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What Causes Upper Right Quadrant Pain?

Posted on Mon, 15 Dec 2014

Question: Hello I have been experiencing upper right quadrant pain that comes and goes for approx 1 1/2 years. The pain is not brought on by eating. Negative ultrasound and hepatic panel done in 7/2013. Negative abdominal catscan done in 2/2014. The pain has recently returned but this time is accompanied with full body itching that comes and goes and is worse at night. I also have nausea that comes and goes for the past week. My doctor just re-ran both cbc w. Differential and hectic panel. All came back normal. She is at a loss and now is suspecting duodenitis and has me on omeperzole and doing gluten free for the itching. Is there anything else She should be checking? I read online that itching can be caused by increased bile acid levels which are not part of the hepatic panel. Should I ask for another abdominal ultrasound even though the previous studies have been negative?

Answered by Dr. Dr Samir Patil (2 hours later)

Brief Answer:
could be duodenitis

Detailed Answer:
Hello,
I have gone through your description and labs and I believe the pain could be due to duodenitis. If the symptoms persist in omeprazole, I would suggest an upper GI endoscopy.

In such cases in also treat my patients for deworming and giardiasis

I would also suggest an alkaline phosphatase, if it was not a part of liver function test. If the alkaline Phosphatase is high, an Anti Mitochondrial Antibody blood test would be required.

An absolute eosinophil count would help in finding the cause of itching.

A repeat ultrasound is not required.

Hope this helps
Regards

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Above answer was peer-reviewed by : Dr. Shanthi.E