Brief Answer:
Right Hypochondriac Pain with Right Scapular pain Under Investigation

Detailed Answer:
Hi,Dear,Thanks for the query to HCM virtual Clinic.
I studied your query with all the details given by you.
It seems you have stomach problems since last 1 yr.

More information is needed to explain your query-
I would need more information to help you out on Right abdominal pain with scapular pain-
How long the right side of your stomach discomfort exists?
Is it related with your diet?
Any gurgling noise with the cramps and moving feels you have?
How is your stool frequency? do you pass mucus with cramps in right abdomen during passing your stools?Any attacks of diarrhea or dysentery in the past?
How frequently you eat food outside?Frequency of fried / oily diet, smoking, alcohol,?
What's are your food habits?Veg / non-veg,spicy/non-spicy?
Details about your life style and job schedule every day?
Any medical history in past about abdominal or chest illnesses in the past?
Update any more information along with any doctor's visit documents for my study and opinion.

Remedy-
I would advise you about the suggestions for dealing with your problem,as I don't have much information from your query.
So explain more as asked above and give more information if any with you.
Hope to meet on next session,when I hope to suggest more about your Right Hypochondriac pain? and about Rt scapular cramps and pains since last 1 yr.
Welcome for any further query in this regard to ME.
Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS, XXXXXXX Surgical Specialist.

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Brief Answer:
?Chronic Giardial Duodenitis with Hepatitis with Renal Stones

Detailed Answer:
Provisional Diagnosis-
-Chronic intestinal Giardiasis with Giardial duodenitis and upper(ileitis)Enteritis
-with Chronic Giardial Hepatitis / peri-Hepatitis and Cholangitis
-with the Renal stones
...................
Hi,Dear thanks for your exhaustive reply with your latest updates on test reports.

I studied your reply meticulously in reference to your query and to your lab and past report updates.

I understood your health concerns as explained above in provisional diagnosis.
Your health issues are all related to your travelling and on site eating lifestyle,which has caused ?Hepatic Giardiasis with Hepatitis,as your SGPT has raised than normal(indicating Liver damage)

I would explain the perplexing case of your right stomach crampy pain with all its details as follows- and Related to your Symptoms-
-Rt Side stomach cramps (due to Chronic intestinal Giardiasis(which is Aysmptomatic as its without diarrhoea,which is the most common symptom of Giardiasis)
-Something Moving down feeling-is mostly Due to duodenitis and upper(ileitis)Enteritis associated with Giardiasis.
-and Shoulder blade cramps and pains for 1 yr-is mostly due to Chronic Hepatic Giardiasis with peri-Hepatitis and Cholangitis and could be due to the Renal stones in your case.
chronicity of 1 year could be explained by Chronic Giardiasis

I would advise-
- USG scan study for Liver and Gall Bladder,
-With USG guided Liver Biopsy of ?Hepatic Granulomas if any,which would detect the cholangitis and hepatitis-if any,due to Giardiasis.
Cysts of Giardia with Occult blood in stool, confirms ?duodenitis with Giardial ulcers and duodenal granulomas.
-Immune Tests to Study of AL3T4 antigen levels and treatment with its antibody would resolve the Hepatic Granuloma issues by fixing its diagnostic confirmations.
-Oesophago-Gastro-Duodenoscopy(OGD scopy) for diagnosing Giardial Duodenitis with Giardial ulcerations would confirm clinical presumptive diagnosis as above.

Remedy-
It is extensive subject and would be dealt if I get direct question from you.
I would advise to consult gastroenterlogist if need be.

Hope this elaborate and specific and comprehensive reply would totally satisfy you for your confusing and perplexing symptoms.

You would need very extensive plan of treatment which is a subject of another query sometimes from you by a direct question to ME at HCM,if you need it.

Welcome for any further query in this regard to ME.I would love to help you out till your satisfaction of this query.

If YOU like this reply,Write excellent reviews and hit thanks,which would improve my rating for other needy visitors to HCM.

Wishing you fast recovery and healthy life in time to come.

Have a good day.

Awaiting for any further query in this regard to ME.

Dr.Savaskar M.N.
M.S.Genl-CVTS, XXXXXXX Surgical Specialist.

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Brief Answer:
?Chronic Giardial Duodenitis with Hepatitis with Renal Stones

Detailed Answer:
Hi,Dear,Thanks for the update query.

I understood your concerns and worries you have regarding this health problem.

I would answer your update query as follows-
-Don't Worry at all.
Although complex, this health problem could be resolved by special treatment,but will need more time as its chronic.These explanations would help you to plan needful treatment in time to come.
The above diagnosis needs to be worked up and needs to be treated as soon as possible to avoid any further complication.
This is just a preventive advise and NOT TO BE WORRIED.

-Whether curable or not?
This is a curable illness but would need meticulous follow up at your end,as You have multiple of health problems.
Get back to me on my mail YYYY@YYYY and I would get everything done online for you and would see that You are out of this trouble,to take care of your family without any tensions or worries anymore.

I hope this would satisfy you and help you to start necessary steps to control your health problem.

Hope this would resolve the complex health problem of your stomach pains and cramps.
AS I have resolved the hidden,root cause of the stomach cramps and pains with shoulder blade pains,You should write excellent review with strong comments,which would improve My rating and would help other needy visitors at HCM to solve their complex health problems.

Welcome for any more query in this regard,before You start on for further treatment by direct query to ME at HCM.

Wishing you fast recovery.

Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS, XXXXXXX Surgical Specialist in Non-Curable and Chronic Diseases.

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