Upper Right Abdominal Discomfort: Causes and Solutions

Q: Upper Right Abdominal Discomfort: Causes and Solutions

Hello： The doctor has already performed an endoscopy and ultrasound for you. <br>I believe all the suspected issues have been examined, and your symptoms have improved. <br>You can safely continue your medication and monitor whether the symptoms fully resolve. <br>Changhua Hospit

I have an unusual sensation in my upper right abdomen?

I have a severe insomnia problem and often find it difficult to sleep.
Last Friday, I tossed and turned in bed until 11 AM without feeling sleepy.
I initially planned to stay awake and just sat up in bed when I suddenly felt a warmth in my upper right abdomen, just below the rib cage (it felt like a heating pad was placed there).
Later, feeling anxious, I fell asleep.
The next day, I started to feel something strange; sometimes it felt like a sharp pain, other times a dull ache, and there was also a sensation of tightness and soreness in my back, but these feelings were very mild.
Since then, I haven't experienced any persistent or significant pain, although the warmth has continued, but it's not very noticeable unless I'm covered with a blanket (after I sleep, I don't feel anything).

Last Monday, I visited a nearby clinic and consulted a gastroenterologist.
After an ultrasound, I was diagnosed with gastroesophageal reflux disease (GERD), and the burning and sharp pain were attributed to a slight ulcer.
Besides the obvious burning sensation, I wasn't sure how to describe my symptoms.
I also experienced excessive gas and belching.
After taking the medication prescribed by the doctor for a week, the gas, warmth, and belching improved significantly, leaving only mild sharp pain and a dull ache in my lower back.

After my follow-up appointment last Friday, the doctor prescribed another week of medication and said the treatment was complete.
However, the sharp pain and dull ache in my back continue to make me anxious.
I've also been monitoring my bowel movements, which occur daily and are mostly normal without abdominal pain.
There were a few days when I passed long, thin stools, but only one or two days had more formed stools.
I'm wondering if the sharp pain could be due to another issue since I don't have most of the symptoms typically associated with GERD.
Due to financial constraints, I cannot afford a full-body check-up, and there are many organs in the upper right abdomen, so I'm unsure what tests I should undergo to confirm the diagnosis and adjust the treatment.
Should I continue to observe my symptoms for a while? Thank you for taking the time to read this; I appreciate it.

Xiao Wang, 20~29 year old female. Ask Date: 2017/12/11

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: The doctor has already performed an endoscopy and ultrasound for you.
I believe all the suspected issues have been examined, and your symptoms have improved.
You can safely continue your medication and monitor whether the symptoms fully resolve.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2017/12/11

More Info

Understanding upper right abdominal discomfort can be quite complex, as the area houses several vital organs, including the liver, gallbladder, and parts of the digestive system. Based on the symptoms you've described, it seems that you are experiencing a combination of discomfort and pain in the upper right abdomen, which may be linked to a few potential causes.

Possible Causes of Upper Right Abdominal Discomfort
1. Gastroesophageal Reflux Disease (GERD): As you mentioned, your doctor diagnosed you with GERD, which can lead to symptoms such as burning sensations, discomfort, and even referred pain in the back. The presence of ulcers can exacerbate these symptoms, causing sharp or stabbing pains.

2. Gallbladder Issues: Given the location of your pain, gallbladder problems, such as gallstones or cholecystitis, could also be a consideration. These conditions often present with pain after eating, especially fatty meals, and can cause referred pain to the back or shoulder.

3. Liver Conditions: Since the liver is located in the upper right quadrant, any liver issues, such as hepatitis or fatty liver disease, could also manifest as discomfort or pain in this area.
4. Musculoskeletal Issues: Sometimes, pain in the upper right abdomen can be due to muscle strain or tension, especially if you've been experiencing stress or poor sleeping positions, which can lead to discomfort in the back and abdomen.

5. Peptic Ulcers: Ulcers in the stomach or the beginning of the small intestine can cause pain that may be felt in the upper abdomen, particularly after meals.

Recommendations for Management
1. Follow-Up with Your Doctor: Since you have already seen a gastroenterologist and received a diagnosis, it is crucial to follow up with them if your symptoms persist or worsen. They may recommend further tests, such as an endoscopy or additional imaging, to rule out other conditions.

2. Dietary Modifications: Avoiding spicy, fatty, or acidic foods can help manage GERD symptoms. Eating smaller, more frequent meals rather than large meals can also be beneficial.

3. Medication Adherence: Continue taking any prescribed medications as directed. Proton pump inhibitors or H2 blockers can help reduce stomach acid and promote healing of any ulcers.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any associated factors (like food intake or stress levels). This information can be invaluable for your healthcare provider.

5. Hydration and Fiber Intake: Ensure you are drinking enough water and consuming a diet rich in fiber to promote regular bowel movements, which can help alleviate some discomfort.

6. Stress Management: Since you mentioned issues with sleep and anxiety, incorporating stress-reducing techniques such as mindfulness, yoga, or gentle exercise can help improve your overall well-being and potentially reduce abdominal discomfort.

7. Consider a Second Opinion: If your symptoms do not improve or if you remain concerned about the nature of your pain, seeking a second opinion from another gastroenterologist or a specialist may provide additional insights.

Conclusion
In summary, while your symptoms may be linked to GERD and possibly peptic ulcers, it is essential to remain vigilant and proactive about your health. Regular follow-ups with your healthcare provider, adherence to treatment plans, and lifestyle modifications can significantly improve your quality of life. If you experience any new or worsening symptoms, such as severe pain, jaundice, or changes in bowel habits, seek medical attention promptly. Your health is paramount, and addressing these concerns early can lead to better outcomes.

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