Health Query: Persistent URQ Discomfort, GI Issues, and Blood Concerns (M/34)
Hello everyone, I am in search of guidance regarding a health issue that has been bothering me since January. I'm a 34-year-old male, standing at 5'10" and weighing 220 lbs, and I've been dealing with ongoing discomfort in my upper right quadrant (around the liver and right rib area) coupled with intermittent stomach issues. This abdominal pain occurs 10 to 15 times throughout the day. Additionally, I have been experiencing occasional diarrhea, light yellow stools, episodes of floaters, and rare rectal pain. Fatigue has also become a daily struggle for me. To improve my health, I have made several lifestyle adjustments, including regular exercise, eliminating fatty foods, and cutting out alcohol, which has contributed to a weight loss of 23 pounds. While these changes have provided some relief from digestive issues, the pain persists. My primary care physician suspected gallbladder problems, but I have undergone various tests such as blood work, ultrasound, and a HIDA scan, all returning normal results (bilirubin level was 1.1), indicating no gallstones and a gallbladder ejection fraction of 70%. Despite this, I continue to experience discomfort when consuming fatty foods, sporadic rib pain, and joint discomfort, alongside unusual symptoms like weekly nosebleeds, an increase in eye floaters over the past year, and what appears to be petechiae rashes appearing in my armpits after returning to doing push-ups. Recent Complete Blood Count results showed a slightly elevated hemoglobin level (17.4) and hematocrit (54.6), raising my concerns regarding polycythemia. My PCP mentioned that no further tests are necessary based on these findings, but I remain anxious, fearing a possible liver condition due to the ongoing nature of my symptoms. I have scheduled an appointment with a gastroenterologist for late April to discuss my upper right quadrant pain and rib discomfort. Additionally, I will have an annual check-up with my PCP in mid-April. Should I advocate for further testing, such as a CT or MRI of my abdomen to gain a clearer understanding? Would it be prudent to undergo testing for the polycythemia vera gene? Is pursuing a second opinion from another physician advisable? I appreciate any insights or recommendations you might have!
Answers (1)
3/30/2025, 8:20:38 PM
OpenHealth AI
It sounds like you're experiencing a complex array of symptoms that are understandably concerning, especially with the ongoing pain and the recent blood findings. It’s important to validate your experience and recognize that seeking clarity about your health is crucial.
Summary of Key Points:
- Ongoing Symptoms: Persistent upper right quadrant pain, gastrointestinal issues, fatigue, unusual rash, and recent elevated blood values.
- Normal Test Results: Blood work and imaging have returned normal, which can be reassuring but does not fully explain your symptoms.
- Next Steps: You have upcoming appointments with a gastroenterologist and your primary care physician, which is a good opportunity for further discussion about your symptoms.
Explanation:
The upper right quadrant pain you’re experiencing, combined with gastrointestinal symptoms and elevated hemoglobin and hematocrit levels, warrants close attention. Normal results from tests like ultrasound and HIDA scans are helpful but may not fully rule out underlying issues. Your concerns over fatigue, floaters, and bruising should also be taken seriously, as they can indicate various conditions that need further exploration.
Actionable Steps:
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Document Symptoms: Keep a detailed diary of your symptoms over the next few weeks. Note when they occur, their intensity, and any triggers (like certain foods). This information can help your gastroenterologist and primary care physician understand your condition better.
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Prepare for Your Appointments:
- Questions to Discuss: Prepare specific questions about your symptoms and express your concerns regarding polycythemia and potential liver conditions. Ask about the possibility of testing for the polycythemia vera gene if you feel it’s warranted.
- Advocate for Imaging: It's reasonable to inquire about further imaging (like a CT or MRI) if your symptoms persist. Ensure your concerns are clearly communicated, emphasizing how they impact your daily life.
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Follow Up on Rashes and Nosebleeds: These symptoms may need further assessment, especially in conjunction with your other concerns. Bring them up during your appointments.
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Consider a Second Opinion: If after your appointments you still feel uncertain or unsatisfied with the explanation of your symptoms, seeking a second opinion can be very helpful. A fresh perspective might uncover something you haven’t yet considered.
By taking an active role in managing your health and ensuring your concerns are addressed, you can work towards finding clarity and relief from your symptoms. You are making strides by adjusting your lifestyle, and continuing on that path should remain a priority. Keep focused on your symptoms and advocate for yourself in your discussions with healthcare providers.
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