OpenHealth Q&A

Concerning Health Complications - RUQ Lump - Seeking Clarity

At 32 years old, weighing 58 kg and standing 164 cm tall, I have faced a series of perplexing health challenges since late 2024. Diagnosed with coeliac disease, asthma, biliary colic, and nephrocalcinosis, I’m currently on a daily dose of Omeprazole. Despite this regimen, the recent onset of multiple issues is leaving me feeling anxious and questioning whether these problems are interconnected. Is my GP overlooking something significant? It all commenced in December 2024 with the onset of reflux, a burning sensation in my chest, regurgitation, nausea, and a constriction-like sensation in my throat. My physician prescribed Omeprazole, which alleviated these symptoms and led to a referral for a gastroscopy for further evaluation. In January 2025, I experienced acute pain in my lower right abdomen along with nausea and tenderness. This prompted a visit to the ER due to the suspicion of appendicitis, but the diagnosis eventually indicated salpingitis. After completing a course of antibiotics, my condition improved, and a follow-up ultrasound was scheduled two months later. By March 2025, I encountered sharp pain in the upper right part of my abdomen that intensified upon palpation. My GP suspected issues with my liver, gallbladder, or possibly an ulcer, leading to another ultrasound appointment. In April 2025, I discovered a palpable mass in my right upper quadrant (RUQ). My GP ordered an ultrasound, which revealed no significant findings. Suspecting a hernia, she referred me for evaluation by general surgery while continuing to address my gallbladder issues. This mass is immovable, only discernible while I’m standing, and vanishes when I lie down. It roughly resembles a golf ball in size. When I inquired about a CT or MRI, my doctor deemed them unnecessary. ### Ultrasound Results Overview **Pelvic Ultrasound:** Comparisons were made with a previous pelvic ultrasound from January 25, 2025. Findings indicated a generally stable elongated structure within the right adnexa containing a 12 mm cystic space, previously measured at 9 mm. While the bladder and kidneys appeared normal, both ureteric jets were visible, leading to a conclusion of a stable cystic space with interobserver variability taken into account. I have now been referred to a gynecologist for further investigation. **Gallbladder/Liver/Kidney Ultrasound Findings:** - The gallbladder shows thickening of up to 3.7 mm, accompanied by sludge and multiple tiny stones. - The common bile duct is borderline dilated, measuring up to 7 mm, with no obstructing masses detected. The conclusion indicates biliary sludge and multiple gallstones, with sonographic signs suggestive of acute cholecystitis, and surgical evaluation is recommended. My mind is racing with worry. Could there be a more serious underlying issue, perhaps cancer? The presence of this mass is deeply concerning. As a mother of three young children, the uncertainty is overwhelming and frightening. Is it possible that the cyst in my adnexa poses a cancer risk? What does this mass signify? Any insights on what steps to take next or guidance on these matters would be immensely helpful. My anxiety is spiraling, as I can’t help but suspect the worst, leading me to contemplate going to the ER for clarity on this mass despite a part of me urging calmness. I need assistance! ### Update: I have undergone numerous tests, including FBC, parathyroid assessments, calcium levels, electrolytes, CRP, and liver panel evaluations. Fortunately, all the results have returned normal.

Answers (1)

3/31/2025, 11:50:46 AM

OpenHealth AI

It's understandable to feel anxious given the complexity of your health situation, especially with the recent discovery of the mass and your existing health conditions. Let's break down your concerns, clarify the current situation, and outline actionable next steps.

Main Points:

1. The mass in your right upper quadrant (RUQ) could be related to your gallbladder issues or possibly be a hernia, but cancer is generally less likely at your age with your test results.
2. Ongoing monitoring and thorough investigation by your healthcare team, especially a gynecologist, is essential for clarity.
3. To manage your anxiety and health, focus on what you can control and communicate openly with your doctors about your concerns.

Explanation:

• Mass in the RUQ: The fact that the mass is palpable when standing and not noticeable when lying down suggests it might not be a solid mass or tumor but possibly related to your digestive organs or a hernia. The ultrasound indicated issues with the gallbladder, such as thickening, sludge, and gallstones, which can contribute to RUQ pain as well.

• Cyst in the Adnexa: The ovarian cyst observed is common and typically not a sign of cancer, especially given its small size and stability over time. Most ovarian cysts are benign and resolve on their own. The additional investigations from a gynecologist will be helpful to rule out any serious issues.

Next Steps:

1. Follow Up with Gynecologist: Attend your appointment as scheduled. Bring your questions and express your concerns about both the cyst and the RUQ mass. Ask about the potential for further imaging if necessary, like a CT scan, which could provide more clarity.

2. Gallbladder Evaluation: Work closely with your GP on evaluating your gallbladder issues. Surgical evaluation has been recommended, and it might be helpful to discuss the urgency of this assessment given your symptoms.

3. Mindful Monitoring: Keep a symptom diary to track any changes in pain, digestive issues, or any new symptoms. This can provide valuable information for your doctors.

4. Manage Anxiety: Consider practices such as mindfulness, deep breathing, or relaxation techniques to help manage anxiety. Staying connected with friends, family, or a support group can also be beneficial.

5. Stay Informed: While it’s easy to jump to conclusions, focus on the test results and what your doctors say. If you remain concerned or experience new severe symptoms (like chest pain, significant changes in abdominal pains, or persistent nausea), don’t hesitate to seek further evaluation.

Taking these steps can provide clarity on your health issues while allowing you to manage your anxiety effectively. You're not alone in this; reach out for support when needed.