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What Causes Upper Right Subcostal Pain?
Question: Please excuse my spelling.
I have a hiatal hernia, GERD, on-off diarrhea and increased gass (burping and trapped). My upper left side just below my bottom rib closer to the center than to the breast nipple is tender and sore. I am 55 and female (hysterectomy when I was 25) I do not have insurance.... I can't afford insurnace because I work part-time and make just enough to not get help and cannot afford the 500+ per month needed for a 6500.00 deductible... My point is, I know I have issues but want to run my plan past you. I thought I would treat it as if it is an ulcer, bland foods in small amounts to see if I can get it to settle down. I've tried to figure out online what it might be; the various results include the obvious, ulcer, GERD, (which as I said I have) to pancreatitus, diverticulitis, and gall bladder attack. Does my approach seem logical? Thank-you, XXXX
I forgot to include:
5'6"
170 lbs
High blood pressure, (take meds)
citrolapam
thyroid (leproxam sp)
I eat healthy and often have a glass of wine with supper.
My plan is to discontinue alcohol, eat small meals, small bites and move more. (We live on a farm.... so moving isn't an issue)
I am very gassy and bloated (frequent burping).
I have a hiatal hernia, GERD, on-off diarrhea and increased gass (burping and trapped). My upper left side just below my bottom rib closer to the center than to the breast nipple is tender and sore. I am 55 and female (hysterectomy when I was 25) I do not have insurance.... I can't afford insurnace because I work part-time and make just enough to not get help and cannot afford the 500+ per month needed for a 6500.00 deductible... My point is, I know I have issues but want to run my plan past you. I thought I would treat it as if it is an ulcer, bland foods in small amounts to see if I can get it to settle down. I've tried to figure out online what it might be; the various results include the obvious, ulcer, GERD, (which as I said I have) to pancreatitus, diverticulitis, and gall bladder attack. Does my approach seem logical? Thank-you, XXXX
I forgot to include:
5'6"
170 lbs
High blood pressure, (take meds)
citrolapam
thyroid (leproxam sp)
I eat healthy and often have a glass of wine with supper.
My plan is to discontinue alcohol, eat small meals, small bites and move more. (We live on a farm.... so moving isn't an issue)
I am very gassy and bloated (frequent burping).
Brief Answer:
Some more investigations might be needed if not relieved.
Detailed Answer:
Hi! Good morning. I am Dr Shareef answering your query.
Your plan to discontinue alcohol, eat small frequent meals and regular walking is superb. This would diminish half of your problems.
You are right, this upper right subcostal pain has multiple clinical diagnosis. I may not be able to predict one without clinical diagnosis. With the background of previous hiatus hernia and GERD, if I had to take a guess, then it would be GERD. Obviously, you will need a general physical examination to confirm the diagnosis.
I understand your limitation to see a doctor. Therefore I suggest the following approach at home:
1) Elevate the head end of the bed with two blocks on each side, so that the regurgitation does not occur while lying down, and the contents of esophagus and stomach flow down with gravity. This might also help you in your hiatal hernia problem.
2) Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food, and strict avoidance of alcoholic beverages and smoking if you do.
3) Regular routine exercises like morning walk depending on your medical fitness.
4) You could go for some acid reducing gel or chewable tablets along with an anti spasmodic and an anti diarrheal if need be which are available over the counter and a proton pump inhibitor like omeprazole (prilosec) if available over the counter in your location for symptomatic relief and to have a control on the acid production and facilitate movement of gastric contents downwards.
I hope with these medications and an active life style, you would have relief for the present. However, in case of the symptoms aggravating or persisting, I am afraid you might need the following :
1) Routine stool test for ova and cyst and treat them if positive.
2) Get your thyroid status tested to see if you are euthyroid
3) Regular follow up of your blood pressure to keep it under control.
4) Get your routine blood tests like cbc, blood sugar, kidney function test, serum lipid profile, serum amylase and lipase, liver function test and treat any abnormality in the reports.
5) Keep the options open for an ultrasound of abdomen and a possible endoscopic assessment by a gastro enterologist.
I hope this information would help you in relieving you symptomatically and if needed in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef
Some more investigations might be needed if not relieved.
Detailed Answer:
Hi! Good morning. I am Dr Shareef answering your query.
Your plan to discontinue alcohol, eat small frequent meals and regular walking is superb. This would diminish half of your problems.
You are right, this upper right subcostal pain has multiple clinical diagnosis. I may not be able to predict one without clinical diagnosis. With the background of previous hiatus hernia and GERD, if I had to take a guess, then it would be GERD. Obviously, you will need a general physical examination to confirm the diagnosis.
I understand your limitation to see a doctor. Therefore I suggest the following approach at home:
1) Elevate the head end of the bed with two blocks on each side, so that the regurgitation does not occur while lying down, and the contents of esophagus and stomach flow down with gravity. This might also help you in your hiatal hernia problem.
2) Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food, and strict avoidance of alcoholic beverages and smoking if you do.
3) Regular routine exercises like morning walk depending on your medical fitness.
4) You could go for some acid reducing gel or chewable tablets along with an anti spasmodic and an anti diarrheal if need be which are available over the counter and a proton pump inhibitor like omeprazole (prilosec) if available over the counter in your location for symptomatic relief and to have a control on the acid production and facilitate movement of gastric contents downwards.
I hope with these medications and an active life style, you would have relief for the present. However, in case of the symptoms aggravating or persisting, I am afraid you might need the following :
1) Routine stool test for ova and cyst and treat them if positive.
2) Get your thyroid status tested to see if you are euthyroid
3) Regular follow up of your blood pressure to keep it under control.
4) Get your routine blood tests like cbc, blood sugar, kidney function test, serum lipid profile, serum amylase and lipase, liver function test and treat any abnormality in the reports.
5) Keep the options open for an ultrasound of abdomen and a possible endoscopic assessment by a gastro enterologist.
I hope this information would help you in relieving you symptomatically and if needed in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef
Above answer was peer-reviewed by :
Dr. Prasad
Thank-you, I feel better knowing my plan is a good one. The good news is that I am feeling better with the exception of bloating. This too shall pass, I'm certain. For the record, I eat very little fast food and my main meal at noon is a salad (spinach leaves only) with fruit, veggies and a small amount of protein and my beloved Gorgonzola cheese crumbles. If I do not eat this.... I do not feel well!
Thank-you for the quick response.
XXXXX
Thank-you for the quick response.
XXXXX
Brief Answer:
Good to know about improvement in your health.
Detailed Answer:
Hi XXXXXXX ! Good evening.
Good to know that you are feeling better. Bloating would also pass off gradually with this regimen. But be sure not to revert back to alcohol for a good health.
Wishing you all the best.
Dr Shareef.
Good to know about improvement in your health.
Detailed Answer:
Hi XXXXXXX ! Good evening.
Good to know that you are feeling better. Bloating would also pass off gradually with this regimen. But be sure not to revert back to alcohol for a good health.
Wishing you all the best.
Dr Shareef.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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