Mysterious Abdominal Weakness and RUQ Pain

Edited , 3 users are following.

If anyone can shed some light on this I would be so grateful. About 7 months ago, during a period fairly heavy exercise at the gym (which may or may not even be relevant), I began to feel a crampy sensation just under my right ribs along with a sensation of weakness and tenseness across my abdomen.

I didn't think much of it at first--in fact, I can't really even recall the exact day I began to have the problem--but when the symptoms didn't go away I saw my GP. He ordered all the standard tests. Blood work all came back normal. H. Pylori and mono negative. Two separate ultrasounds revealed a "possible" epigastric hernia and a slightly enlarged liver. Based on the liver finding we re-tested LFTs and they were normal (ALT and AST in the low 20s). We also tested for Hep B and C which came back negative.

At this point I was referred to a surgeon for possible hernia surgery, but he wanted to rule out gallbladder motility problems so he ordered a HIDA scan first. My HIDA scan came back with an ejection fraction of 38%, which was the exact threshold for a "normal" functioning gallbladder. However, since I didn't have any of the other classic symptoms of gallbladder problems, we sort of moved past this as a possible explanation for my symptoms.

I managed to convince my GP to refer me for an MRI, hoping it would confirm the hernia and give me the confidence I needed to proceed with hernia surgery. However, the MRI didn't show any epigastric hernia at ALL. It was otherwise completely normal.

At this point I'm at a loss. I have no clear explanation for my symptoms, and they are showing no sign of getting better. The "pain" is fairly minimal. Occasional poking sensations just under my right ribs, along with some muscle cramping when I contract my oblique muscle. But it's the abdominal WEAKNESS and tenseness that is most bothersome. It's not even pain so much as pure discomfort. The discomfort seems to get worse when I use my core muscles. My rectus abdominis feels "tight" when I stretch on my hands and knees. Laying down makes it better.

My leading theory at this point is the epigastric hernia, even though it wasn't seen on the MRI. I do also have a small bulge in my stomach when I raise my head from a laying down position which seems to confirm the epigastric hernia as well. But I struggle with the fact that an epigastric hernia doesn't really explain the RUQ pain. I also can't totally get past the slightly enlarged liver and borderline abnormal HIDA scan.

Lastly, there are a couple other unexplained, small symptoms that I've been experiencing over the past few months which quite possibly relate to my issue. Lots of trapped air seems to "gurgle" up my esophagus. I have also always had occasional benign palpitations, but they have increased in frequency since this whole thing started. These symptoms in connection with everything else make me think of a possible hiatal hernia or ulcer. However, I don't really suffer from heartburn and at the very begining of this whole situation my GP prescribed a PPI, thinking possible GERD, and it did nothing (I understand this to be the frontline treatment for a HH).

Anyway, if you've read through all this, thank you. If you have any ideas what my problem could be or you have experienced something similar, please let me know!

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4 Replies

  • Posted

    Hi Patrickp9

    If you do regular intense exercise this could affect your adrenals and cortisone levels. Adrenals are the glands that sit on top of your kidneys that release cortisone our natural pain killer. Over exertion can affect the natural process of our adrenals and cause gut problems. Ask your doctor to check your adrenals and cortisone levels. ....

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    • Posted

      Thanks for the suggestion. However, I have since toned down the exercise due to this issue, and even stopped exercise altogether for a period of 3 weeks to see if it would help. It made no difference, unfortunately.

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    • Posted

      Hi Patrick9

      Probably because the damage is already done as a process of elimination get your adrenals/cortisone checked due to the fact that all your other tests were ok...best wishes..

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  • Posted

    HI, just a couple other ideas...maybe do the swallow test to see if anything is going on in the throat, and also get an endoscope code, as well as a ct scan with contrast. I think a ct scan is a better tool when viewing the internal organs. Since most ulcers are caused by the h. pylori don't think you have this. A visit to a Physical therapist may also be helpful to determine if it may be muscular/nerve in nature. 😃

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