Having Upper Abdominal Pain In Gall Bladder Region. Done With The Tests. Suggest The Treatment?

Posted on Wed, 18 Sep 2013

Question: Have had mostly upper right abdominal pain for 5 months. Pain occasionally moves to left or back but primarily in gall bladder/liver region.. All labs have been normal until recently found lipase to be at 105. Some labs call this "normal" my PCP is ready to call it pancreatitis due to the fact that ultrasound, and CT scan showed nothing. Any thoughts.
Very confused and scared

Answered by Dr. Nitin Rao (27 minutes later)

Brief Answer:
Take care

Detailed Answer:
Hi

Thanks for posting your query on XXXXXXX

I looked at the attached reports.
Endoscopy shows mild gastritis so first of all do take treatment for it including some diet changes that your PCP would advice.
The lipase level of 105 is not high however it depends on the reference range of the lab where it was done to know what is normal for them. CT abdomen and US being normal I gather does not appear to have any anatomical problem.
Does US by any chance show gallstones or sludge? Microcalcifications in the biliary system is another thing to look at and talk to your PCP if he/she would like to do a MRCP to look at the bile duct and pancreatic duct as well.

Till then I will advise you the following lifestyle changes:
- Take nutritious,high fiber diet. Take more of fruits and vegetables, atleast 5 times a day
- Hygienic food and pure drinking water
- Take low calorie diet. Avoid high calorie foods like milk products (butter, ghee, cheese, icecream, etc). Can take milk.
- Take regular and small meals.
-Try doing some exercise. It will help with better blood circulation.

Take care and do not be worried. Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Nitin Rao (1 hour later)

Had a HIDA scan done last week and also appears normal. My PCP has indicated that normal Lipase for his lab is 60 or less and appears to be concerned about pancreas. Is there another test to ensure that it is not pancreas? Another main symptom I have been having is regular night sweats which I have attributed to the Benadryl I am taking to help me sleep. Is this possible?
Also like to add that although HIDA scan was normal the 2nd ultrasound showed sluggish gall bladder. Could this be what is causing all of my problems?

Answered by Dr. Nitin Rao (10 hours later)

Brief Answer:
Amylase test

Detailed Answer:

1. In this case, I suggest to look at the Amylase level as well and if it is significantly high then I would think of pancreatitis as a possibility.

2. Benadryl is relatively well tolerated. Night sweats is unlikely to be related to benadryl.

3. Well a slowly emptying gallbladder (sluggish) is also likely going to give the symptoms mentioned by yourself. Take a diet low in fats (lipids) and see how it helps you.

Take care.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Prasad