Pain in the Upper Right Abdomen
Greetings. I’m in the process of figuring out which medical examinations to request. Here’s a chronological summary of my situation: During my pregnancy, while dealing with Hashimoto's, I experienced mucus in my stool during the last trimester, accompanied by severe nausea. After attempting a vaginal birth after cesarean (VBAC), I ultimately delivered my baby through C-section. Following this, I contracted Covid, which led to sinusitis. I was prescribed amoxicillin, but the issue persisted. Subsequently, I received another antibiotic and underwent a month-long steroid treatment. Throughout this period, I began having episodes of breathlessness and what my primary care physician labeled as 'dumping syndrome.' Initially, these episodes were infrequent. I also developed an intense sensitivity to light and suffered from headaches that lasted from June to October, with no relief found through various medical treatments. Eventually, I started taking high doses of vitamin D3 as recommended by a specialist, which alleviated my headaches. I am currently taking 5,000 IU daily. Beginning in September, I started experiencing pain in my right upper abdomen. I went to the emergency room, but no issues were detected. I was put on a proton pump inhibitor, which did not alleviate my symptoms. After basic blood tests and a CT scan, my initial doctor was unable to assist further, so I sought a second opinion. The new doctor indicated possible inflammation of my gallbladder based on the previous scan results and referred me for a HIDA scan, which revealed a positive diagnosis for cholecystitis. However, the medical team concluded that no additional treatment was required. Since then, I have had to make multiple trips to the ER due to persistent pain while continuing to face episodes of dumping syndrome. I started experiencing difficulties digesting fats without subsequent diarrhea, although my stools did not contain oil. I also noticed undigested food in my feces. By November, I was overwhelmed with terrible stomach gurgling, consistent nausea, and ongoing pain in the right upper quadrant. My diarrhea also appeared infected. After testing positive for C. difficile and E. coli, I was treated with two different antibiotics which resolved these issues. Following that treatment, I was left with mostly yellow or orange, loose stools and experienced significant weight loss, dropping from 135 to 120 pounds rapidly. In December, I began vomiting, which escalated to the point where an eight-day hospitalization became necessary because I was unable to eat or drink. They conducted various blood tests and a second HIDA scan, which showed improvement compared to the first. They suggested the potential for Small Intestinal Bacterial Overgrowth (SIBO), but could not conduct the necessary tests during my inpatient stay. I was referred to follow up with a gastrointestinal specialist locally for treatment with rifaximin. However, I was unable to begin that treatment immediately due to my recent history with C. difficile, which posed a risk of reinfection. Before my hospital discharge, it was confirmed that I could manage to eat, drink, and have regular bowel movements using a combination of zofran, omeprazole, levsin, and Imodium. For a month, the pain and episodes of dumping syndrome disappeared. This treatment regime allowed me to regain weight to 124 pounds, but the right upper quadrant pain resurfaced, along with the reappearance of undigested food in my stool. Subsequently, I contracted norovirus twice, leading to rapid weight loss down to 112 pounds. After the norovirus infections, I started rifaximin for SIBO, though it had not been officially diagnosed yet, as testing would have required a six-month wait. While on rifaximin, my stools varied, with fluctuations ranging from normal to mucous-like, alongside episodes of dumping syndrome and abdominal diarrhea. I also suffered from nausea and stomach discomfort. Currently, the pain has spread to both sides of my ribs, leaving me fatigued and struggling with deep breaths. I am concerned about my gallbladder or possibly experiencing bile acid malabsorption. Although I’m maintaining my weight while consuming three to four meals a day (avoiding sugar and limiting fat), something does not feel right. I’m curious about suggestions for further testing or what my healthcare providers might consider regarding my condition?
Answers (1)
4/1/2025, 3:20:57 PM
OpenHealth AI
Main Points: It sounds like you are experiencing a complex range of symptoms that could be related to your gallbladder, digestive issues (possibly bile acid malabsorption), and potential ongoing effects from prior infections. Given the intricacies of your case, it’s crucial to seek targeted evaluations to better understand what’s happening.
Explanation: Your history includes significant gastrointestinal symptoms, multiple infections, and treatments that suggest both digestive and potential systemic issues. The recurrence of your abdominal pain and the experiences of undigested food in your stool, along with past diagnoses and treatments, point towards a potential digestive disorder, possibly related to bile production or absorption post-gallbladder issues. Your fear of possible gallbladder or bile issues is valid and needs further exploration.
Next Steps:
-
Follow-Up Gastroenterology Appointment:
- Schedule or prioritize a follow-up with a gastroenterologist if you have not already done so. Bring a detailed symptom diary, noting when pain occurs, frequency of diarrhea, and any dietary changes or reactions.
-
Testing for Bile Acid Malabsorption:
- Ask your healthcare provider about testing for bile acid malabsorption. A stool test can assess fat absorption and you might consider a SeHCAT scan if available. This will help determine if bile acid malabsorption is contributing to your symptoms.
-
Nutritional Support and Monitoring:
- Consider working with a nutritionist familiar with gastrointestinal issues. They can help tailor a diet that minimizes your symptoms but ensures adequate nutrition. Focusing on small, frequent, well-balanced meals may aid digestion.
-
Medication Review:
- Review your current medications with the gastroenterologist. Since you've experienced multiple treatments, it's important to ensure all medications are appropriate and not contributing to your digestive issues.
-
Assessment for Small Intestinal Bacterial Overgrowth (SIBO):
- Follow through with the SIBO diagnosis. If you have not yet received confirmation or treatment, express this concern with your specialist.
-
Pain Management and Symptomatic Relief:
- Discuss pain management strategies with your healthcare provider, focusing on medications that may help alleviate discomfort during episodes of pain.
-
Regular Monitoring:
- Keep monitoring your weight, stool characteristics, and any other symptoms. Updates during your follow-ups will provide critical information for your doctors.
If your symptoms worsen or if you experience new concerning symptoms like fever, significant changes in bowel movements, or increased abdominal pain, seek immediate medical attention. Your concerns are valid, and a thorough evaluation will help aim towards more effective management of your condition.
Related Questions
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!
28-Year-Old Male Experiencing Scalp Sensations Post-Amitriptyline Treatment
I am a 28-year-old man in generally good health, without any cardiac concerns. Approximately a month ago, I encountered intense pain localized to one side of my head, which was unresponsive to paracetamol. However, a single dose of a migraine treatment provided substantial relief. Following that, I began a regimen of amitriptyline, starting at a nightly dose of 10 to 25 mg. While my head pain has diminished significantly—by about 90 to 95%—I now experience occasional uncomfortable sensations on my scalp. These feelings include pins and needles, a cooling sensation, and some crawling feelings near my hairline and ears. There are fleeting moments where I feel brief throbs lasting a second, but I do not have any persistent headaches. To clarify, I do not experience any of the following: - Nausea - Weakness in my limbs - Numbness - Changes in my vision - Coordination difficulties - Seizures The symptoms I have are transient, shifting around and often intensifying when I become conscious of them or as the day progresses. I would like to know: Is it common to experience these sensations during the recovery stage following episodes of neuralgia or migraine-like discomfort? Additionally, could the amitriptyline potentially be causing these temporary paresthetic sensations? I am seeking some reassurance or advice on what is typically observed during this healing process. Thank you.