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This question was answered on Wed 09, Apr 2008 08:04am by Dr Heinrik M, MD

bilater upper quadrant pain, loss of appetite -ultra sound showed chronic cholecystitis


    
Asked by bushra (Male ) on Tue 08, Apr 2008 03:37pm

i m 27 yrs old and having bilateral upper quadrant pain. RUQ pain started a year ago but LUQ started 2 months ago..i have lost 5 pounds in a week due tu loss of appetite,i feel full all the time,,no hunger at all. but every morning my stool is yellow and loose with foams.i went for hepatic funtion and basic metabloic blood work,which came out normal. i cannot eat at all,i am nausous after food..or regurgitation..fatty tastse in my throat.. now bilat upper quadrant pain is constant,,trouble in sleeping.. ultra sound showed chronic cholecystitis,,, do u think bilat pain is beacuse of that,,
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Answer by Dr Heinrik M, MD  on Wed 09, Apr 2008 08:04am:

Hi, The symptoms you described may indeed be related to cholecystitis (particularly pain). The finding of normal examinations for a liver profile is unlikely however, so there may be other reasons for the symptoms aside from pain. Are you diagnosed with any cancer? If so, there may be other possibilities depending on the primary site, metastatic sites, the stage of the disease. If not, then it may be best to undergo more investigations. While it sounds unpleasant, an examination of the stomach using scopes would be a logical next step. There are some less invasive options in which images of the abdomen with a computed tomography (CT) scan could also be helpful (I am assuming you had a sonogram for the liver and gall bladder, I'd be interested to look at the pancreas).

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Comment by bushra on Wed 09, Apr 2008 09:12am: thanx for the quick reply.i m MRI Student also,one day around this januray 2008 my class pick me as a patient for abdominal MRI. there they saw something in RLQ and my live was enlargeg and gall bladder was big ang glowing. before that i ignored the pain. after that i realized that i should have ultra sound done.i have the H/o endomertiosis and lyomyoma at my leff ovary in 2003.but pelvic ultra sound was normal. but now bilat pain wid appetite loss.. so i should go for CT tat is yur recommendation. my CA 125 was normal also... thanx for the reply
Comment by Dr Heinrik M, MD on Mon 14, Apr 2008 08:09am: Hi, Have you had an operation for the enodmetriosis and the leiomyoma? If you are having difficulty eating, could it be possible that you may have adhesions from a previous operation? If you've never had an operation, you could consider having a scope into the stomach to investigate for ulcers. What were the specific tests done for the liver?
Comment by bushra on Tue 15, Apr 2008 05:19pm: yes laproscopy was done in 2003.Docter also found adhesion of sigmoid with my uterus because i was having back pain too.He did remove the lyomyoma and endometriosis and did put me on 6 luperon shot every month. Since i m not sexually active, he does pelvis ultra sound and Ca 125 whenever i feel symptoms or my period are irregular as per needed basis. Laproscopy was my first surgery but still i had adhesion of sigmoid and uterus. For the liver i got Liver function done which showed albumin 4.1 ALK Phosphate 44 ALT(SGPT) 13 ALT(SGOT) 19 Bilirubin(total) 0.9 Bilirubin Direct 0.1 Total Protein 7.2 Metabolic Total CA Sodium 138 Potassium 4.2 chloride 105 co2 25 Blood Urea Nitrogen 7 creatin 0.7 calcium 9.1 Glucose 82 and the ultra sound was done which sounf inflammation. I have question i m throwing up all acids from my stomach and i still digest food every day. My stool and urine is yellow. My thyrois is always normal. thanx for the reply Docter. u could be right that i do have pain and lower pelvic area sometime by my ovaries but there is no way we can rule out adhesion. i work with a docter and he thinks it is a stress and lower rib pain, cartilage inflammation.I could not sleep, if i sleep on right side left side hurts,if i sleep on left right hurts. thanx again DOC...
Comment by Dr Heinrik M, MD on Wed 16, Apr 2008 08:17am: Hi, are you still receiving the hormonal medications? do you notice a pattern related with the pain? there is also a possibility of the endometriosis being present outside the pelvis (though these are pretty rare cases). Discuss the possibility of investigating for ulcers within the stomach as a cause of the pain and the difficulty feeding. This is usually done through an endoscope.

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