"Only" 24/7 pain in the upper right quadrant - IBS??
Posted , 9 users are following.
Hi all.
My first post on these forums.
I'm 43.
15 years ago I had some kind of infection while in India after which I had a short period of acid reflux problems for the first time, followed by a few months of extraordinarily smelly gas. Like abnormally foul.
Soon after that a curious problem appeared. Every time I ate a slightly larger meal than the usual, I got pain just below the ribs on the right side about 1h after eating or perhaps 90 minutes tops. The pain was only mild to moderate but continuing 24 hour per day, lasting 3 - 7 days, after which all went back to normal. It happened rarely later as I got used to eating smaller meals.
9 months ago it happened again and I also had constipation for some time afterwards. About 2 weeks in the pain was almost gone, but then had a slightly too large meal and it increased again.
It's been almost the same since:
- Nonstop pain since the end of March, pain level between 2/10 when feeling good up to 4/10 when feeling depressed. Never sharp, never completely absent.
- No diarrhoea and only occasional mild constipation
- Pain is neither increased nor decreased by either eating or defecating
- fodmap diet - a little less gas, but no change in pain
Ultrasound normal, CBC normal, liver enzymes test normal, stool color normal (ranging between light brown and dark brown, but never yellow or black), urine color normal.
- Rifaximin improved stool consistency, but no change in pain
- Mebeverin (antispasmodic) - no effect
- Antidepressants - increased frequency of movements but no or virtually no change in pain
What do you guys think?
Both gastroenterologists thus far have said IBS, which would be fine if the pain was, say, 5 hours per day, but I just can't manage another permanent incurable pain (I'm living with back pain as a result of surgery 10 years ago).
Thanks (and sorry for a long post)
1 like, 24 replies
maria47829 Guest
Posted
Hi, I have very similar symptoms but on the left side . I was told it was trapped gas at the top part of large intestine otherwise known as splenic flexure.
Guest maria47829
Posted
maria, the right side has the hepatic flexure, but the symptoms don't seem to fit. I will, however, ask the next gastronterologist I see (probably a month from now) about it. Thanks.
stephen29372 maria47829
Posted
what do you take for your pain. I have had upper right pain, CT and bloods 2 weeks ago, all perfect. I have been told I suffer from IBS and functional dyspepsia
moon53540 Guest
Posted
It sounds like it is IBS ask to try another antispasmodic like alverine. Also if they have deflatine in India try them or a anti gas chewable tablet. You could possibly have a food intolerance like dairy or gluten, try for a couple of weeks cutting one of those out to see if it helps and if not try cutting out the other. You could also have a hiatus hernia, which can sometimes feel painful. You could try a low acid diet and see if it helps a bit. If it starts to become much more painful or your symptoms get worse, ask for a CT with contrast, it is the most accurate stomach scan.
Guest moon53540
Posted
moon, it doesn't satisfy enough criteria as per the international guidelines to be diagnosed as IBS, but it could very well be another form of a functional intestinal disorder, so basically more or less the same thing.
Hiatal hernia symptoms don't fit.
I have in the past stopped both gluten and dairy for 2 weeks (or 3?), but no effect.
I will ask the next gastroenterologist I see if it makes sense to try Alverine. I think they'd say no because the mode of action seems to be the same as Mebeverine.
I checked about Deflatine - it's an antacid, which doesn't do anything for me + simeticone. Maybe I will try the same product or at least something containing simeticone which is the anti-gas component of Deflatine.
Thanks
moon53540 Guest
Posted
I have had both mebevarine and alverine and alverine works but mebevarine actually made my symptoms worse. A lot of people say on this forum mebevarine doesn't work for them. You may want to get another upper endoscopy if you haven't had one for years, h-pylori can cause a lot of stomach complications and it may have not gone completely after your course of antibiotics or it may have come back if it is very common in your country.
pippa58442 Guest
Posted
Have you had an endoscopy to check for gastritis or h pylori? Have you had a colonoscopy? It may possibly be either of these conditions or post infectious IBS since you had an infection before your symptoms began.
pippa58442 Guest
Posted
Mebeverine isn't a great drug and often causes further stomach upset. I was prescribed to see if I had IBS and it made me worse.
Guest pippa58442
Posted
hi pippa.
Mebeverine gave me mild constipation, otherwise no noticeable effects.
I had a gastroscopy years ago when this problem was still just occasional, but it only showed h. pylori (like in about half the population). I took a combination of antibiotics, but nothing changed after that so h. pylori must have been asymptomatic.
I have not had a colonoscopy yet. Both gastroenterologists said it wouldn't show anything since there's no blood in the stool, no diarrhoea or constipation, no change in stool color.
It is likely that it's some type of post-infectious functional intest. disorder. But I'm sadly running out of treatment options.
Oh, yeah, should have mentioned, I also have bloating issues (consistent with IBS) and reduced appetite (by, say, 30 percent).
Could it still be something to do with liver, as in, can you have a sensitive liver or something like that (I know, a question for the next g.e.)?
Because the location of pain, combined with bloating and reduced appetite all fit with liver disorders as well. (It's just that I don't drink or smoke, I eat healthy food, and oily food doesn't make it worse).
pippa58442 Guest
Posted
Your symptoms sound like IBS and since two specialists diagnosed IBS, I would leave it at that and trust your doctor. There is no set number of hours for IBS pain to last. IBS can cause back pain or aggravate existing back pain. If the pain moves about, that is a common symptom of IBS. While left sided pain abdominal pain is common with IBS, everyone is different.
Your liver enzymes were normal so I wouldn't worry about your liver. Normal enzymes suggests a healthy functioning liver.
Guest pippa58442
Posted
Pippa, I do not have IBS.
IBS international definition:
Rome II criteria for IBS include at least 12 weeks (which need not be consecutive) in the preceding 12 months of abdominal discomfort or pain that has AT LEAST TWO of the three following features: 1. relieved with defecation, 2. onset associated with a change in frequency of stool, and 3. onset associated with a change in form (appearance) of stool.
So while I may have a functional intestinal disorder I do not have IBS regardless of 2 doctor's opinions. Doctors are not gods and trusting them unconditionally is one of the worst things you can do in life. Even if 5 doctors agree, there's still at least 1 or 2 percent chance they're all wrong.
In my spinal case all 4 orthopaedic surgeons I saw said it's a herniated disc (due to the MRI results) and all were found to have been wrong later on as the discs were asymptomatic.
So I would suggest anyone to get at least 5 doctors' opinions and even then consider it 98-99% sure and not 100%.
moon53540 Guest
Posted
You are looking at Rome II criteria? Why not the updated Rome IV criteria? This is continually being updated because there is no laboratory test for this condition!
pippa58442 Guest
Posted
I would trust your doctor's opinion because they are the experts in interpreting the criteria. Two doctors have told you with confidence you have IBS, so I would accept that.Did any doctor tell you you don't have IBS or is it your own personal belief you don't have IBS? Just because you have had one misdiagnosis with your spine, does not mean that you should never trust any doctor. However, when you have one bad experience it can colour your judgment and cause you to trust no one. My IBS was caused by the stress after a medical mistake with a badly done blood test.It left me with permanent neuralgia. While this caused me not to trust any nurse in my doctor's surgery, I got a much better experience with nurses in hospital at the phebotomy department and led me to believe that there are competent people in the NHS.
You can only say you don't have a particular condition if a doctor proves it via tests. A 1 or 2 % chance that you will get a misdiagnosis is tiny and if you still doubt five doctors telling you the same thing, you can never be happy. Only one doctor diagnosed my IBS and he was right! As soon as I believed and trusted my doctor, my symptoms got better. Had I not believed my doctor, I would still have daily and constant pain and rampant health anxiety. You don not need five doctors to confirm you have a particular condition; you only need one.
sam18386 Guest
Posted
ibs type pain would hit the left hand side first i would have thought.
stephen29372 Guest
Posted
hello, I have struggled with gut issues for 20 years. the last 2 years has been bad, perhaps my diet hasn't been great, and I am stressed over my tummy. My speclist says I have functional dyspepsia and ibs. It started with a burning in my chest and stomach, so I had a camera down, a small hotel hernia was found. A few months later I had a CT and colonoscopy and found I have some diverticulios. I stressed some much year I paid for an MRI, everything was fine. I then got mumps and got constipated, I had another CT to see if everything was clear, and it was. Christmas has come and I ate and drunk bad, since the 1st Jan my stomach has been cramps, loose stools, pain in abdomen and right side back ache, and bloated. My speclist says i have upset my gut over the Christmas period, but still i stress...
pippa58442 stephen29372
Posted
IBS and other gut conditions can flare up with stress or food. The best thing you can do is to trust and believe in your doctor's diagnosis since you have had all the tests. Getting my diagnosis of IBS from my doctor, stopped me stressing about it being something else and my anxiety disappeared.