Right Abdominal Bloating: Causes and Next Steps - Gastroenterology and Hepatology

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Understanding right abdominal bloating can be quite complex, especially considering the various potential causes and the individual’s medical history. In your case, you are experiencing right-sided abdominal bloating that has persisted for three weeks, and despite consultations and ultrasound examinations, no significant abnormalities have been identified. Here’s a comprehensive look at the possible causes, next steps, and additional insights based on your symptoms.


Possible Causes of Right Abdominal Bloating
1. Gastrointestinal Issues: The most common cause of abdominal bloating is related to gastrointestinal function. This can include conditions such as irritable bowel syndrome (IBS), which can cause bloating, gas, and changes in bowel habits. Even though you mentioned that your bowel movements have normalized recently, IBS can still be a possibility, especially if stress or dietary changes are involved.

2. Food Intolerances: Certain food intolerances, such as lactose intolerance or gluten sensitivity, can lead to bloating and discomfort. Keeping a food diary to track what you eat and any subsequent symptoms may help identify potential triggers.

3. Constipation: Even if you feel that your bowel movements have improved, intermittent constipation can still lead to bloating. The presence of stool in the intestines can cause distension, particularly if it is located in the right colon.

4. Mesenteric or Colonic Issues: Given your previous CT scan findings of nonspecific mesenteric inflammation and fecal retention, it’s possible that there are ongoing issues in the mesentery or colon that could contribute to your symptoms.
5. Hernias: Although you did not mention any visible bulging, hernias can sometimes present with bloating and discomfort without an obvious external manifestation.

6. Other Organ Involvement: The right side of the abdomen houses several organs, including the liver, gallbladder, and parts of the intestines. Conditions affecting these organs, such as gallstones or liver issues, can also lead to discomfort and bloating.


Next Steps
1. Further Evaluation: Since your symptoms have persisted and you have had a previous colonoscopy that only examined the left side, it may be prudent to consider a full colonoscopy. This can help rule out any issues in the right colon that may not have been visible in previous tests.

2. Dietary Modifications: Consider evaluating your diet for potential irritants. Reducing intake of high-FODMAP foods, which are known to cause bloating, may be beneficial.
3. Symptom Monitoring: Keep a detailed log of your symptoms, including when they occur, their severity, and any associated activities or foods. This information can be invaluable for your healthcare provider in determining the next steps.

4. Consultation with a Gastroenterologist: Given the complexity of your symptoms and the previous findings, a referral to a gastroenterologist may be warranted. They can provide specialized insight and may suggest additional diagnostic tests, such as an MRI or specialized breath tests for food intolerances.


Additional Insights
Regarding your question about the "organ-like" structure you feel under your right rib cage, it is likely to be the liver or gallbladder, as these organs are located in that area. It is not uncommon for individuals to feel the outline of their organs, especially if there is any distension or bloating present.

As for the ability to palpate bloated intestines, it is possible to feel areas of distension, particularly if the bloating is significant. However, this should be done by a healthcare professional to ensure accurate assessment and to rule out any serious conditions.

In conclusion, while your symptoms may not currently indicate a severe underlying condition, persistent bloating warrants further investigation. Engaging with your healthcare provider to explore these options will be crucial in identifying the root cause and finding effective relief.