Upper Right Abdominal Discomfort: When to Seek Further Tests

Hello, doctor?

Hello Doctor, I am 25 years old.
About two months ago, I woke up with some discomfort in my upper right abdomen, and it has persisted until today.
The discomfort is mild, and my bowel movements are normal.
I have undergone an ultrasound, blood tests, and gastroscopy, all of which came back normal.
Most doctors believe there is nothing wrong, but I still feel some mild discomfort.
What should I do? Should I consider getting a colonoscopy or a CT scan? Thank you.

Kang Kang, 20~29 year old female. Ask Date: 2002/11/09

Dr. Yang Peizhen reply Gastroenterology and Hepatology

Hello! The tests you have undergone have ruled out peptic ulcers, gallstones, liver disease, pancreatic disease, and kidney stones.
The most likely remaining issue is related to the intestines; however, given your young age, the likelihood of malignancy is low (unless there is a family history of gastrointestinal malignancies).
Therefore, it is advisable to first obtain an abdominal X-ray to check for bowel obstruction, intestinal gas, or fecal impaction.
Additionally, a stool occult blood test can be performed to assess the possibility of gastrointestinal bleeding.
Only if intestinal disease is suspected should a colonoscopy be considered, and if any issues are found, further evaluation with an abdominal CT scan may be warranted.
Wishing you and your family health and happiness.
Sincerely, Dr.
Yang Pei-Chen, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2002/11/09

More Info

When experiencing discomfort in the upper right abdomen, especially when it persists for an extended period, it is essential to approach the situation thoughtfully and systematically. Given your age and the fact that you've already undergone several tests, including ultrasound, blood tests, and gastroscopy, it is understandable that you may feel anxious about your symptoms, especially if they continue despite normal results.

First and foremost, it is crucial to consider the potential causes of upper right abdominal discomfort. Common causes can include gallbladder issues (such as gallstones or cholecystitis), liver problems (like hepatitis or fatty liver disease), gastrointestinal issues (such as gastritis or peptic ulcers), and even musculoskeletal pain. Since your previous tests have returned normal results, this suggests that serious conditions may be less likely, but it does not entirely rule out other underlying issues.

In your case, since the discomfort has persisted for two months, it may be worthwhile to revisit your healthcare provider for a more comprehensive evaluation. Here are some steps you can consider:
1. Detailed Symptom Review: Keep a diary of your symptoms, noting when they occur, their intensity, any associated symptoms (like nausea, changes in appetite, or weight loss), and any triggers you may notice. This information can be invaluable for your doctor.

2. Follow-Up Consultation: Schedule a follow-up appointment with your primary care physician or a gastroenterologist. Discuss your ongoing discomfort and the results of your previous tests. It’s important to communicate how this discomfort affects your daily life.

3. Further Testing: If your doctor deems it necessary, they may recommend additional tests. A colonoscopy could be suggested if there are concerns about gastrointestinal issues, especially if you have a family history of colorectal diseases or if you experience changes in bowel habits. A CT scan may be recommended to provide a more detailed view of the abdominal organs and help identify any abnormalities that may not have been visible on previous tests.

4. Consider Referral to a Specialist: If your symptoms persist and no clear diagnosis is made, your doctor might refer you to a specialist, such as a gastroenterologist or a hepatologist, who can provide a more focused evaluation of your symptoms.

5. Lifestyle and Dietary Considerations: Sometimes, abdominal discomfort can be related to diet or lifestyle factors. Consider evaluating your diet for potential irritants (like spicy foods, caffeine, or alcohol) and assess your stress levels, as stress can also manifest physically.

6. Monitoring and Patience: While it is understandably frustrating to deal with ongoing discomfort without a clear diagnosis, it is essential to remain patient. Some conditions may take time to manifest or may require a process of elimination to diagnose.

In conclusion, while your initial tests have returned normal results, ongoing discomfort warrants further investigation. Engaging in open communication with your healthcare provider, documenting your symptoms, and considering additional tests like a colonoscopy or CT scan can help in identifying the underlying cause of your discomfort. Remember, your health and well-being are paramount, and seeking further evaluation is a proactive step in addressing your concerns.

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