Right Upper Abdominal Pain: Causes and Concerns - Gastroenterology and Hepatology

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Understanding right upper abdominal pain can be quite complex, as it can stem from various underlying conditions. Based on your description, it seems that you have been experiencing discomfort in the right upper quadrant of your abdomen, which has persisted despite treatment with medications. Let's address your specific questions and provide some additional context regarding potential causes and concerns.

1. Possibility of Gastric and Duodenal Ulcers: Given that you had a gastroscopy two months ago that did not reveal any significant issues, the likelihood of developing gastric or duodenal ulcers in such a short time frame is relatively low, but not impossible. Stress, dietary changes, and certain medications can contribute to the development of ulcers. However, if your symptoms are consistent with ulcer pain, such as burning or gnawing sensations, especially after eating, it would be prudent to discuss further diagnostic options with your physician. This could include repeat endoscopy or imaging studies to rule out any new developments.

2. Helicobacter pylori (H. pylori) Infection: The risk of a previously negative H. pylori test turning positive within two months is generally low, but it is not entirely out of the question. H. pylori can be acquired through contaminated food or water, and if you have been exposed to it, it could lead to gastritis or ulcers. If your symptoms persist, it may be worthwhile to retest for H. pylori, especially if you have any risk factors or if your symptoms suggest a peptic ulcer.

3. Duration of Gastric Spasms: Gastric spasms can indeed last for an extended period, sometimes more than a week. These spasms can be triggered by various factors, including stress, dietary choices, or underlying gastrointestinal conditions. If the spasms are severe and persistent, it is essential to investigate further to rule out any serious underlying conditions, such as gallbladder disease, pancreatitis, or other gastrointestinal disorders.

In addition to the above points, it is crucial to consider other potential causes of right upper abdominal pain. Conditions such as gallstones, liver disease, pancreatitis, or even referred pain from the right kidney can manifest as pain in this area. Since you mentioned that an ultrasound did not reveal any abnormalities, gallbladder disease might be less likely, but it is not entirely ruled out, especially if the stones are small or if there is inflammation without stones.

Given your history of gastroesophageal reflux disease (GERD) and the recent onset of pain, it is also important to consider the possibility of esophageal spasms or complications related to GERD, such as esophagitis. The medications you are taking—dimethicone (an anti-foaming agent), domperidone (a prokinetic agent), and oxethazaine (a topical anesthetic)—are typically used to manage symptoms of dyspepsia and reflux but may not address underlying issues if they exist.

In conclusion, it is essential to maintain open communication with your healthcare provider regarding your symptoms. If your pain persists or worsens, or if you develop new symptoms such as jaundice, fever, or significant changes in bowel habits, seek immediate medical attention. Further diagnostic testing, including repeat imaging or endoscopy, may be necessary to identify the underlying cause of your symptoms and to guide appropriate treatment. Remember, persistent abdominal pain should never be ignored, as it can be indicative of more serious conditions that require timely intervention.