Hey Doctor, I’ve Had This Problem For A Couple Of

Posted on Wed, 7 Nov 2018

Question: Hey doctor,

I’ve had this problem for a couple of years now and have had a lot tests the last year regarding my stomach mainly to do with pains and heartburn. I underwent a gastrosocpy/colonoscopy plus an abdominal ultrasound and blood tests which came up with nothing. But basically I get this nausea, full feeling in my stomach after eating a big meal and this aching pain under my right shoulder blade that extends down. It stays there for an hour or so and then disappears. What exactly could these unusual symptom be my doctors strugged it off as nothing once all my other tests where clear. I’m just a little concerned now because my friend had a similar pain in his left shoulder but only after drinking alcohol and he just got diagnosed with lymphoma could that be related I also had a chest x-ray which showed nothing either.

Follow up: Dr. Anders Mark Christensen (4 minutes later)

I don’t have any of the typical lymphoma symptoms like coughing, swollen lymph nodes, night sweats etc and I’m not sure if there’s any other tests that I haven’t done that would check for that?

Follow up: Dr. Anders Mark Christensen (1 minute later)

The pain I get under my right shoulder is almost like stabbing ache type of pain that feels like a pulled a muscle or something but only occurs when I eat too much like I said.

Follow up: Dr. Anders Mark Christensen (0 minute later)

To add to that PPI, antacids, h2 blockers don’t work at all they do nothing so I don’t think it’s gastritis or reflux.

Answered by Dr. Anders Mark Christensen (1 hour later)

Brief Answer:
It could be malabsorption

Detailed Answer:
Hi XXXXXXX

Thank you for the elaborate history. What you describe, and in the absence of positive findings on endoscopy, ultrasound and blood tests, I suspect you may suffer from some sort of malabsorption. Considering your age, celiac disease, lactose intolerance, or Crohn's disease should be considered. To ascertain this, it is necessary with bowel biopsies. Have these been taking during your endoscopies?

Best wishes.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Anders Mark Christensen (14 minutes later)

Hey Mark I have done biopsy’s of my stomach and bowels which came out perfectly normal. With the pain on the right side under my shoulder after eating a big meal I read that pain in that area in general is a symptom of lymphoma could that be a possibility or not so much with my symptoms? Could it also be my gallbladder possibly as well my mum has had gallbladder problem but she is 55 years old I’ve had an ultrasound and no gallstones but could it still be dysfunctional?

Follow up: Dr. Anders Mark Christensen (2 minutes later)

I’m going on holiday overseas for a couple of weeks do you think any further testing based on my symptoms could wait and is there anything else I can do to control it? I’ve found any type of acid suppressant actually makes my symptoms much worse especially the nausea and it doesn’t help for the pain under my shoulder at all.

Follow up: Dr. Anders Mark Christensen (2 minutes later)

For example I had quite a big meal for dinner tonight consisting of beef cutler, carrot, broccoli, rice and mushroom and I found after eating the beef which is the first thing I ate the pain under my right shoulder started to come on along with bad nausea and stomach pain.

Answered by Dr. Anders Mark Christensen (6 minutes later)

Brief Answer:
You can easily go on holiday

Detailed Answer:
Hi, again XXXXXXX

You can easily go on holiday. Is it certain food items that provoke your symptoms?

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Anders Mark Christensen (12 minutes later)

Sometimes onions or cucumber will create this really badly along with just eating a large meal in general i'll also get burping as well but the moment im currently having an episode and the pain in the right side of the back is definitely the worse symptom it kind of feels like a shooting stabbing pain almost.

Follow up: Dr. Anders Mark Christensen (1 minute later)

If for example it were my gallbladder and it was dysfunctional/inflamed would it be able to wait until I get back or is it something I should get checked again?

Follow up: Dr. Anders Mark Christensen (2 minutes later)

I was reading up about these articles as well, but i've had a chest x-ray a couple of months ago so it would shown a mass in that area if I had lymphoma for example right?

https://journals.lww.com/ajpmr/Fulltext/2010/11000/Upper_Back_Pain__An_Unusual_Presentation_of.1.aspx

https://www.healthline.com/health/lymphoma/symptoms#pain

Answered by Dr. Anders Mark Christensen (5 hours later)

Brief Answer:
It sounds benign

Detailed Answer:
Hi again XXXXXXX

If it is your gall bladder, it can easily wait. Inflammation of the gall bladder (cholecystitis) usually is associated with more or less constant pain and raised inflammatory markers (leukocytes, c-reactive protein) and slightly elevated liver enzymes. Also, you would be distinctly soar under the right rib cage.

A lymphoma seems highly unlikely, given the absence of symptoms. If it was to be completely ruled out, I suppose you would need a PET-CT scan. Depending on your country's health care system, this may need a physician-approved indication, alternatively, you may have private health care that would cover it.

Please let me know how it goes. Best wishes.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Anders Mark Christensen (2 days later)

Hey Mark thanks for following up, im in the process of travelling overseas at the moment and I just had a burger and nuggets before and I started to notice the pain in the upper right side of my back just below my shoulder blade. Is there anything I can do to aliverate it if it is my gallbladder?

Answered by Dr. Anders Mark Christensen (10 hours later)

Brief Answer:
NSAIDs are usually good

Detailed Answer:
Hi XXXXXXX

Sorry for the late reply. Symptomatic gallstone disease can often be treated using NSAIDs (e.g. diclofenac). If you have heart problems or dyspepsia, including previous peptic ulcer, you should be especially cautious with diclofenac. Otherwise, they often provide excellent relief.

Hope this helps.

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

Follow up: Dr. Anders Mark Christensen (1 hour later)

Thanks for that doctor just one last thing on this flight I’ve been struggling to pass a stool as I get quite nervous pooing in plane toilets. I’ve got about another 5 hours on the flight would taking some Valium help? I’ve got some tablets my doctor prescribed me but I’m just a little scared to use it as I’ve never had them before he said to take 1-2 but how long would they last if I took them would they still have an effect when I land in 5 hours or would they wear off how long are they in your system?
If I were to not be able to go before I land would it be bad staying in my bowels? I’ve been letting out a lot of gas and my ass feels sore as well but I’d say that’s probably from sitting down on the plane for so long.

Answered by Dr. Anders Mark Christensen (7 minutes later)

Brief Answer:
Imodium would be alot better

Detailed Answer:
Hi again XXXXXXX

Valium seems a bit strong. If you want to avoid emptying your bowels on the plane, imodium (over-the-counter) should do the trick, and it barely has any side effects.

I would not recommend valium.

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