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Hi. I’d Like A Second Opinion About Chronic Abdominal Pain
Posted on
Mon, 11 May 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 11 May 2020
Answered on
Last reviewed on
Question : Hi.
I’d like a second opinion about chronic abdominal pain below right rib line:
- Pain onset usually about 20 minutes after a meal. May be triggered by acidic wine, or fat steak. But may come after any large meal. Sometimes pain triggered by itself, without meal.
- Pain radiates to lower back. Note I have structural back problems in the same location (arthritis, hypertonic back muscles etc) and these pains *always* flare up in parallel. I also think a part of that pain complex may be due to anxiety (there is a documented anxiety history).
- Ultrasound did not reveal stones or sludge in gallbladder. Choledoch was clear. There is a thickened gallbladder wall 4mm but it has been like that since 2015 (when previous ultrasound was carried out, it revealed a 4mm thickened wall as well).
- Liver and gallbladder never painful on palpation and on various diagnostic maneuvers and percussions, no pain is elicited. Generally the pain is in a well defined spot I can point to, but when it is pressed there is no “body” of pain.
- No nausea or vomiting. Stool is basically ok. Appetite normal, BMI high end of normal/borderline overweight.
- CBC all normal. ESR 2-3. Liver function (ALT, AST, GGT, ALP) all within ranges except indirect bilirubin (which has been raised for a number of years now and doc suspects it may be due to Gilbert’s syndrome).
- Celiac and h.pylori bloodwork negative. CRP low range of normal.
- Endoscopy revealed superficial gastroduodenitis, but doc said this was basically a norm.
- If the pain attack goes on for long I usually stretch my low back or jog and it is usually beneficial.
In the end the GE concluded there was nothing serious.
That said, pain after eating is not pleasant and I would like to understand where it’s coming from (ie is it gastroenterological in nature or vertebral/amplified anxiety), why its linked to meals, and what can be done.
Thanks!
I’d like a second opinion about chronic abdominal pain below right rib line:
- Pain onset usually about 20 minutes after a meal. May be triggered by acidic wine, or fat steak. But may come after any large meal. Sometimes pain triggered by itself, without meal.
- Pain radiates to lower back. Note I have structural back problems in the same location (arthritis, hypertonic back muscles etc) and these pains *always* flare up in parallel. I also think a part of that pain complex may be due to anxiety (there is a documented anxiety history).
- Ultrasound did not reveal stones or sludge in gallbladder. Choledoch was clear. There is a thickened gallbladder wall 4mm but it has been like that since 2015 (when previous ultrasound was carried out, it revealed a 4mm thickened wall as well).
- Liver and gallbladder never painful on palpation and on various diagnostic maneuvers and percussions, no pain is elicited. Generally the pain is in a well defined spot I can point to, but when it is pressed there is no “body” of pain.
- No nausea or vomiting. Stool is basically ok. Appetite normal, BMI high end of normal/borderline overweight.
- CBC all normal. ESR 2-3. Liver function (ALT, AST, GGT, ALP) all within ranges except indirect bilirubin (which has been raised for a number of years now and doc suspects it may be due to Gilbert’s syndrome).
- Celiac and h.pylori bloodwork negative. CRP low range of normal.
- Endoscopy revealed superficial gastroduodenitis, but doc said this was basically a norm.
- If the pain attack goes on for long I usually stretch my low back or jog and it is usually beneficial.
In the end the GE concluded there was nothing serious.
That said, pain after eating is not pleasant and I would like to understand where it’s coming from (ie is it gastroenterological in nature or vertebral/amplified anxiety), why its linked to meals, and what can be done.
Thanks!
Hi.
I’d like a second opinion about chronic abdominal pain below right rib line:
- Pain onset usually about 20 minutes after a meal. May be triggered by acidic wine, or fat steak. But may come after any large meal. Sometimes pain triggered by itself, without meal.
- Pain radiates to lower back. Note I have structural back problems in the same location (arthritis, hypertonic back muscles etc) and these pains *always* flare up in parallel. I also think a part of that pain complex may be due to anxiety (there is a documented anxiety history).
- Ultrasound did not reveal stones or sludge in gallbladder. Choledoch was clear. There is a thickened gallbladder wall 4mm but it has been like that since 2015 (when previous ultrasound was carried out, it revealed a 4mm thickened wall as well).
- Liver and gallbladder never painful on palpation and on various diagnostic maneuvers and percussions, no pain is elicited. Generally the pain is in a well defined spot I can point to, but when it is pressed there is no “body” of pain.
- No nausea or vomiting. Stool is basically ok. Appetite normal, BMI high end of normal/borderline overweight.
- CBC all normal. ESR 2-3. Liver function (ALT, AST, GGT, ALP) all within ranges except indirect bilirubin (which has been raised for a number of years now and doc suspects it may be due to Gilbert’s syndrome).
- Celiac and h.pylori bloodwork negative. CRP low range of normal.
- Endoscopy revealed superficial gastroduodenitis, but doc said this was basically a norm.
- If the pain attack goes on for long I usually stretch my low back or jog and it is usually beneficial.
In the end the GE concluded there was nothing serious.
That said, pain after eating is not pleasant and I would like to understand where it’s coming from (ie is it gastroenterological in nature or vertebral/amplified anxiety), why its linked to meals, and what can be done.
Thanks!
I’d like a second opinion about chronic abdominal pain below right rib line:
- Pain onset usually about 20 minutes after a meal. May be triggered by acidic wine, or fat steak. But may come after any large meal. Sometimes pain triggered by itself, without meal.
- Pain radiates to lower back. Note I have structural back problems in the same location (arthritis, hypertonic back muscles etc) and these pains *always* flare up in parallel. I also think a part of that pain complex may be due to anxiety (there is a documented anxiety history).
- Ultrasound did not reveal stones or sludge in gallbladder. Choledoch was clear. There is a thickened gallbladder wall 4mm but it has been like that since 2015 (when previous ultrasound was carried out, it revealed a 4mm thickened wall as well).
- Liver and gallbladder never painful on palpation and on various diagnostic maneuvers and percussions, no pain is elicited. Generally the pain is in a well defined spot I can point to, but when it is pressed there is no “body” of pain.
- No nausea or vomiting. Stool is basically ok. Appetite normal, BMI high end of normal/borderline overweight.
- CBC all normal. ESR 2-3. Liver function (ALT, AST, GGT, ALP) all within ranges except indirect bilirubin (which has been raised for a number of years now and doc suspects it may be due to Gilbert’s syndrome).
- Celiac and h.pylori bloodwork negative. CRP low range of normal.
- Endoscopy revealed superficial gastroduodenitis, but doc said this was basically a norm.
- If the pain attack goes on for long I usually stretch my low back or jog and it is usually beneficial.
In the end the GE concluded there was nothing serious.
That said, pain after eating is not pleasant and I would like to understand where it’s coming from (ie is it gastroenterological in nature or vertebral/amplified anxiety), why its linked to meals, and what can be done.
Thanks!
Brief Answer:
Definitely not related to the GI tract from the above!!
Detailed Answer:
Hi and thanks so much for this query.
I have reviewed this information fully. The GI tract has been thoroughly evaluated and there are no findings suggestive of an ongoing GI problem. This pain is certainly a concern and i take it very serious. Though has a temporal relationship with meals, this is rather deceptive.
I will put this as a functional pain. Symptomatic management would be my recommendation. Whatever makes you feel better is welcomed: Exercise, over the counter pain relievers, etc. Also, try to see if this is related to certain food types such that you may limit frequent intake.
I hope this helps and guides. I wish you well. Feel free to follow up with me if need be.
Definitely not related to the GI tract from the above!!
Detailed Answer:
Hi and thanks so much for this query.
I have reviewed this information fully. The GI tract has been thoroughly evaluated and there are no findings suggestive of an ongoing GI problem. This pain is certainly a concern and i take it very serious. Though has a temporal relationship with meals, this is rather deceptive.
I will put this as a functional pain. Symptomatic management would be my recommendation. Whatever makes you feel better is welcomed: Exercise, over the counter pain relievers, etc. Also, try to see if this is related to certain food types such that you may limit frequent intake.
I hope this helps and guides. I wish you well. Feel free to follow up with me if need be.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Definitely not related to the GI tract from the above!!
Detailed Answer:
Hi and thanks so much for this query.
I have reviewed this information fully. The GI tract has been thoroughly evaluated and there are no findings suggestive of an ongoing GI problem. This pain is certainly a concern and i take it very serious. Though has a temporal relationship with meals, this is rather deceptive.
I will put this as a functional pain. Symptomatic management would be my recommendation. Whatever makes you feel better is welcomed: Exercise, over the counter pain relievers, etc. Also, try to see if this is related to certain food types such that you may limit frequent intake.
I hope this helps and guides. I wish you well. Feel free to follow up with me if need be.
Definitely not related to the GI tract from the above!!
Detailed Answer:
Hi and thanks so much for this query.
I have reviewed this information fully. The GI tract has been thoroughly evaluated and there are no findings suggestive of an ongoing GI problem. This pain is certainly a concern and i take it very serious. Though has a temporal relationship with meals, this is rather deceptive.
I will put this as a functional pain. Symptomatic management would be my recommendation. Whatever makes you feel better is welcomed: Exercise, over the counter pain relievers, etc. Also, try to see if this is related to certain food types such that you may limit frequent intake.
I hope this helps and guides. I wish you well. Feel free to follow up with me if need be.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks Doc. I have a couple theories (but of course I am not a doctor).
1/ Abdominal wall and back muscle -constant tension in these areas due to spinal problems translates into gallbladder/intestinal spasm when food is traveling through GI tract.
2/ Parasites?
3/ Psychosomatically «learnt» spastic cycle.
The more I can get to the bottom of this the easier it is for me to handle this. Knowledge is power :) Would love to hear your views.
Thanks!
K
1/ Abdominal wall and back muscle -constant tension in these areas due to spinal problems translates into gallbladder/intestinal spasm when food is traveling through GI tract.
2/ Parasites?
3/ Psychosomatically «learnt» spastic cycle.
The more I can get to the bottom of this the easier it is for me to handle this. Knowledge is power :) Would love to hear your views.
Thanks!
K
Thanks Doc. I have a couple theories (but of course I am not a doctor).
1/ Abdominal wall and back muscle -constant tension in these areas due to spinal problems translates into gallbladder/intestinal spasm when food is traveling through GI tract.
2/ Parasites?
3/ Psychosomatically «learnt» spastic cycle.
The more I can get to the bottom of this the easier it is for me to handle this. Knowledge is power :) Would love to hear your views.
Thanks!
K
1/ Abdominal wall and back muscle -constant tension in these areas due to spinal problems translates into gallbladder/intestinal spasm when food is traveling through GI tract.
2/ Parasites?
3/ Psychosomatically «learnt» spastic cycle.
The more I can get to the bottom of this the easier it is for me to handle this. Knowledge is power :) Would love to hear your views.
Thanks!
K
Brief Answer:
Knowledge is truly power!!!
Detailed Answer:
Hi and thanks for following up.
1. These are two distinct organs. However, passage of food could serve as a trigger for muscle spasm in this area explaining symptoms . However, these symptoms have no underlying strictly GI issues to explain why.
2. Not parasites. Nothing really points to this.
3. Plausible but seems triggered by food making it less automated. Seems a conditioned sequence.
In truth, we do not fully understand everything that transpires in the body. However, we are able to adequately spot threats to life and address that. At this point, there is no threat to life from thee reported symptoms.
I wish you well and feel free to follow up with me. Hope you are getting more knowledge and feeling empowered by the day.
Knowledge is truly power!!!
Detailed Answer:
Hi and thanks for following up.
1. These are two distinct organs. However, passage of food could serve as a trigger for muscle spasm in this area explaining symptoms . However, these symptoms have no underlying strictly GI issues to explain why.
2. Not parasites. Nothing really points to this.
3. Plausible but seems triggered by food making it less automated. Seems a conditioned sequence.
In truth, we do not fully understand everything that transpires in the body. However, we are able to adequately spot threats to life and address that. At this point, there is no threat to life from thee reported symptoms.
I wish you well and feel free to follow up with me. Hope you are getting more knowledge and feeling empowered by the day.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Knowledge is truly power!!!
Detailed Answer:
Hi and thanks for following up.
1. These are two distinct organs. However, passage of food could serve as a trigger for muscle spasm in this area explaining symptoms . However, these symptoms have no underlying strictly GI issues to explain why.
2. Not parasites. Nothing really points to this.
3. Plausible but seems triggered by food making it less automated. Seems a conditioned sequence.
In truth, we do not fully understand everything that transpires in the body. However, we are able to adequately spot threats to life and address that. At this point, there is no threat to life from thee reported symptoms.
I wish you well and feel free to follow up with me. Hope you are getting more knowledge and feeling empowered by the day.
Knowledge is truly power!!!
Detailed Answer:
Hi and thanks for following up.
1. These are two distinct organs. However, passage of food could serve as a trigger for muscle spasm in this area explaining symptoms . However, these symptoms have no underlying strictly GI issues to explain why.
2. Not parasites. Nothing really points to this.
3. Plausible but seems triggered by food making it less automated. Seems a conditioned sequence.
In truth, we do not fully understand everything that transpires in the body. However, we are able to adequately spot threats to life and address that. At this point, there is no threat to life from thee reported symptoms.
I wish you well and feel free to follow up with me. Hope you are getting more knowledge and feeling empowered by the day.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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