Upper Abdominal Discomfort: Possible Causes and Insights

Continuing to inquire about the area just above the navel, in the middle of the ribs, slightly to the left?

Hello, doctor.
Today I went to a nearby clinic for an ultrasound examination.
The doctor said there were no significant issues with my liver, gallbladder, or kidneys.
However, I still feel something unusual in the area just above my navel; it feels like there might be a lump, although it seems to come and go.
The ultrasound also examined that area, and the doctor mentioned that there didn't appear to be any problems.
I've been observing it for the past three days, and today the pain has diminished significantly, but occasionally I still experience brief pain that disappears.
The doctor only prescribed me gastrointestinal medication.
Last December, I had an endoscopy, and the doctor mentioned mild gastroesophageal reflux disease.
It seems that after the endoscopy last year, I experienced pain in the area above my navel that would come and go.
Sometimes the pain lasts for 1 to 2 days or even 2 to 3 days, then it disappears.
After several weeks, it might flare up again and then resolve.
I also feel some discomfort in my right side of the back.
Could you please tell me what this issue might be? Could it be a duodenal ulcer? It seems to hurt when I'm hungry, but the pain goes away after I eat.

L, 20~29 year old female. Ask Date: 2012/04/10

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Mr./Ms.
L, if the pain above the navel is not related to liver or gallbladder issues, then it is likely related to gastrointestinal or muscular problems.
If the pain intensifies when you are hungry, it suggests a gastrointestinal issue, and I recommend undergoing an upper gastrointestinal endoscopy.
If the pain is associated with fatigue or exercise, it may be a muscular issue.
If your symptoms do not improve, please seek further evaluation at a nearby medical facility.
Thank you for your inquiry.
Changhua Hospital cares about your health.
Dr.
Yang Chih-Chao.

Reply Date: 2012/04/10

More Info

Understanding upper abdominal discomfort can be quite complex, as it can stem from various underlying issues. Based on your description, it seems you have been experiencing intermittent pain in the area just above your navel, particularly on the right side, along with some discomfort in your right side back. You mentioned that you had an ultrasound that showed no significant issues with your liver, gallbladder, or kidneys, and that you were prescribed gastrointestinal medication.
Given the symptoms you've described, there are several potential causes to consider:
1. Gastroesophageal Reflux Disease (GERD): Since you have a history of mild gastroesophageal reflux disease, this could be contributing to your discomfort. GERD can cause pain in the upper abdomen, especially after eating, as stomach acid can irritate the esophagus.
2. Peptic Ulcers: Your concern about a possible duodenal ulcer is valid. Duodenal ulcers can cause pain that is often described as a burning sensation in the upper abdomen, particularly when the stomach is empty. Eating can temporarily relieve this pain, which aligns with your experience of pain subsiding after meals.

3. Gallbladder Issues: Although your ultrasound did not show any gallbladder problems, gallstones or inflammation can sometimes cause intermittent pain, especially after fatty meals. The pain is typically located in the right upper quadrant and can radiate to the back or shoulder.

4. Musculoskeletal Issues: Sometimes, pain in the upper abdomen can be referred pain from musculoskeletal issues, such as muscle strain or rib dysfunction. This could explain the pain in your right side back as well.

5. Irritable Bowel Syndrome (IBS): Given that you have been prescribed gastrointestinal medication, it’s possible that you may be experiencing symptoms related to IBS, which can cause abdominal pain, bloating, and changes in bowel habits.

6. Other Gastrointestinal Disorders: Conditions such as gastritis, pancreatitis, or even functional dyspepsia could also be contributing to your symptoms.
Since your pain seems to be intermittent and has been improving, it may be a sign of a functional issue rather than a structural one. However, it is essential to monitor your symptoms closely. If the pain persists, worsens, or is accompanied by other symptoms such as significant weight loss, vomiting, or changes in bowel habits, it would be prudent to follow up with a gastroenterologist for further evaluation.
In the meantime, keeping a symptom diary can be helpful. Note when the pain occurs, its intensity, any associated symptoms, and what you were doing or eating at the time. This information can provide valuable insights for your healthcare provider.

In summary, while your ultrasound results are reassuring, it is essential to remain vigilant about your symptoms. Conditions like GERD, peptic ulcers, or even gallbladder issues could still be at play. If you continue to experience discomfort, further diagnostic testing, such as an endoscopy or additional imaging, may be warranted to rule out any underlying conditions.

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