Seeking Insights: Persistent Upper Right Quadrant Discomfort and Medical Consultations
For the past three months, I (43 years old, female) have been experiencing persistent and varying pain in my upper right abdomen, just beneath the ribs. The discomfort fluctuates from mild sensations to excruciating levels, occasionally incapacitating me. This pain sometimes radiates along my lower ribs and up to my right shoulder blade, and I’ve also lost 35 pounds during this time. My general practitioner suspects it could likely be related to my gallbladder. I have dealt with ulcerative colitis for two decades, so I’m no stranger to pain and illness. Periodically, I also experience various inflammations—things like scleritis (which I wouldn’t wish on anyone), arthritis, and gingivitis. When I say my current condition is dire, I genuinely mean it. To date, I have undergone: - Three ultrasounds, all of which appeared normal, though the biliary tree has never been clearly visible. - A CT scan revealing a normal gallbladder and liver, but showing areas of intestinal collapse, along with inflammation and thickening in parts of my intestines. There is also inflammation noted around the valve that separates the large and small intestines, and my lymph nodes are swollen at 0.9 centimeters. A recent HIDA scan confirmed there are no issues with my biliary system, gallbladder, or liver. An endoscopy has revealed the presence of ulcers, and I am currently awaiting a colonoscopy. Discomfort is constant unless I lie completely flat, and most positions cause varying degrees of discomfort, particularly over time. My upper abdomen feels perpetually tender, often painful to the touch and occasionally swollen. Heat applications help alleviate some of the pain, and very hot baths bring the most relief, albeit only temporarily. Laying on my right side is unbearably painful, as if I’m lying on shards of glass. Post-meal discomfort is severe. I’ve significantly reduced my fat intake and opted for small meals, which seemed to help maintain pain at a lower level. I recently attempted a two-day clear liquid diet, but when I transitioned to full liquids, the pain escalated, leading me to visit the emergency room. During my GI consult in the ER, I was diagnosed with an ulcer and costochondritis, which seemed to make some sense to me—perhaps a partial explanation, especially in light of my inflammatory bowel disease and the upcoming colonoscopy. However, a different ER physician suggested that the diagnosis of costochondritis is often simply a catch-all for patients whose pain cannot be clearly identified through testing and is sometimes used to pacify them in hopes the situation resolves itself without further intervention. For a brief moment, I felt a sense of validation after the diagnosis, something I had not experienced in three months. I am reaching out in hopes of gaining perspective on this situation. Is costochondritis often perceived as a diagnosis that lacks seriousness, or is it a legitimate concern? My quality of life has drastically declined. I find myself crying daily, grappling with intense health anxiety. My passion for food has diminished, and I feel utterly drained. Preparing meals has grown increasingly difficult, leaving me struggling to cope. My cognition is clouded by exhaustion and confusion. Any thoughts or insights would be greatly appreciated. Thank you for taking the time to read my situation. ❤️
Answers (1)
3/29/2025, 12:30:45 AM
OpenHealth AI
I'm really sorry to hear how difficult things have been for you. Your description of the persistent abdominal pain and your ongoing struggle with ulcerative colitis suggests that you're dealing with a complex situation. It’s completely understandable to feel overwhelmed, given the uncertainty surrounding your symptoms and the significant impact on your quality of life.
Main Points:
- Your symptoms and medical history indicate a need for further investigation.
- Costochondritis is a legitimate diagnosis, but it can be misunderstood.
- Immediate relief strategies and symptom management are essential for improving your quality of life.
Explanation:
Costochondritis refers to inflammation of the cartilage that connects the ribs to the sternum, typically causing localized chest pain that can mimic heart problems or other serious conditions. It can be painful and is often aggravated by certain movements or positions. While it is a recognized condition, your concerns about it being labeled as a catch-all diagnosis are valid, especially since it does not fully address the overall discomfort you are experiencing.
Given your existing medical history with ulcerative colitis and your current symptoms, it’s possible that your pain is multifactorial, possibly related to inflammatory bowel disease (IBD), as well as the costochondritis. The involvement of various body systems may complicate both diagnosis and treatment, requiring a comprehensive approach.
Next Steps:
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Keep a Detailed Symptom Diary: Document your pain levels, locations, activities, meals, and symptom triggers. This can help you and your healthcare providers identify patterns and correlations that might not be immediately visible.
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Nutritional Management: Since you've found small, low-fat meals helpful, consider consulting with a dietitian specialized in gastrointestinal disorders. They can help devise a tailored meal plan that minimizes discomfort and ensures you receive necessary nutrients, especially with your weight loss.
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Physical Therapy: Gentle exercises focusing on posture and core stability may alleviate some of the discomfort associated with costochondritis. A physical therapist can provide personalized guidance.
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Pain Management: Discuss with your healthcare provider about safe pain relief options, including anti-inflammatory medications. Ensure these are compatible with your current treatment for ulcerative colitis.
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Regular Follow-Ups: Stay in close communication with your healthcare team, especially before and after your upcoming colonoscopy. Make sure to express any persistence or worsening in symptoms that could require escalated treatment or further diagnostics.
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Emotional Support: Acknowledge the emotional toll this situation has taken on you. It may be beneficial to consider counseling or support groups specifically for those dealing with chronic pain and complex medical conditions.
Please remember, your health is a priority, and seeking support and validating your concerns is essential for coping with these challenges. You're not alone in this; there are pathways to improve your quality of life. If you have specific questions or concerns as you navigate this situation, feel free to ask. ❤️
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