Question: Hello doctor,

I’m having issue with my abdominal pain and other pains for over a year now and I’d like to hear second opinion. My story is a bit long so I appreciate your patience to read it through.

I’m a 29 years old male and I started to have abdominal pain since last October, initially the pain was on the upper right abdominal region. I would describe the pain as mix between dull pain and sharp pain, from mild to moderate. The pain is mostly on my upper right abdominal region. Sometimes is on the left side of the 8th or 9th rib (soft side), or between ribs. Or sometimes it’s on the left side, occasionally on the back. The pain seems to have no pattern, not related with hungry or full of food, or fatty food. However changing posture may make me feeling better. If I lie on my right side sometimes I can feel the pain. Sometimes, when the pain happens, heavy breathing (breath in and hold the air) could make the pain worse. The pain usually goes away after 10 to 30 minutes, however could happen several times per day. Usually I don’t feel the pain in the morning, so it happens in the afternoon and evening. When I use my hand to touch my upper middle or right abdominal region, I feel tender and uncomfortable. Starting this XXXXXXX I started to feel back pain however the pain location is all over my back, from left side to right side below the shoulder blades, on the spine and sometimes close to the waist. Like I mentioned before, these days I can have pain on my upper left and middle abdomen too. The pain doesn’t impact my daily activity however it just keeps me thinking (and worrying) about it.

There is no change of appetite, no weight lost, urine and bowel movement are OK (about twice a day in the morning). Recently I had a fecal occult blood test and it was positive, so I’ll have a colonoscopy soon however my GP told me it’s highly unlikely this is related with my upper abdominal pain, and the positive was probably caused by a spilt on my anal.

I’ve been seeing my GP and specialist since last year and I’ve done a lot of tests, the blood / stool test results are attached. I also had gastroscopy which showed that I have gastritis, but no ulcer nor polyp. I had several ultrasounds over the last year, which showed that I have several gallbladder polyps which the largest is 6mm (in last year the largest was 5mm). The exact words are:

“The liver echogenicity is felt to be within normal limits. No focal hepatic masses or intrahepatic biliary dilation. Multiple gallbladder polyps are again demonstrated, largest 6mm, previously 5mm. No gallstones, gallbladder wall thickening, nor pericholecysic fluid. The common bile duct, spleen, kidneys and visualized pancreas, aorta, and IVC are unremarkable. There is a stable accessory splenule.”

My GP and specialist suggested that it’s possibly functional pain or muscle pain, I really hope this is the case however I’d like to hear second opinion. So here are my questions:

1.     What’s the most likely reason of my abdominal pain and back pain?
2.     Is it related with my gallbladder polyps? Since it grew 1mm over a year should I consider gallbladder removal?
3.     Do you think I might have some serious diseases?

Thank you very much for reading so much words, I appreciate it.

Thank you Dr. Kaltari, do you think this could be related with my pancreas?