the nerves running along the ribs become irritated or compressed. This can lead to sharp, shooting pains that may come and go, often exacerbated by certain movements or positions.

3. Gastrointestinal Causes: While you mentioned that you do not have symptoms like nausea or diarrhea, it is still important to consider gastrointestinal issues. Conditions such as gallbladder disease (including gallstones) or gastritis can sometimes present with pain in the right upper quadrant. However, these conditions typically come with additional symptoms, such as changes in appetite or digestive disturbances.

4. Liver Issues: Since you are a carrier of Hepatitis B, it is crucial to monitor liver health. While your pain may not directly indicate liver problems, any persistent discomfort in the right upper abdomen warrants further investigation, especially considering your history. Regular ultrasounds and liver function tests are recommended to ensure that there are no underlying issues.

5. Referred Pain: Sometimes, pain in the right upper abdomen can be referred from other areas, such as the heart or lungs. Given your previous symptoms of chest discomfort, it is wise to follow up with your cardiologist or gastroenterologist regarding the esophageal evaluation. It is not uncommon for different specialties to collaborate on a patient's care, and your concerns about waiting for a comprehensive explanation during your next appointment are valid. It is essential to have a clear understanding of your health status, especially when multiple systems may be involved.

In terms of your follow-up with the cardiologist regarding the esophageal issue, it is perfectly acceptable to wait until your next appointment to discuss the findings. Medical professionals often share information across specialties, and your cardiologist should be able to interpret the results of the endoscopy in the context of your overall health. If you experience any new or worsening symptoms, such as significant changes in pain, fever, or gastrointestinal disturbances, it would be prudent to seek medical attention sooner.

In conclusion, while your right upper abdomen pain may be benign, it is essential to remain vigilant, especially given your medical history. Regular check-ups, maintaining a healthy lifestyle, and being proactive about any changes in your symptoms will help ensure your well-being. If the pain persists or worsens, do not hesitate to seek further evaluation to rule out any serious conditions.

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