Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Remedy For Cramps And Tenderness When Diagnosed With Gall Stones
Question: Hello. I have history of gallstones. Last few days, have cramps and tenderness in that area, but not feeling sick at all. Srill have appetite, no nausea or fever. How can i distingusih between muscle pain and inflamed gallbladder? O4 just intestinal cramps? Area is tender when I puff sromach out. Is that abdiminal wall/muscle? Dont want to go to ER amd wait hours for ultrasound unless absolutely necessary. Not in much pain, just some mild discomfort. Not sure how to Murphy's sign exactly? Doctor once gold me i would be wimving in tre'mendous pain if touched there and gallbladde inflamed. Is not the case with me. Just feels like a tender knot. PLease advise
Brief Answer:
it's difficult to do the assessment yourself
Detailed Answer:
Hello,
I'll try to present the clinical clues to the diagnosis of this disease but it's difficult to do the assessment yourself.
First of all there are two kinds of gallbladder insult: bile colic and cholecystitis. The colic usually lasts for minutes (less than 1 hour) and usually follows a fatty meal. Cholecystitis is a more severe disease with inflammation of the gallbladder and persistent pain for hours or days, nausea and perhaps vomiting.
The XXXXXXX sign is feeling severe pain when taking a deep breath with your fingers pushing the abdomen right below the rib cage (on the right of course). Gallbladder pain can be referred to the back (just below the scapula). There are other indirect signs which are very helpful for the doctor to determine whether a serious abdominal inflammation is possible or not, like the bowel sounds, signs of peritonitis, etc
The matter is that detecting the signs requires experience and knowledge of potential factors which may interfere with them. The ultimate tests are the radiological ones (the ultrasound scan is one of them). A general rule is that persistent abdominal pain needs a surgical evaluation unless the diagnosis is already established.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
it's difficult to do the assessment yourself
Detailed Answer:
Hello,
I'll try to present the clinical clues to the diagnosis of this disease but it's difficult to do the assessment yourself.
First of all there are two kinds of gallbladder insult: bile colic and cholecystitis. The colic usually lasts for minutes (less than 1 hour) and usually follows a fatty meal. Cholecystitis is a more severe disease with inflammation of the gallbladder and persistent pain for hours or days, nausea and perhaps vomiting.
The XXXXXXX sign is feeling severe pain when taking a deep breath with your fingers pushing the abdomen right below the rib cage (on the right of course). Gallbladder pain can be referred to the back (just below the scapula). There are other indirect signs which are very helpful for the doctor to determine whether a serious abdominal inflammation is possible or not, like the bowel sounds, signs of peritonitis, etc
The matter is that detecting the signs requires experience and knowledge of potential factors which may interfere with them. The ultimate tests are the radiological ones (the ultrasound scan is one of them). A general rule is that persistent abdominal pain needs a surgical evaluation unless the diagnosis is already established.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I don't have severe pain when pressing under rib age. Just tenderness in that general area, not really under rib cage, but rather when stomach is puffed out.
What do you mean by bowel sounds? I odd hear some rumbling from around there from time to time.
I have had attacks before that were much worse pain. This is very mild but ongoing. Though not feeling sick at all, not,al bowel movements, stool looks notmal, eating normally sleeping normally, not feeling ill at all.
Anyways, will probably visit a doctor this week to check it out. Does not seem acute ot emergency situation to me. But will. Keep monitoring. I assume if cholecystitis will get worse and it will become obvious to me?
What do you mean by bowel sounds? I odd hear some rumbling from around there from time to time.
I have had attacks before that were much worse pain. This is very mild but ongoing. Though not feeling sick at all, not,al bowel movements, stool looks notmal, eating normally sleeping normally, not feeling ill at all.
Anyways, will probably visit a doctor this week to check it out. Does not seem acute ot emergency situation to me. But will. Keep monitoring. I assume if cholecystitis will get worse and it will become obvious to me?
Brief Answer:
you'd better go to the ER
Detailed Answer:
bowel sounds can be heard with a stethoscope and needs some experience to distinguish normal from abnormal ones, although silence is expected in intra-abdominal inflammation. The gallbladder may cause referred pain to the upper part of the abdomen ('the stomach'). These two organs may confuse the patient (and the clinician sometimes).
The fact that you had pain attacks in the past makes it very possible that the gallbladder caused them. The problem is not the bile colic. It's the danger it's putting the pancreas into. Gallbladder content (stones) may obstruct the ducts and cause pancreatitis which is a very severe life threatening disease.
So getting to the ER at least makes sure that an obstruction would be promptly treated and you'll have a much better chance to avoid serious complications.
Cholecystitis will make the pain last for hours or days, instead of minutes (up to an hour). Depending on its course the symptoms may get much worse and even cause peritonitis which is something you wouldn't miss! In that case though, the prognosis is much worse than in an uncomplicated case, which is another reason for you to visit the ER promptly.
I think you should have a more clear view of your situation right now. Contact me again, if you still have questions about it. I'll be glad to help!
Kind Regards!
you'd better go to the ER
Detailed Answer:
bowel sounds can be heard with a stethoscope and needs some experience to distinguish normal from abnormal ones, although silence is expected in intra-abdominal inflammation. The gallbladder may cause referred pain to the upper part of the abdomen ('the stomach'). These two organs may confuse the patient (and the clinician sometimes).
The fact that you had pain attacks in the past makes it very possible that the gallbladder caused them. The problem is not the bile colic. It's the danger it's putting the pancreas into. Gallbladder content (stones) may obstruct the ducts and cause pancreatitis which is a very severe life threatening disease.
So getting to the ER at least makes sure that an obstruction would be promptly treated and you'll have a much better chance to avoid serious complications.
Cholecystitis will make the pain last for hours or days, instead of minutes (up to an hour). Depending on its course the symptoms may get much worse and even cause peritonitis which is something you wouldn't miss! In that case though, the prognosis is much worse than in an uncomplicated case, which is another reason for you to visit the ER promptly.
I think you should have a more clear view of your situation right now. Contact me again, if you still have questions about it. I'll be glad to help!
Kind Regards!
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
