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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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i am suffering from an upper right abdomen pain, often feeling

Resolved Question:

i am suffering from an upper right abdomen pain, often feeling as if I am lying on something at night. The pain is more like a sting, often spreading across the upper front of my stomach, but mainly to the right side. I had my gall bladder removed circa 10 yrs ago. My doctor sent me for a MRI scan of my whole abdomen, where a dye was inserted, all came back normal, my liver, kidneys, pancreas etc. I have also had a CT scan. I am 61 yrs old and find that this invisible lump that I am lying on at night is making it very difficullt to get a full night sleep. I can generally ignore it during the day just by giving it a rub. My bowel movements are regular and normal.
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.

Ken :

Hello

Ken :

I am Dr ken and I will be helping you today

Ken :

Are there associated symptoms like pain, tingling or numbness at the legs?

Customer:

no

Ken :

I am happy that MRI and CT came negative.

Ken :

We need to consider few other causes.

Ken :

Three things need to be ruled out -

Ken :

1. Irritation of the nerve at the spine level. The spine consists of vertebrae and intervertebral discs {soft tissue cushion if I may say}. The cord or bunch of nerves in simple word passes through the spinal canal {formed by vertebral body in front and ring like posterior part around}. Any bone spur of displacement or bulge of the disc cause pressure over the cord which results in symptoms like pain due to nerve irritation.

Ken :

2. Reduced blood flow to the bowel loops {secondary to atherosclerosis}.

Ken :

3. Irritation of the stomach and duodenum {allergy/ H. Pylorie infection/ increased acid secretion}.

Ken :

All the three causes are not picked up on CT or MRI.

Ken :

I would also like to rule out any abnormality at the right lung base {this may cause referred pain to upper abdomen}.

Ken :

Next step -

Ken :

Few investigations like - Upper GI scopy/ Chest x ray/ Color doppler study for abdominal vessels followed by CT angiogram/ x ray for dorsal spine followed by MRI.

Ken :

Treatment would be started once we reach at the cause of pain.

Ken :

Does this make sense?

Customer:

Yes, now that you mention the spine, I get regular numbness of both hands at night with no obvious cause, as carpel tunnel was rules out, where is the dorsel spine please?

Ken :

The spine is divided mainly into three parts.

Ken :

1. Cervical spine {neck} - Abnormality here can cause pain or symptoms at upper limbs.

Ken :

2. Dorsal spine - Behind the abdomen - This may cause symptoms in abdomen {as with you}.

Ken :

3. Lumbar spine {behind the pelvis} - Abnormality here causes symptoms in lower limbs.

Ken :

Carpel tunnel would cause symptoms at fingers {especially}.

Ken :

As the symptoms are in both the hands I would rule out abnormality at the cervical spine.

Ken :

Other causes like -

Ken :

Diabetes/ Vitamin B defeciency also needs to be ruled out.

Ken :

deficiency I meant

Ken :

As you are having symptoms at hands too - I would go for whole spine MRI.

Customer:

OK will follow up all of above, I am interested in the Vit B deficiency, why would that be a factor?

Customer:

I do not have Diabetes, all clear there

Ken :

Vitamin deficiency causes irritation of the nerve {nerve sheet to be specific}. This leads to abnormal signals by the nerve concerned and hence the symptoms. The symptoms generally go away if deficiency is treated.

Ken :

No diabetes relieves me:)

Ken :

Please do not worry, you will be fine.

Ken :

Best

Customer:

Thank you, XXXXX XXXXX given my reassurance

Customer:

All the best

Ken :

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Ken :

Good Luck

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