Pain on the Right Side of the Abdomen Accompanied by Nausea
A 35-year-old male, weighing 250 pounds and standing 6 feet 2 inches tall, underwent gallbladder removal in February of the previous year due to biliary dyskinesia, with a HIDA scan revealing only 2% functionality. Post-surgery, I enjoyed a smooth recovery and maintained a sense of well-being for approximately six months. However, starting in mid-August, I began experiencing discomfort on my right side along with episodes of nausea. The nausea often intensified in the morning, particularly after sleeping on my right side the night before. In an effort to determine whether an ulcer was the culprit, I took over-the-counter Prilosec for two months. Unfortunately, I found no relief from either the discomfort or nausea, and neither symptom worsened after I discontinued the medication. During a physical examination in September, I discussed my ongoing issues with my general practitioner. We continued the Prilosec through that month, and if there was no sign of improvement, I planned to incorporate Metamucil into my routine to address potential constipation. While Metamucil did help regulate my bowel movements, it did not alleviate the pain or nausea. In December, I attempted a low-fat diet, hoping it might ease my symptoms. However, I experienced three consecutive days of persistent nausea. This response led me to believe that my body was struggling to digest fats post-gallbladder removal, despite having tolerated them well previously for six months. This dietary shift produced a slight reduction in nausea, but the pain persisted. In January, I visited my GP again, who examined my abdomen. He noted increased tenderness on the lower right side, distinct from the upper right, leading him to suspect chronic appendicitis. Consequently, he ordered a CT scan. The results of the CT scan came back clear, prompting a referral to a gastroenterologist I had seen before. During my appointment with the GI specialist in March, he reviewed the scan and suggested that the discomfort could be attributed to constipation. As a result, he recommended I add Miralax to my regimen alongside the Metamucil. Currently, I am using Miralax at a dosage of a half cup daily, which has resulted in looser stools that still maintain some form. However, despite this adjustment over the past four to five days, I have yet to see any improvement in my abdominal pain or nausea. Should I continue this regimen for a month or two, or would it be wise to schedule another appointment for further evaluation?
Answers (1)
3/23/2025, 7:10:41 PM
OpenHealth AI
It sounds like you're experiencing ongoing discomfort and nausea despite several attempts to manage your symptoms. Let's break down your situation and focus on actionable steps to help address your concerns.
Main Points:
- Persistent Pain and Nausea: After gallbladder removal, ongoing right-sided abdominal pain and nausea can stem from various factors, including digestive adjustments and potential complications.
- Current Regimen: You are using Miralax alongside Metamucil to address constipation; however, this hasn't alleviated your pain or nausea.
- Next Steps: Monitoring your current symptoms is important, but a follow-up with your healthcare provider may be needed for further evaluation.
Explanation:
After gallbladder surgery, your body goes through several changes in how it processes fats and digests food. Since you initially felt well after surgery but are now experiencing discomfort, it's possible that your digestive system is not fully adjusting to this change.
The nausea and pain you are experiencing might be due to several factors:
- Dietary Issues: Sometimes, individuals develop sensitivities or difficulties digesting certain foods, even after a period of normal digestion.
- Constipation: While your bowel movements have regularized, that doesn’t necessarily mean the discomfort will resolve, as the pain may not be entirely related to constipation.
- Other Conditions: Even with clear imaging results, there's still a chance that conditions like adhesion or functional gastrointestinal disorders (e.g., post-cholecystectomy syndrome) could be factors.
Next Steps:
- Continue Current Regimen: Since you've only recently added Miralax, it would be reasonable to continue monitoring your symptoms with this regimen for another week or so, particularly as your bowel movements have improved.
- Track Symptoms: Keep a detailed diary of your symptoms, noting when they occur, their intensity, any food triggers, and other details. This can help identify patterns and may provide valuable information for your healthcare provider.
- Diet Adjustments: Consider maintaining a low-fat diet if it has shown any improvement, but ensure you’re still eating balanced meals with lean proteins and complex carbohydrates. Gradually reintroduce fats in small amounts and observe how your body reacts.
- Follow-Up Appointment: If your symptoms do not improve significantly in the next few weeks, or if they worsen at any point, contact your healthcare provider for a follow-up. They may want to explore additional investigations or refer you for specialized treatment.
Your ongoing discomfort is challenging, and it's understandable to be frustrated. You're definitely taking positive steps in managing your health, and continuing to communicate with your healthcare team will be crucial. If symptoms escalate—as in increasing pain or new symptoms—do not hesitate to seek immediate medical attention. Let me know if you have further questions or need more tailored advice!
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