Unexplained Discomfort in the Upper Right Abdomen: Seeking Answers
Hello, I am a 43-year-old woman diagnosed with celiac disease, and I currently have a Body Mass Index (BMI) of 28.4. For several years now, I have experienced sporadic pain in my upper right abdomen. This discomfort is not localized; rather, it seems to shift locations. At times, the pain feels anchored in the area of the gallbladder, while other times it is positioned near the ribs or even lower, resembling sensations in the colon. I’ve observed that this pain can occasionally be triggered by drinking water too quickly, though there are many instances where no specific cause is apparent. I have undergone multiple ultrasounds, which revealed that my gallbladder is mostly normal, with just a small amount of sludge present. I also have a mild case of fatty liver; however, my liver size remains normal, and my liver function tests are satisfactory. I am actively pursuing a weight loss journey and have successfully shed 11 pounds thus far, with a target of losing an additional 24 pounds to reach a healthy BMI. Managing my celiac condition has posed challenges in maintaining adequate fiber intake, resulting in my stools typically being on the harder side, though I do manage to have daily bowel movements. If my gallbladder and liver have been ruled out, what potential causes could be contributing to my symptoms? UPDATE: I have also had a colonoscopy, which did not reveal anything unusual either.
Answers (1)
7/7/2025, 8:50:47 PM
OpenHealth AI
It's understandable to feel concerned about ongoing discomfort in your upper right abdomen, especially given your medical history with celiac disease and recent investigations. The shifting nature of your pain can be perplexing. Since your gallbladder and liver function tests have shown mostly normal results, let's consider potential causes and your next steps in managing these symptoms.
Main Points:
- Potential Causes: The discomfort could be related to digestive issues, muscle strain, or even referred pain from other areas.
- Next Steps: Focus on dietary adjustments, hydration, and symptom tracking to identify potential triggers.
Explanation:
Given your history of celiac disease, it’s important to ensure that your gluten-free diet is strictly maintained, as even small amounts of gluten can lead to inflammation and gastrointestinal discomfort. The shifting pain could indicate issues related to gas, bloating, or irritable bowel symptoms, which are common in those with celiac disease. Additionally, having stools that are on the harder side suggests possible constipation, which can exacerbate abdominal discomfort.
Your weight loss journey is commendable, but it's crucial to ensure you are receiving adequate nutrition, particularly fiber, as lack of fiber can lead to harder stools and possible digestive issues. Even though you've had a colonoscopy, which ruled out serious conditions, minor issues like diverticulosis or functional bowel disorders may still exist, and trigger points may lead to discomfort.
Specific Next Steps:
-
Dietary Review:
- Fiber Intake: Gradually increase your fiber intake by incorporating gluten-free, high-fiber foods such as fruits (e.g., berries, bananas), vegetables (e.g., leafy greens, carrots), and gluten-free grains (e.g., quinoa, brown rice). Aim for a gradual increase to avoid bloating.
- Hydration: Drink plenty of water throughout the day to help soften stools. Consider sipping water more slowly to prevent triggering pain.
-
Monitor Symptoms:
- Keep a symptom diary, noting when the pain occurs, what triggers it (e.g., food, drink, activities), and any associated symptoms like bloating or changes in bowel habits. This can help identify patterns or potential dietary triggers.
-
Gentle Physical Activity:
- Engage in regular, light physical activity, like walking or yoga, which can aid digestion and reduce discomfort.
-
Stress Management:
- Consider relaxation techniques, as stress can sometimes contribute to digestive discomfort. Techniques may include meditation, deep breathing exercises, or gentle stretching.
If symptoms persist or worsen, particularly with severe pain, significant changes in bowel habits, or new symptoms like jaundice or unexplained weight loss, reconsider discussing further diagnostic options with a healthcare professional to explore other gastrointestinal conditions.
Feel free to reach out if you have more questions or need further guidance on specific aspects of your care!
Related Questions
Dizziness and Muscle Spasms When Standing Up
Hello, doctors! I’m a 36-year-old female, generally healthy, living with bipolar disorder and currently on a regimen that includes Lamictal, Gabapentin, and Latuda. Lately, I've been experiencing a troubling issue. About half the time, when I rise from a seated position, I feel just fine for about five to ten steps. However, soon after that, I get lightheaded, and my whole body begins to spasm. I attempt to regain my balance, but when the spasms intensify, I often find it safer to drop onto my knees to avoid a more severe fall, though I still end up hitting the ground, occasionally landing hard on my face. I’m reaching out because I’m genuinely concerned about the injuries that are resulting from these falls. Just today, I struck the back of my head with such force that my face is now in pain—which seems quite unusual. I’ve taken into consideration all potential influencing factors such as my diet, sleep patterns, medication changes, and so forth—I’ve seen no direct connections to these episodes. Recently, I underwent medical scanning and blood tests for an unrelated issue, and everything came back normal (unless there’s something undisclosed). Any insights or advice would be incredibly helpful. Thank you!
Experiencing Dizziness When Rising: Is It a Concern?
Each time I transition from lying down or sitting to a standing position, I experience feelings of dizziness and lightheadedness. This sensation intensifies if I rise quickly, sometimes causing me to black out briefly for a fraction of a second. Should I be concerned about this issue?
Navigating Symptoms of Vestibular Migraines at 26
For the past three years, I have been facing various health challenges, but recently, both the frequency and severity of my symptoms have escalated. Below is a list of the key issues I'm experiencing: - Constant nausea and vomiting that has persisted daily for over three years; this typically occurs if I consume food or liquids in the hour following my wake-up. - Extreme sensitivity to certain foods, particularly dairy, coffee, and alcohol; I have eliminated coffee and alcohol from my diet altogether as they provoke severe vomiting. - Ongoing fatigue, weakness, and episodes of lightheadedness. - Generalized muscle cramps throughout my body. - My limbs tend to fall asleep if I rest on them for even a minute, which is a new development. - Occasional vertigo, particularly triggered by rapid changes in position, such as standing up quickly or climbing stairs. - Mornings leave me with a ‘hangover-like’ sensation, even though I have abstained from alcohol for nearly a month. - Breast tenderness and slight lactation when pressure is applied. - Recently, I have been struggling with insomnia that began about a month ago. - Blurred vision occurs when I rise too quickly. Regarding relevant medical tests and findings: - Previously, I had low glucose readings from a continuous monitor; alerts were triggered nightly due to low glucose levels. Blood tests revealed glucose levels as low as 55 mg/dL, even after eating beforehand. - Recent blood tests showed low sodium (135 mmol/L), a low anion gap (3 mmol/L), and elevated amylase (114 U/L). - My family has a history of diabetes, thyroid issues, various cancers, and an aortic aneurysm. - I was raised in an industrial area with seven plants nearby, releasing pollutants like sulfur dioxide, hexavalent chromium, and volatile organic compounds. - Multiple CT scans (brain and abdomen) and an echocardiogram did not reveal any significant abnormalities. - I have been diagnosed with vestibular migraines, PTSD, bipolar disorder, anxiety, depression, and ADHD. In terms of medication history: - At present, I am using ondansetron orally disintegrating tablets as needed, as well as albuterol, and plan to start omeprazole tomorrow morning. - Previously, my medication regimen included lamotrigine, aripiprazole, lorazepam, and bupropion, but I am currently transitioning between psychiatrists, making medication management a priority for me. I am sincerely struggling with exhaustion, continuous pain, and persistent fatigue, and I would greatly welcome any guidance or suggestions that could help improve my situation.
Experiencing Increased Bleeding After Intimacy
A 30-year-old female has been using a contraceptive implant for the past year and a half without complications and has experienced her typically irregular and painful menstrual cycles. She has had a steady partner for roughly a year. Around 10 months ago, she noticed occasional blood after intimate encounters. The bleeding did not seem to correlate with different positions or the intensity of the activity. Afterward, she visited a health clinic for a comprehensive STD screening, which returned negative results. Following this, she consulted her general practitioner (GP), who recommended a colposcopy. This examination revealed a minor tear, which was treated with silver nitrate; however, the specialists suggested this wasn't likely the source of the issue, as everything else appeared normal. A cervical screening test was also conducted, yielding standard results. Recently, the situation has worsened, with increased bleeding both in volume and frequency. She is now experiencing bleeding after bowel movements and irregular bleeding between her periods, as well as consistent bleeding following any sexual activity. To investigate further, her GP suggested a colonoscopy, which also came back clear, although the preparatory process for the procedure was not very effective. The persistent bleeding has begun to significantly affect her daily life, prompting her to seek answers. She is feeling increasingly anxious about her health condition.
Concern About Doctor's Professionalism
Subject: 17 years old, 5'2", 49 kg, residing in the UK **Presenting Symptoms:** Excessive sweating, severe migraines, recurring vomiting, persistent nausea, extreme fatigue, dizziness, body discomfort, frequent urination (especially at night), insatiable thirst, weight loss, reduced appetite, debilitating menstrual cramps, and consistent aches in the thighs. I have been enduring these symptoms, alongside more that I may have forgotten, for quite a while—over a year, in fact. I've visited my healthcare provider multiple times regarding some of these issues. Specifically, I visited three times to address my frequent urination problem. To clarify, there are moments when I feel an urgent need to urinate every five minutes, which is incredibly vexing. Despite taking a urine sample during each appointment—wherein the tests indicated no abnormalities—the doctor prescribed antibiotics each time, insisting that it might be a urinary tract infection. Additionally, I sought care for my migraines once, and I was given a medication from Pfizer, which hasn't proven effective. Today marked another visit, prompted by a worsening sensation of nausea. Given my family's history with several genetic disorders—particularly type 1 diabetes and thyroid complications—I sought screening for these conditions as my symptoms seem to align with that of diabetes based on my research. At the onset of my appointment, the doctor proceeded to review my medical history. She inquired about the duration of my health issues. Upon stating that they have persisted for more than a year, she questioned my last visit, which was in December for an ear infection. I informed her that I had actually been to see the doctor four times before December—three for urination and once for migraines, which I remembered took place in October. However, she appeared dismissive of this clarification and shifted her focus to the next item in my records, asking why I was receiving treatment at the Royal Orthopaedic Hospital. My mother explained that I have Cat's Eye Syndrome, a genetic condition. Subsequently, the doctor began to detail the distinctions between secondary and tertiary care and mentioned unrelated facilities for an extended period without prompting. While discussing my daily routine, she asked if I maintained regular meals. I replied that while I attempt to eat three times a day, my persistent nausea and vomiting make this challenging. I explained that I often gag during or after meals, with a 50% chance of vomiting. When she inquired about snacking, I said it depended on my appetite. She also asked about my exercise habits, to which I mentioned that I do not engage in much physical activity due to a benign tumor in my back that's quite painful. I have been waiting over a year for pain management injections. The doctor insisted that I must exercise in some capacity, suggesting I couldn't possibly maintain my appetite without it. I reiterated that my pain limits my physical activity, and I can hardly manage any exercise. At this juncture, she began collecting a social history—inquiring about substance use, relationships, and school attendance. I clarified that I neither smoke nor drink, do not use drugs, and remain a virgin. Additionally, I am not attending school because of the aforementioned back pain. When it came to discussing my menstrual cycle—specifically, the duration of bleeding and the number of pads used—I explained that I bleed for about four to five days and do not track pad usage closely, since I typically experience severe cramps that disrupt my sleep and often trigger vomiting. I also detailed the dull pain radiating from my thighs to my feet, which renders my leg weak and forces me to limp. She seemingly disregarded this information and instead asked if I still interacted with school friends, to which I confirmed I do. Her response baffled me: "Perhaps you and your friends should enjoy a sticky bun and some tea; that might help." My mother interjected, voicing her concern, recalling that my last outing resulted in a debilitating migraine that caused me to vomit and faint in a cinema restroom for two hours. The doctor seemed to brush this off, redirecting her attention to her computer. My mother then inquired about the possibility of being screened for type 1 diabetes, prompting the doctor to assert that my symptoms did not align with diabetes and that one would need to collapse and be hospitalized to be diagnosed. She proceeded to minimize concerns about diabetes, emphasizing that type 2 diabetes primarily affects individuals who are overweight, and noted that healthcare systems often create challenges for them concerning dietary advice. At this point, I was at a loss for words. Then, the doctor exhibited signs of frustration regarding her slow-loading computer, making comments about how she could walk to London faster than it was loading and referencing her nephew's advice on patience. She prescribed Gaviscon to manage my vomiting, although I found this baffling since I often vomit due to nausea and not acidity. She informed me she would arrange for some blood tests. While the appointment had been peculiar, I was hopeful that the blood tests would bring clarity. Ultimately, she concluded that my condition was likely a minor, transient issue, merely a bug I'd contracted. I mentioned that this had been ongoing for more than a year, and she reiterated that since I hadn’t seen a doctor since December, it could just be a fleeting ailment. Feeling uncomfortable and anxious, I nodded along. Upon returning home, I received a phone call indicating that they would only be measuring my height and weight the following day and that the blood tests were canceled. Is this typical? Was this encounter professional? I'm left feeling utterly perplexed.