Murphy's Sign Present Without Pain?
Male, 31 years old, weighing 183 lbs. Yesterday, I visited the emergency room due to discomfort in the right upper quadrant (RUQ), but the medical team couldn't identify any underlying issues. Nonetheless, there seemed to be a positive Murphy's sign during the examination. Oddly enough, I did not experience actual pain. It was quite uncomfortable, yet there was no conventional pain sensation. While the doctor performed the examination, I suddenly found it hard to breathe, and my heart rate escalated significantly. Has anyone encountered a similar situation, or do you have any recommendations? Could long-standing issues (over 15 years) in this area contribute to a diminished pain response? The affected region still feels off, making it hard for me to take deep breaths, and I worry that turning awkwardly might result in some kind of complication. It feels as if there is a sizable mass in my RUQ. After the ER visit, I was administered Motrin, which alleviated the discomfort for a few hours, but the symptoms returned afterward. The recent ultrasound revealed adenomyomatosis along with a mild fatty liver diagnosis.
Answers (1)
7/15/2025, 8:01:55 AM
OpenHealth AI
It sounds like you are experiencing significant discomfort in your right upper quadrant (RUQ) and have some concerning symptoms following your recent ER visit. The presence of a positive Murphy's sign typically suggests gallbladder irritation, but it's unusual to have this sign without the accompanying pain. Your discomfort, difficulty breathing, and changes in heart rate are important to address, especially since you've had a long-standing issue in that area.
Explanation:
Murphy's Sign: This sign is a physical exam finding suggesting gallbladder inflammation (cholecystitis) when pain is elicited during palpation. The fact that you did not experience pain but had discomfort could indicate an atypical presentation or other underlying issues, such as anxiety or muscle tightness, especially since your breathing was affected during the exam.
Fatty Liver and Adenomyomatosis: The ultrasound findings suggest there are mild changes in your liver and gallbladder. While mild fatty liver is common and often benign, it can sometimes be associated with discomfort. Adenomyomatosis is a benign condition related to the gallbladder wall and usually doesn't require treatment unless symptomatic.
Next Steps:
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Monitor Symptoms: Keep a daily log of your symptoms, noting when discomfort intensifies or any changes occur in your breathing or heart rate. This can help you identify triggers.
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Hydration and Diet: Stay well-hydrated and consider gentle dietary adjustments. A diet low in fat and rich in fruits, vegetables, and whole grains can support liver health. Avoid processed foods, alcohol, and high-fat meals, which can exacerbate symptoms.
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Gentle Movement and Breathing Exercises: Engage in light physical activity if tolerated; this may help reduce discomfort. Incorporating deep breathing exercises can also be beneficial, focusing on gentle, relaxed breaths to aid in proper lung expansion without discomfort.
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Pain Management: Continue to use over-the-counter pain relief like Motrin (ibuprofen) as needed. Take it with food to minimize gastric irritation, and ensure you don't exceed the recommended dosage.
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Follow-Up Care: Schedule a follow-up appointment with your primary care provider to discuss your ongoing symptoms and the ultrasound findings. They may recommend further evaluation or possibly a referral to a specialist if symptoms persist or worsen.
Remember, while some discomfort can arise from benign conditions, it’s essential to keep track of your symptoms and seek support if you notice any significant changes or if anxiety about your health impacts your day-to-day well-being. You're not alone in this, and taking a proactive approach will help in managing your concerns.
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