How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask DrRussMD Your Own Question
DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64393
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
24257177
Type Your Medical Question Here...
DrRussMD is online now

Pain under right shoulder blade and right side of chest, nausea. 2

Customer Question

Pain under right shoulder blade and right side of chest, nausea.

2 x liver function tests, all normal apart from slightly raised ALP.

Ultrasound showed - normal liver, pancreas spleen. Sludge found in gallbladder.

MRI showed liver pancreas normal.

My consultant has decided to remove gallbladder.

My concern is that my symptoms seem to be worse after an alcohol binge (although I drink rarely). The shoulder blade/back and chest pain seem worse for a couple of days after drinking alcohol.

Can you advise why this may be?
Submitted: 3 years ago.
Category: Medical
Expert:  DrRussMD replied 3 years ago.
Yes I can.

Alcohol binges will always make gallbladder pain worse.


That is why this is happening. If the gallbladder has been removed, it can still be due to spasm of the ducts. It can be because the alcohol is hurting your liver, regardless of previous labs. It can be because you have a stomach or duodenal ulcer, and that should be ruled out by your doctor.

Tell your doctor about this asap.

If it happens and gets worse, go to the ER.

You should stay away from alcohol entirely.

That should be part of the plan here.


Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
My gallbladder has not yet been removed.
Surely the mri or ultrasound would show if anything was wrong with the liver? This what my consultant has told me.

How does alcohol make gallbladder pain worse.
Expert:  DrRussMD replied 3 years ago.
Alcohol and fat both stimulate the gall bladder and will make the situation worse.
No I don't think it is liver.
stop drinking
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
So do you agree that if it was liver something would show on the mri or ultrasound?

Can Alcohol hurt a gallbladder with sludge or does there have to be stones??

Is alcohol likely to make a gallbladder inflamed?

Will these symptoms go after gallbladder removal


Expert:  DrRussMD replied 3 years ago.
No MRI or ultrasound will only show extensive liver damage, not up to moderate liver damage.

Yes.

Yes, as I said before.

Yes.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
So what would you class as mild to moderate liver damage then?

So basically you are saying the problem could still be my liver?

I have been told that mri will show fatty liver , hepatitis and cirrhosis?.
Expert:  DrRussMD replied 3 years ago.
That is all correct, except that it is unlikely to be liver pain here, but rather gallbladder pain.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
You are really not answering my questions.

You say that mri will only show extensive liver damage, what types of liver damage will mri not show?
Expert:  DrRussMD replied 3 years ago.
Chronic inflammation before fatty liver, scarring or fibrosis form, which can take up to 5 to 10 years.

Ask any question you like.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
Surely if the liver was inflamed, this would be evident from the combination of the lfts, ultrasound and mri?
Expert:  DrRussMD replied 3 years ago.
No
Chronic low level cellular damage from toxins occurs long before there is any gross evidence.
Then on might see liver enzyme elevations.
If that continues to go on, then gross damage, fatty liver and the rest.

As I said, I don't think this is liver at this point.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
Ok, what makes you think this is not liver and what do you think is going on?
Expert:  DrRussMD replied 3 years ago.
I have stated this already.
It is classic for gallbladder pain.
It acts like alcohol would with gallbladder disease.

In addition

If the liver were in pain, there would probably be elevated enzymes, not always, but usually, which you do not have.

Liver pain is usually a constant, dull, or intermittent dull ache and does not typically go to the shoulder blade. It can happen, but rarely.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.

Customer: replied 3 years ago.
Where would liver pain normally be felt?
Expert:  DrRussMD replied 3 years ago.
Right over the liver.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
By this you mean underneath the rib cage?
Expert:  DrRussMD replied 3 years ago.
Yes on the right.
Same place as gallbladder , but usually not unless there has been major damage, and does not typically radiate or act spasmodically.

Good luck with this, but I think it is gallbladder.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
Can gallbladder pain be felt I under right shoulder blade, mid right back and right side of chest. Sometimes even feel pain in right side of back of the neck
Expert:  DrRussMD replied 3 years ago.
Yes
It is fairly common.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
What is alcohol likely to do to a gallbladder with sludge?
Expert:  DrRussMD replied 3 years ago.
I have answered this above.
It is likely to cause pain and spasm.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
Could any of this be related to pancreas?
Expert:  DrRussMD replied 3 years ago.
No that would have shown up on labs, positive lipase and amylase, and it is really on the wrong side, right instead of left.

I have seen no positive ratings from you.
Please realize that we are only paid by JA PER positive rating.
Customer: replied 3 years ago.
It says to rate when finished which I will do.

These enzymes would not be included in lfts though would they?

I think I may have had a full blood count as my inflammatory markers were tested
Expert:  DrRussMD replied 3 years ago.
Lipase and amylase would be ordered separately from the liver function and full blood count.


Please do not forget a positive rating.
Customer: replied 3 years ago.
That's what I mean, I don't think these we're done? Would it be usual for the doctor to order these? I'm just worried that these May have been missed

My pancreas looked normal on ultrasound and mri , do you think pancreas should be ruled out?
Expert:  DrRussMD replied 3 years ago.
No one thinks it it the pancreas. Pancreatitis is severe and puts most people into the hospital, and it would show up on exam.
I don't think they missed anything.
I think this is your gallbladder.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.
What types of liver problems would cause bad pain under the right shoulder blade
Expert:  DrRussMD replied 3 years ago.
In fact no specific liver problems give that type of picture. Sorry that is a completely different question and really has nothing to do with your situation..I have still not seen a positive rating.
So, I have not been paid by ja for any of my work.

Feel free to find me by request for new questions.
Customer: replied 3 years ago.
But that is my symptom and you said that liver issues can cause this symptom? If you can elaborate, I will give my rating based on the answers you have provided
Expert:  DrRussMD replied 3 years ago.
I already , in fact, quite a few posts ago stated that liver pain is localized over the liver, and does not go to the shoulder.

Gallbladder pain goes to the shoulder.

Customer: replied 3 years ago.
It's not my actual shoulder though, it's just under my right shoulder blade
Expert:  DrRussMD replied 3 years ago.
Yes
That is classic for gallbladder.
Not liver.

DrRussMD and other Medical Specialists are ready to help you

Related Medical Questions