Persistent Upper Abdominal and Back Discomfort - Gallbladder History
A 21-year-old female, standing at 5 feet 6 inches and weighing 180 pounds, has a history of gallbladder removal that occurred a decade ago and currently vapes. I have previously shared my concerns here, driven by anxiety over pancreatic cancer, but my physician seems unsure of the next steps. On February 25, I underwent a CT scan with oral and contrast enhancement, which indicated no abnormalities except for a diagnosis of fatty liver. However, just 13 days after that scan, I started enduring daily, intense pain beneath and around both sides of my ribs (LUQ and RUQ), which radiates significantly into my back, including the area between my shoulder blades. Occasionally, I experience pain extending into my throat, depending on which rib side is most affected. The discomfort in my back tends to be more severe than that in my abdomen and at times is severe enough to wake me in panic, feeling as though I’m in a critical state. The pain episodes can last between 5 minutes to an hour and occur multiple times throughout the day. Since December, I have been grappling with intense anxiety tied to concerns over pancreatic cancer, which may also be linked to a reduction in my bowel movements—something unusual for me, as I was accustomed to regularity before my gallbladder surgery. In early January, I had blood tests for CA 19-9, CEA, and CA125, all of which returned normal levels. I have also undergone an endoscopy that initially revealed gastritis, but subsequent biopsies were clear. An ultrasound further confirmed the presence of fatty liver, paralleling the findings from the CT scan. Despite the test results, I remain fearful that the severe pain I am experiencing now may indicate a growth that went undetected during the CT scan. Regardless of these health anxieties, the persistent pain is debilitating and interferes with my daily life. I know that my insurance does not cover MRI scans, leaving me and my doctor at a crossroads about the next course of action. The intensity of this discomfort is overwhelming, perpetuating my anxiety. In the decade since my gallbladder removal, I have not encountered significant issues aside from occasional loose stools.
Answers (1)
3/18/2025, 4:20:43 AM
OpenHealth AI
Your situation involves complex symptoms, significant anxiety, and a history of gallbladder removal, which can understandably lead to concerns about serious conditions. It's important to focus on addressing both the persistent pain you are experiencing and your anxiety.
Main Points:
- Your Symptoms: The severe pain you describe, particularly when it radiates to your back and throat, can be linked to several issues, including irritation from gastritis, digestive changes after gallbladder removal, and possibly anxiety.
- Recent Tests: Your blood work and imaging tests, including a CT scan and endoscopy, have not indicated any major abnormalities that would suggest a serious condition like pancreatic cancer.
- Ongoing Anxiety: Your anxiety is impacting your quality of life and might be exacerbating your perception of pain and discomfort.
Explanation:
The pain and discomfort you’re experiencing could be related to digestive issues that can arise after gallbladder removal, such as post-cholecystectomy syndrome, which includes symptoms like abdominal pain, bloating, and changes in bowel habits. The presence of gastritis may also contribute to your symptoms, as it can cause abdominal pain and discomfort.
It's also crucial to acknowledge that anxiety can amplify physical sensations and pain, which can create a cycle of discomfort and fear. The fact that your CA 19-9, CEA, and CA125 levels are normal, combined with your recent imaging results, makes serious conditions like pancreatic cancer less likely but does not alleviate your symptoms.
Next Steps:
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Dietary Modifications: Since you have been diagnosed with fatty liver and have a history of gallbladder removal, consider following a liver-friendly diet. Focus on:
- Reducing saturated fats (found in fried foods, fatty cuts of meat).
- Increasing fiber intake (fruits, vegetables, whole grains).
- Staying hydrated and avoiding excessive alcohol.
- Eating smaller, more frequent meals instead of large ones.
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Managing Pain and Discomfort: If you are not already, consider over-the-counter pain relief options like ibuprofen or acetaminophen after consulting your doctor, especially pertaining to any gastrointestinal issues.
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Anxiety Management: Engage in anxiety-reducing practices such as mindfulness, deep-breathing exercises, or gentle physical activity (like walking or yoga). Cognitive-behavioral therapy (CBT) techniques can also be beneficial in managing health-related anxiety. You might find it helpful to focus on the symptoms of anxiety and how they manifest physically, which could improve your management of discomfort.
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Monitor Symptoms: Keep a daily diary of your symptoms, noting their frequency, duration, and any possible triggers. This can help both you and your doctor identify patterns and inform further management.
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Open Communication: Continue discussing your concerns with your physician, sharing updates regarding your symptoms, how they affect your life, and any new information from your diary. It may be beneficial to explore options your doctor recommends for managing both the physical and the psychological aspects of your discomfort.
If your symptoms worsen or you develop new symptoms (like yellowing of the skin or eyes, significant changes in bowel habits, or severe unrelenting pain), seek medical attention promptly. Your comfort and peace of mind are very important, and taking these steps can help pave the way for better health and reduced anxiety.
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