I Have Had Intermittent Pains On And Off In RUQ

Posted on Wed, 12 Jun 2019

Question: I have had intermittent pains on and off in RUQ for two months pain 2-4 on 10 point scale.
Had Abdominal MRI and Ultrasound. I had had IBS for over 30 years.
Findings: Fatty liver although liver enyzmes normal. Right simple kidney cyst 10 x 8 x 8, Small cyst in liver and 6 mm hemangioma. In the last 6 weeks I have as a 6'1 inch male gone from 208 pounds to 198 by cutting out all alcohol, limiting bad fats, and more exercise. I believe IBS, Right large kidney cyst, or a hemangioma could cause RUQ pains or possibly an ulcer albeit before and endoscopy I went on Nexium for now 2 1/2 weeks. So an ulcer could cause it I believe and 8 years ago with a colonoscopy they noted some Divriticulitis; not sure possibly thats gotten worse and is causing the problem. Any thoughts of whats more likely scenario and next steps? Thanks

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

I have had intermittent pains on and off in RUQ for two months pain 2-4 on 10 point scale.
Had Abdominal MRI and Ultrasound. I had had IBS for over 30 years.
Findings: Fatty liver although liver enyzmes normal. Right simple kidney cyst 10 x 8 x 8, Small cyst in liver and 6 mm hemangioma. In the last 6 weeks I have as a 6'1 inch male gone from 208 pounds to 198 by cutting out all alcohol, limiting bad fats, and more exercise. I believe IBS, Right large kidney cyst, or a hemangioma could cause RUQ pains or possibly an ulcer albeit before and endoscopy I went on Nexium for now 2 1/2 weeks. So an ulcer could cause it I believe and 8 years ago with a colonoscopy they noted some Divriticulitis; not sure possibly thats gotten worse and is causing the problem. Any thoughts of whats more likely scenario and next steps? Thanks

Follow up: Dr. Dr.P.Ratnakar Kini (37 minutes later)

Clarifying I have not had an endoscopy as we decided to to start on Nexium. And, while I think I have had similar RUQ pains before from IBS I don't remember it for as long even though intermittent. I have had significant more stress than normal too.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Answered by Dr. Dr.P.Ratnakar Kini (6 hours later)

Brief Answer:
Peptic Ulcer Disease

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
Right upper quadrant pain is not typical of IBS.
Most often right upper quadrant pain is due to gallbladder disease, peptic ulcer disease and pancreatitis.
The scans did not show anything abnormal with regards to gallbladder and pancreas. So peptic ulcer disease is the likely cause. So you start taking Nexium as decided
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr.P.Ratnakar Kini (11 hours later)

Ok I will get endoscopy too. I have no symptoms besides the intermittent RUQ pain and occasional heartburn. No loss of appetite no weight loss no nausea. No family members with stomach cancers.

Is stomach cancer a low percentage likelihood?

Thanks

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Follow up: Dr. Dr.P.Ratnakar Kini (1 minute later)

Forgot to mention it’s usually better on waking and gets worse over course of the day.

Thanks

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Forgot to mention it’s usually better on waking and gets worse over course of the day.

Thanks

Follow up: Dr. Dr.P.Ratnakar Kini (29 minutes later)

Sorry, worried. Would the MRI of abdomen or ultrasound seen stomach cancer?

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Sorry, worried. Would the MRI of abdomen or ultrasound seen stomach cancer?

Follow up: Dr. Dr.P.Ratnakar Kini (33 minutes later)

I apologize for adding but MRI report on abdomen says stomach unremarkable.

Sorry thanks

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

I apologize for adding but MRI report on abdomen says stomach unremarkable.

Sorry thanks

Answered by Dr. Dr.P.Ratnakar Kini (33 hours later)

Brief Answer:
Stomach cancer unlikely

Detailed Answer:
Hi,
Thanks for getting back to me with more questions.
Based on the information you have given, stomach cancer is unlikely.

Yes, MRI of the abdomen would have shown it if stomach cancer was present.
Let me know if you have any more questions.
Regards,
Dr.R.K.

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