[42M] Experiencing sharp, pulsating upper right abdominal pain

Patient Description

A 42-year-old male presents with a sharp, pulsating pain in the upper right abdomen that has been persistent for three days, rated at a severity of 6 out of 10. The pain does not alleviate with any measures and does not worsen after eating. The patient's bowel movements are slightly soft, with the last one occurring at 9 am on the day of reporting. There is no fever, jaundice, changes in appetite, weight loss, or darkening of urine. The patient also reports daily dandruff for the past two weeks and abdominal bloating. There is no known medical history of chronic illnesses or allergies, and the patient is currently taking Amitriptyline.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Postcholecystectomy Syndrome: This is a condition that can occur after gallbladder removal. It's characterized by persistent right upper abdominal pain, bloating, and other digestive problems. The cause is often related to changes in bile flow and digestion.

    • Treatment typically involves managing symptoms and may include medications to relieve pain or spasms, dietary changes, or in some cases, further surgery.
  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like upper abdominal pain and bloating.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Prescription medications or surgery might be necessary in severe cases.
  • Peptic Ulcer Disease: Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. Symptoms of peptic ulcer disease include upper abdominal pain and bloating.

    • Treatment typically involves medications to decrease stomach acid and protect the lining of your stomach and duodenum.
  • Gastritis: This is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic). Gastritis can cause upper abdominal pain and bloating.

    • Treatment typically involves medications to reduce stomach acid and inflammation.

As for the dandruff, it's a common condition that causes the skin on the scalp to flake. It isn't contagious or serious, but it can be embarrassing and sometimes difficult to treat.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may recommend further testing, such as blood tests, imaging studies, or an endoscopy to help determine the cause of your symptoms.
  2. In the meantime, you can try over-the-counter antacids for temporary relief of your abdominal pain. However, these should not be used long-term without the guidance of a healthcare provider.
  3. For the dandruff, try using a dandruff shampoo. There are several types available over-the-counter, and you may need to try a few to find one that works best for you.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe or worsening abdominal pain
  • Blood in your stool or black, tarry stools
  • Vomiting blood or material that looks like coffee grounds
  • Unexplained weight loss
  • Difficulty swallowing
  • Yellowing of your skin or the whites of your eyes (jaundice)

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of Postcholecystectomy Syndrome?

Common symptoms of Postcholecystectomy Syndrome include persistent right upper abdominal pain, bloating, diarrhea, and digestive problems. These symptoms are often related to changes in bile flow and digestion after gallbladder removal.


How can Gastroesophageal Reflux Disease (GERD) be managed at home?

GERD can be managed at home by making lifestyle changes such as avoiding foods and drinks that trigger reflux (like spicy foods, alcohol, and caffeine), eating smaller meals, not lying down immediately after eating, and elevating the head of the bed. Over-the-counter antacids or medications like H2 blockers and proton pump inhibitors can also help.


What are the typical signs of Peptic Ulcer Disease?

Typical signs of Peptic Ulcer Disease include burning stomach pain, bloating, heartburn, nausea, and in severe cases, vomiting blood or having black, tarry stools. The pain often occurs between meals or at night.


What are some effective treatments for dandruff?

Effective treatments for dandruff include using over-the-counter dandruff shampoos that contain ingredients like zinc pyrithione, selenium sulfide, ketoconazole, or salicylic acid. It's important to follow the instructions on the shampoo bottle and try different products to see which works best for you.


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