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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Upper Abdominal Pain, Nausea, Vomiting. Normal Chest X Ray, Ultrasound, Low Blood Count. Any Ideas?

My wife has had upper right abdominal pain for the last few months. She had pneumonia last year and there is still some crackling when she's breathing. Her blood count is very low (11) and course of tablets have not improved her condition. Nobody can tell us what the problems are. She has had numerous blood tests, Chest X-rays and today had an ultrasound. All clear. Doctor does believe liver is inflamed. Pain is always there but severity of pain fluctuates. She has had some nausea, vomiting and generally a feeling of not being right
Sat, 27 Apr 2013
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General & Family Physician,  's  Response
Thank you for your query.

Liver inflammation does not create pain for a long time.
It usually occurs for a short period.
Along with this, other features of inflammation like jaundice & abnormal blood biochemistry present.
So it is unlikely having liver inflammation.

Peptic ulcer disease, non ulcer dyspepsia & irritable bowel syndrome are other possibilities of long term abdominal pain.

Pneumonia may cause bronchiectasis as a complication.
As a result some crackling may be produced.

I think that her blood count is not so low.
It is mildly reduced from normal level.
Iron deficiency anemia should be excluded as it is most common.
The common causes are excessive menstrual bleeding,helminthiasis,increasing demand etc.

Consult your doctor about these.
Take care.
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General Surgeon,  Dr. M Y Shareef's  Response
Hi ! The feeling of being not ok signifies that some infection is still persisting in your wife's body, possibly the lungs. As such the description of your history suggests that the chest infection has not resolved completely. The cause of such a long lasting infection could be a chronic infection like tuberculosis which may also lower the hemoglobin in the blood. Many times tuberculosis is not diagnosed even after all investigations. The abdominal symptoms could also be due the same infection leading a sub acute intestinal obstruction which gets relieved of its own ( extra pulmonary involvement ). So I would suggest you to see a medical specialist at the earliest and get your wife re-investigated for her problem. Good luck.
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Upper Abdominal Pain, Nausea, Vomiting. Normal Chest X Ray, Ultrasound, Low Blood Count. Any Ideas?

Thank you for your query. Liver inflammation does not create pain for a long time. It usually occurs for a short period. Along with this, other features of inflammation like jaundice & abnormal blood biochemistry present. So it is unlikely having liver inflammation. Peptic ulcer disease, non ulcer dyspepsia & irritable bowel syndrome are other possibilities of long term abdominal pain. Pneumonia may cause bronchiectasis as a complication. As a result some crackling may be produced. I think that her blood count is not so low. It is mildly reduced from normal level. Iron deficiency anemia should be excluded as it is most common. The common causes are excessive menstrual bleeding,helminthiasis,increasing demand etc. Consult your doctor about these. Take care.