I joined this community about a month ago and, rather than simply reading different threads, have finally mustered the courage to post a question. Of all the threads I've read so far, there are many people who appear to have similar stories – although, I've never been able to find out how their stories end. To be clear, I'm not looking for a diagnosis but just some insight from other people's experiences – specifically, people who have the same symptoms.
My apologies in advance for the lengthy post but I want to share as much detail as possible...
Beginning with a little about me – I'm a 32 year old male, healthy weight (142 lbs. at 5' 7"), vegetarian, no recreational drug use (aside from alcohol), no long-term over the counter medication use, and no preexisting conditions. However, like some folks on this forum, I do have a history of drinking. I started drinking when I was 21 but didn't really begin abusing alcohol until my late twenties. And by abuse, I mean about 3 to 4 drinks a night for a few years and occasionally binging on the weekends. But after my daughter was born in 2017, I wanted to make a change and cut back to the recommended levels (no more than two drinks a night or 14 drinks per week). But, needless to say, there were good days and bad days.
Fast forward to late June 2019, I started experiencing some unexplained pain in my upper right quadrant – nothing major, just a dull ache. In other words, no nausea, indigestion, rashes, joint pain, itching, etc.; just a dull pain about 2" below my right rib cage and 1" to the right of my navel. Likewise, I've had tenderness in my right lateral abdominal wall (kind of where your rib cartilage ends and your rib bones begin; near your floating ribs) and occasional back pain below my right shoulder blade.
After a week, I went to my general practitioner just to get it checked out. After a brief exam, he said it was likely gastritis (it was apparently going around at the time). Nonetheless, I insisted that I get some blood work done and he obliged.
A few days later, I received my results. My liver function test and blood count were both normal. He said my cholesterol was a little low but, with regular exercise, that could be remedied. Relieved, I pretty much carried on as usual. I joined a fitness group at work where we do high-intensity training twice a week for 45 minutes. Likewise, my drinking habits remained the same. I'd usually have a beer while making dinner, a beer with dinner, and (once in a while) a beer while working on freelance projects or during a movie in the evening. And, about a week after my getting my initial test results, the pain disappeared.
But then, in early October, the pain returned and that's when I truly started to worry. I wound up doing what most people here do, I consulted Dr. Google. Eventually, I returned to my actual doctor and explained to him what I thought was going on. He was very understanding and was willing to perform a multi-planar ultrasound.
This was the second time I would receive good news. The ultrasound was “unremarkable” and he said that there's nothing to worry about – my liver, gallbladder, spleen, and pancreas were all normal as it relates to shape, size, and visibility. In fact, he believed that my discomfort might be stomach-related and prescribed an over the counter proton-pump inhibitor (Prilosec).
After two weeks on being on Prilosec, nothing improved. So, convinced that I had done unrepairable damage to my liver, I adopted – what could be considered – extreme levels of self-care. I quit drinking cold turkey, I began taking supplements (milk thistle, fiber, and turmeric), and virtually eliminated both salt and fat from my diet.
This hard right turn in diet, in conjunction with my obsessiveness and anxious mental state, ultimately lead to a moment of uncharacteristic panic and a trip to the emergency room. At the hospital, they conducted a second round of blood tests and a CT scan. A few hours later, the nurse reported that both the blood test and the CT scan were completely normal – again; my liver, gallbladder, spleen, and pancreas were all normal as it relates to shape, size, and visibility.
Following the visit to the ER, I began rationalizing all the symptoms I believed I had. For example, my “yellowish” stool was a product of turmeric supplements and sweet potatoes (which I had almost every night that week). Likewise, the weight loss was a result of the water weight I'd lost from reducing my sodium, working out, and my anxiety-induced loss of appetite. Hindsight being 20/20, I began to feel pretty foolish.
Nonetheless, per the ER nurse's direction, I followed up with my family doctor. He was jovial but clearly a little frustrated with my knee-jerk reaction. He reiterated to me that there's nothing wrong with my liver and said that, after all my normal test results, the pain is likely muscular or skeletal. Ultimately, he prescribed a weeks worth of steroids (Prednisone).
It is now nearly a month later and, while I'm still experiencing the pain (it's much milder than it used to be), I still have no definitive answer. I've kept a food log since the beginning of November and have not been able identify any triggers – not coffee, not alcohol, not fatty foods. For the record, I've only had two drinks since late October (one on my wife's birthday and another during American Thanksgiving). Nonetheless, the pain simply comes and goes as it pleases. However, I can say that it is much more noticeable while sitting in the car or during certain physical activity e.g. carrying my 2.5 year-old daughter, housework, seated meditation, etc.
Currently, I have appointments with both a gastroenterologist (to check for ulcers) and a doctor of physical medicine and rehabilitation (to investigate either costochondritis or abdominal cutaneous nerve entrapment syndrome). Both appointments are scheduled this December.
At this point, you're probably saying to yourself “great story but what do you need from me?” Honestly, I'm not sure. I think, since so many people and I have had similar experiences with unexplained RUQ pain, I was hoping to get some practical insight and an answer to a specific question...
“If you've had a similar experience and knowing what you know about yourself now, do you believe that your liver is still the cause of your pain? Or were you ever officially diagnosed with something else that you found to be satisfactory?”
I've noticed that the people in this group are tremendously supportive. So, I appreciate you taking the time to hear me out and consider some of my questions.
My sincerest thanks.
“Pain is inevitable. Suffering is optional.” – Haruki Murakami
Written by
SecondArrow
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You've got some explaining to do, "great story"….book, I though I'd start with this :-
Haruki Murakami is a famous novelist of realistic fiction books. His works are known to understand the core human identity and he takes the reader through happiness and sadness all in one time. Many people have heard so much about him and want to pick up a book by Haruki Murakami but are confused about where to start from. ❓
The last bit stood out. I think you have said it all and on my second strike (reading) it appears that the medical team over there are on the case.
What happened to your First arrow?
I'm afraid I've been fortunate in not having experienced the symptom/s you describe. So on the Third strike arrow I'm out. 🤔
Truthfully, I'm not super familiar with Murakami's work. However, that quote is popular in certain Buddhist circles. I actually heard it from someone else and, after Googling for its origination, came across Haruki Murakami's work and wanted to give credit where credit is due – even if it is the result of a quick internet search.
Nonetheless, the sentiment is the same as my username. It's a Buddhist parable. The short version is, if someone's struck by an arrow (pain), they may manifest an imaginary, second arrow (suffering) as a result of worrying about the first one – and why put yourself through that, right?
I'm probably not doing the quote justice but, based on my experience and literally worrying myself sick, I thought it was appropriate.
Sounds good to me, Pointed Arrow. I missed that search, way off target. Initially I was looking down the road of Asian American health until railroaded by Murakami's work. 🤔🙄🤓
It's not quite like practicing for the Olympics or an exam but more like how one might practice law or medicine – the practice never really ends, you just keep practicing until you can't practice anymore.
I've come to terms with the fact that, even if what I'm experiencing has nothing to do with my liver, I was doing myself – and by extension, my family – a great disservice by abusing alcohol. So, even if I wind up with a clean bill of health, I will likely continue practicing abstinence with you, Ofeckman.
Thank you for taking the time and sharing your thoughts.
Sounds very familiar and I know what kind of anxiety this can cause. I have a similar story and have been told that I have Fibromyalgia and costochondritis. I would like to say that I have shaken the idea that there is something liver related, especially as when I do have a drink the pain in my liver area is worse the next day (so I am avoiding booze completely for now). I am getting my GP to look into the whole Gastritus thing again!!
Congratulations on avoiding booze completely, arthole.
Likewise, I have essentially gone cold turkey save for the aforementioned exceptions. Honestly, I plan to keep it that way. After a few months of abstinence, I've realized that I really don't miss alcohol that much and can carry on a “normal” existence without drinking in excess.
That said, on the two occasions that I had a drink since October, I did not notice any immediate or long-term effects. Like I mentioned in my post, I haven't been able to identify any “triggers”.
I'm not familiar with fibromyalgia but, after a cursory Google search, I can say that I do not have pain in the same areas described online. I'm not ruling it out or anything but my pain is really limited to my right upper quadrant.
I have an endoscopy scheduled on the 9th of December to check for both ulcers and gastritis.
P.S. I have a question for you. In another post, you mentioned that you had an ultrasound that reveled fatty liver. Was that your first ultrasound? Like I said above, I've had two normal blood test (i.e.normal ALT, AST, and CBC) and an “unremarkable” three-dimensional ultrasound. So if nothing was discovered following those tests, I assume that would rule out fatty liver, correct?
They would / should have told you if you had fatty liver at the time. It shows up as bright areas on the scan. I ended up having a Fibroscan after changing my diet and cutting down on booze. This tests for liver stiffness and fatty liver Kpa and CAP score and they are using it a lot instead of biopsy these days. I passed with flying colours on both accounts supposedly ruling out liver disease, however I still feel nausea and my right side hurts all the time. I got the diagnosis of Fibromyalgia because I also have all over muscle and joint pain. I have read that this can also occur due to a dysfunctional liver so ho, hum. Five steps forward and 6 back is how it seems most of the time.
You however have really good results all round so it's even more baffling. Get them to check for the various forms of Hep just in case. As Oldham12 has just stated, it is not always obvious and the 'experts' often miss things and you have to be insistent in my experience. Good luck.
My doctor and I talked about a Firoscan but, based on my results, he'd like me to follow through with a few other tests first.
Like I shared with Oldham12 below, I count myself lucky to have a GP who understands that peace of mind is important to me. However, I also recognize that it is a two-way street – he remains open to my thoughts but I must also respect his professional opinion.
Keep up the good work and thanks again for taking the time. I hope to have more updates as I receive them.
Hi
I'm sorry you aren't feeling too good. I have upper right quadrant pain. 5 years ago a so called good consultant said it was muscular!! 2016, a fantastic GP did loads of bloods, referred me to gastro. The wait was 4.5 months so we went private to get a diagnosis. Diagnosed with nafld caused by meds from my Drs over the years. Another consultant took me on under NHS. Had biopsy in November 2016-diagnosed with Nash. My liver is so enlarged it stretches the capsule around it which causes the pain. I'm due a fibroscan in January. Please take care of yourself Lynne
It looks like you've made a number of posts over the last eight months – so I apologize if you covered this in another thread – but what were the results of your other tests that ultimately lead to a biopsy? In other words, after visiting your GP in 2016, did you have elevated levels in your blood work or did you have any other scans with questionable results that warranted a biopsy?
I ask because, according to both a 3-D ultrasound and a CT scan, my liver is visually normal in regard to size, shape, and texture.
The size of my liver wasn't mentioned until I'd had MRI . When i had the ultrasound the sonographer said oh there's just a little bit of fat on your liver but when I'd had the MRI it showed u had a very fatty liver. Then the biopsy showed Nash with fibrosis. Please take care of yourself Lynne
I understand that everyone's experience is different but it sounds like, between an ultrasound and a CT scan, my doctor would have noticed some fat in my liver.
Nonetheless, I know better than to speculate and will have to wait until further testing.
Thanks again.
Hi
My GP did loads of bloods, my enzymes were elevated. Ultrasound showed a little fat in the liver but my Dr thought there was more to it so that's when she referred me. I had camera up and down, MRI and then biopsy. I'm so pleased that this particular Dr saw me that day and had bloods done the next day and an ultrasound the week after. I hope you start feeling better soon. Please take care of yourself Lynne
Yes, like you, I've been lucky enough to have a wonderful GP who listens to me and has been open minded as it relates to additional testing – as long as it's safe and I don't mind paying for peace of mind.
I've mentioned before that I have several upcoming appointments. So, hopefully, I'll have some more information soon.
Welcome to the forum. I am sure you will find it a nice group of folks here who are very supportive.
Honestly, I was skimming until l read your quote, that's when l scrolled back up to see your name! 👆😊 It's perfect, Murakami is one of my one of my favorite authors. I am no scholar, but your description of that parable pretty much sums up his main characters' dilemmas, great insight!
Believe it or not, with abstinence and time, the RUQ pain will subside, if alcohol and alcoholic hepatitis is the source of the problem. The tricky thing is that the damage is not always evident at first.
Trust that you are attuned enough to your body (vessel, haha, little 1Q84 reference) to know when it is not working properly, and that these changes are under your control. Alcohol is a poison arrow to your body, yet the damage is often done by many small cuts. The pain is the first indication that something is wrong. Go with that, liver damage is sneaky, the liver synthesizes an enormous amount of toxins, until it starts to become scarred and stiff due to cellular damage, and then it is simply too late, you have cirrhosis, and now you have even more to deal with. I think you have been given a great gift of insight, pay attention before your health suffers.
I'm intellectual?? according to the guy who speaks perfect French!😏
But.. I am wearing my sleep mask! The magic✨ conch of slumber, except l still can't sleep. 🎭
The idea is that l will get a "gold badge" if l wear this 8 hours a day, and after three months l will finally feel rested, with loads more energy! Any small improvement would be most welcome! 🤣👍
You would like Murakami, the main character usually worries himself sick. 🤮🙁
So are you just wearing the mask to earn a gold star? How shallow of you.
<only joking boot!>
Do you have to get a gold star to keep your insurance. You do seem to have some funny rules and the like attached to the wearing of this mask. 👎. I hate to think how horrid it must be and really feel for you , I do 🙁.
There must be a few readers of Murakami on this forum atm then 🙁. Such a shame when people worry - and I know because I am one of them too, and there’s nowt you can do about it despite trying to rationalise things in your head. Nothing makes a blind bit of difference. You just have to learn to go with the flow - so I keep telling myself 😀. And, as the saying goes, don’t let the buggers grind you down 😀. Where buggers = your issuettes. 🙂.
The gold star is supposed to be just this motivational thing you can do, it's taken from the data sent wirelessly from the CPAP machine, wild, eh?
But that's also how the insurance company makes sure you're in compliance. If you're not using the equipment, their position is, why should they pay for it? So you have to be working up to this x hours in a 24 hour period within the first 90 days, and also go in for a follow up appointment.
OMG - how bad is that! We must we must, we must develop the b.....oh before your time that and not at all relevant but it’s just the you must do this you must do that thingie. Let’s not stress the poor patient out by setting ridiculous targets. We really do want them to get better, don’t we, or do we? Or shall we save money?
I hated targets when I was at work, and even more so now. It’s ridiculous, that is.
As I said before, I’m actually unfamiliar with Murakami’s writing. But I imagine, by virtue of being a Japanese author, there may be a lot of Buddhist themes in his work – I am a practicing Zen Buddhist. Based on the response the quote has received on this forum, I’ll be sure to check out his writing.
My hope would be that either the multi-planar ultrasound or the CT scan would have noticed any damage. But I understand that neither of those tests can detect “stiffness”. In that case, if all else fails, I may politely request a Fibroscan.
Nonetheless, given my optimistic test results, continued abstinence, and relatively young age; I’m confident – but not cocky – that, if there’s something up with my liver, I’ve caught it early and am responding to it in positive ways.
By that same token, if my liver is perfectly healthy, I’ve been given an opportunity to embrace a healthier lifestyle than I had before – and that’s not a bad thing.
You might like Murakami, but he is not really a conventional writer, he's a mix of fantasy and fiction, including science fiction. Have you ever seen a Japanese horror movie (Godzilla)?!
According to Penguin Random House, a good place to start is Murakami's A Wild Sheep Chase. With Christmas around the corner, I may treat myself to a copy.
P.S. While I'm familiar with the pop culture phenomenon, I can say I've never seen the original Godzilla.
BTW l have cirrhosis and fibromyalgia, I have had multiple bouts of costochondritis, and l have shown up in the ER multiple times for pains that were ultimately due to anxiety, including just a few months ago. I almost stroked out once due to uncontrolled high blood pressure. I completely understand wanting to know specifically where your pain is coming from, sometimes it is frustrating when you know it's different than last time but no one will listen to you. I can tell you that fibro doesn't cause joint pain, that's usually caused by arthritis, but the stiffness in both conditions makes it hard to distinguish.
Thank you for the clarification. Yes, looking back, I believe I felt the most ill when I was obsessing, Googling, and generally feeling anxious. Following that trip to the ER, I vowed to not make the situation any worse than it needs to be. I may not be getting the results as soon as I'd like them but I feel like I'm doing everything within my power to ameliorate the situation.
You're the second person to bring up fibromyalgia. I did some cursory research and, honestly, can't identify with a lot of the symptoms. Again, not ruling anything out, I'm just being truthful.
Likewise, I have an appointment later this month with a doctor of physical medicine and rehabilitation to check for both costochondritis or abdominal cutaneous nerve entrapment syndrome (ACNES). I'll keep you posted.
I look forward to hearing what he says. You do know costochondritis is a type of inflammation, right? It is commonly confused with heart pain, but my doctor gave me a quick tip to distinguish it from that. Thump on the place where the ribs join, if it's painful, it is not the heart, but rather costochondritis inflammation. That doesn't hurt when your heart is in in cardiac arrest, haha, see l know the feeling of being labeled a complainer when you know something is wrong. I have scoliosis, it can be an aggravating factor.
Is that what it's called. I had that chest pain back in Aug. GP said one possibly was inflammation of the cartilage. He sent me to A&E, nothing sinister was found & the pain only lasted 2-3 weeks. A follow up at the Chest clinic Oct has since diagnosed Atrial Fibrillation. I did have costochondritis which moving forward uncovered a separate issue AF. 🤔
I should add that I do feel a slight tightness tenderness in that same spot although I don't know if it's from one or the other now. The initial cost...itis. pain did disturb sleep. 💤🤔
Yes, I've heard that about costochondritis. But I want to emphasize that I'm definitely no expert.
I understand that it typically manifests on the left side but it can occasionally present on the right. Likewise, I've heard that it's normally localized to the area where the upper ribs meet the sternum but can radiate to the lower ribs, the side, and the back.
Personally, I do have some tenderness around my bottom and floating ribs – which is why my GP may be convinced that my pain is muscular or skeletal in nature. I still understand very little about the condition but plan on asking plenty of questions during my visit to the specialist later this month.
So true, I have fibro, Nash, IBS, diverticulitis, gastritis, retinopathy, costochondritis, under active thyroid, diabetes, degeneration of the facet joint, osteoarthritis in knees to name but a few!! The majority of these cause me pain, no wonder I can't sleep!!! Please take care of yourself Lynne
Hi SecondArrow
I joined the group around the same time as you and have also found it to be a hugely supportive and diverse group of people.
I also experience RUQ discomfort - not pain as such but more ‘sensation’. Sometimes a mild ‘burning’ feeling in my RUQ back and sometimes the feeling that I can just feel my liver against my rib cage, on the very outer edge towards my side. As I say, nothing debilitating but more just intermittent sensation of something!
A recent Fibroscan indicated Kpa 7.9 so mild/moderate scarring and recent bloods were all completely normal. I’ve not yet had an ultrasound.
I am 49 and a typical ‘drink at home while preparing / with dinner / maybe one after dinner’ wine drinker. It just catches up with you after a few years and denial/ignorance gives way to panic and a reality check!
I have completely cut back (had one glass of wine on two separate occasions over the last few weeks) and I don’t miss it at all. I daresay I’ll have a glass with Christmas dinner and other occasional toasts but that’s about it.
I’m also hoping the RUQ feelings will disappear but I do wonder now how much is psychosomatic??
It sounds like you’ve turned things around in good time, and I’m hoping to have done the same.
Welcome, sjbreiki. I'm glad that both you and I stumbled across this excellent community.
Yes, the word “pain” is a little misleading. I've described it to my doctor as a general awareness around my bottom right rib. Sometimes it manifests toward the center, a few inches lower (near my navel), near my oblique muscles, and occasionally in my back below my right shoulder blade. I've never felt all those sensations all at the same time nor has it ever been debilitating – it has a way of moving around throughout the day. So, I can empathize with you – it's hard to say how much is psychosomatic.
Likewise, I can empathize with your “slippery slope”. I never thought twice about my drinking because I never missed a day of work, always woke up in my own bed, etc. But, to your point, it can catch up with you. I consider myself fortunate that I don't miss it all that much and have been able to carry on without “jonesing” for a beer.
I'm scheduled for a few more tests before my GP and I can explore a Fibroscan. So, if I'm still empty-handed by the end of December, that may be my next step. However, out of curiosity, did you have any other tests done before your Fibroscan? In other words, did you have elevated enzymes that ultimately warranted the Fibroscan (I understand you have not yet had an ultrasound)?
My liver is very fatty and enlarged which stretches the capsule around it which causes the pain, it reminds me of when u had gall stones, the pain shoots from front to back and also my shoulder. Take care Lynne
I paid privately for a Fibroscan and liver function bloods, I haven’t yet gone down the conventional GP route. I’ll monitor things after a period of abstinence and review my course of action.
You mentioned that your private Fibroscan yielded a result of 7.9. kPa, but what about your liver function blood test? Were your enzymes elevated as well?
same here, drank a bit more that that tho. Around 3-4 drinks a day :(. When drinking more, I would have the twinge pain under right rib cage and discomfort would go away, too scared to see doctor, then I would be moderate in my drinking. I've cut back alcohol this year, down to 2.5 a day until December when I noticed the bloating and pain(? - more like a intermittent, random sharp discomfort) was present most days. The pain would also be more on the edge of rib cage, if I press on lower rib, I feel it. Or it would be a bit below. Hard to describe. Doctor gave me pantoprazole and taking it 2 weeks, the pain disappeared! I had blood work done, all looks good. I've quit all alcohol since January 01st. This week, the twinge reappeared :(. Still taking pantoprazole. The discomfort is very mild but nervous I've caused damage.
Having to say Hello is hard, can I ask one burning question to you experts. Having lost over 2 stone in 6 months, pain in my uppitiest RUQ, itching, chills etc is loosing this 2 stone attributed to the Liver not working properly. Ive been scanned from head to foot in the last 4 months. From going to an Urgent 2 week endoscopy now to a MRCP urgent possible Bile duct blockage. Feel I am going mad and cold hands with swollen left ankle and foot since August whilst on a family holiday, feeling suicidal ....
Welcome, archeryqueen. I hope you find what you’re looking for in this community.
I cannot speak for the other people in this group but I don’t feel qualified to answer a lot of your questions – it sounds like the kind of thing a doctor can help diagnose.
However, I am willing to suggest that, if you believe you’re capable of self harm, you seek some guidance from a professional.
I’m relatively new here but I understand there are professionals from The British Liver Trust who can help.
I posted about this in the past. I have had RUQ pain for several years off and on. The pain is relatively mild but caused a lot of worry in my life. I am 56 years old and in the past drank quite heavily. My Gallbladder went out about 1.5 years ago, so I’m not sure if that had anything to do with my RUQ pain. When it blew out, I had severe pain mostly in the middle of my chest. I have had an ultrasound, CT Scan, Liver enzymes normal except ALT is 1-3 points high. Fatty liver has been a part of my life for 20 years.
Fast forward to today, I lost 25 lbs , am mostly eating much better and I still drink under the recommended limits probably average 6-10 drinks a week. My situation has improved. Not really sure though what makes pains come and go occasionally. I know almost all in a Liver Forum are going to say “Do not Drink at all!” I totally understand that. There are people though that can stay within the drinking perimeter goals. Overall, drinking is a health gamble, the same as eating Donuts ,and greasy cheeseburgers. Please don’t get the wrong idea that I’m promoting alcohol because, all good health lifestyle changes are good for us in the long haul. In closing from this long rant of meaningless chatter, I don’t have a clue on RUQ pain. 😀lol. I’ve just excepted it as part of my aging pains. I think the positive is you can have it for a long time without it turning to something tragic. Good luck and God Bless🙏
Thank you for sharing your story. Ultimately, it's responses like yours that lead me to post to this forum – so, I apologize if I jump directly to the questions.
You mentioned that fatty liver has been a part of your life for 20 years, were you ever officially diagnosed – especially since all your tests appear to be normal?
Lastly, congratulations on making some pretty significant lifestyle changes. Sincerely, no judgment here. Admittedly, whether I like it or not, fear is a big motivator for me. So I'm happy to abstain knowing that, to use your words, “drinking is a health gamble”.
Thanks again for opening up. Take care of yourself.
Well, Looking back on my past numbers my LFT's were higher as far as AST and ALT back in 2004. I just don't think they were as concerned about fatty liver that long ago. I drank like a Sailor and ate terrible.
Since I have calmed down, getting older, my numbers fell back into place. Never really got an answer for the RUQ pain. I think at the end of the day, The Liver is a Badass Organ.
From what I have read in here the chances of full blown Cirrhosis are still quite rare. Someone in here said that out of the worst alcoholics I think maybe 10% of them end up with it.
I feel real bad for the people who never drank and end up with it. Seems like folks with Hepatitis are far more prone to end up with more severe Liver problems. I was way scared when I came in this forum too. Great people with a fountain of knowledge. I must confess though, It feels like half the world has liver disease if you come in here too much.
I appreciate the additional detail, Casinobo. I've also heard that the liver is very resilient but, like everything, it has its limits.
Like I mentioned in another reply, my hope is that my relatively young age, otherwise healthy lifestyle (including newfound abstinence), and “unremarkable” test results will help put my mind at rest.
That is really a great perspective! l have been thinking carefully about exactly what you are saying, basically "if it ain't broke, don't fix it"! Sometimes we ( l am including myself even though l have cirrhosis and have been advised not to drink at all) go way overboard with everything, feeling guilty over every little cookie or sip of champagne. This can make you feel ill, when otherwise you would be fine, l know this for a fact firsthand.
Where is everyone’s liver pain? Everyone seems to say upper shoulder blade or upper right quadrant. If I were to stand straight and put my arms at my side mine is more under my arm, not my front and not my back. Not sure if this is my liver in this spot?
I understand that words can be clumsy but I will do my best to illustrate where I'm feeling discomfort.
If I take two fingers and place them on the bottom of my sternum, I feel a little a little tenderness – and about 1" to the right from there, the pain is a little worse. From there, if I walk my fingers down toward my navel about 2 or 3", there's a little pain there too.
Additionally, if I begin at the bottom of my sternum again and walk my fingers along my lowest rib, I feel tenderness about 3 " from the center of my abdomen. Continuing right another 3" along my bottom rib, there's sensitivity around my floating ribs.
Lastly, I have experienced some back pain. Imagine taking a string from the bottom of the sternum, wrapping it around the right side, and ending about 1" to the right of the spine – that's where I experience some discomfort too.
It's tricky because I understand that the liver is a relatively large organ and could technically be located or manifest in all the aforementioned areas.
Thanks again for the great clarifying question.
P.S. Like you, my pain is very vague and is not aggravated by breathing.
Thanks for your response. Mine is more towards the back and seems to be about horizontally over where my rib cage and probably two inches in from towards into my backside (if you were to split my body in half lol). When I look at pictures of where deferred pain is felt my spot looks to be higher then the back section they show and much lower than the neck and shoulder area. In fact it has also changed a few times over the course of the past couple of weeks so I think it's probably in my head. My enzymes have consistently been good (ALT at 8 AST 12) and no fat showed on my ultrasound. Texture looked great from what they said. I later had a laparoscopic surgery in March wherein they took pictures of my liver while they were in there and I was told from a morphological perspective it looked good. The only thing I have as a concern was that my liver measured 16.8 CM. I'm a fairly petite female so that was worrisome to me but the radiologist didn't note anything on the report about it, in fact said it was a normal upper right quadrant ultrasound. When I asked my doctor about it he said because of the shape everyone's linear measurements can vary. No fat was also noted during my surgery.
So that being said, I'm unsure whether to continue to worry about the size, or not.
I think I understand where you're coming from, TSManning.
While I don't experience discomfort in the exact same area, I can empathize with the fact that it does appear to change over time.
Ultimately, I'm a little surprised just how difficult it's been to clearly define what I'm experiencing. In other words, I never imagined it'd be so hard to distinguish between muscular, skeletal, or organ pain – which isn't helpful to my GP, I'm sure.
Likewise, I've had multiple normal blood tests and scans. And, like you, they never mentioned anything other than “unremarkable” or “no hepatic abnormality is seen” – nothing about the size of my liver. I trust that, if there were something out of the ordinary, they would have mentioned it. In fact, in a response to sangeethshan below, we discussed the complexities of defining what is “normal”.
I am now, more than ever, convinced it’s in my head. That being said I have decided to abstain from alcohol. I may have the occasional holiday beer, I may not. The guilt will probably make it not worth it to me. I have very easily replaced my weekend glass of wine with a nightly cup of warm chamomile tea and am just as happy and sleeping more soundly (that is if you excuse my toddlers who seem to wake me up every hour and kicking and pushing me out of the bed). I think we need to focus on the good news which is that nothing has been found wrong. For me, theyve seen my liver live. I don’t think it gets much more clear then that I’m an ultrasound, MRI, or CT scan, right?
I’ve always eaten healthy and been an avid runner so my diet and exercise is good. I may have had a few times of drinking more then I should have since that’s surgery but that’s about a handful and I’m not sure that’s enough to cause liver disease. So I’ll continue to abstain out of choice and continue my works outs and rabbit eating lol.
After this experience, I've told myself that, even if everything's perfectly healthy, I will unlikely fall back into old habits. To quote someone else in this community, “the juice ain't worth the squeeze”.
Ultimately, the last few months of abstinence has taught me that I can function perfectly well without drinking every day, every week, or even every month – I'll simply carry on without it.
I believe that all this is part of the diagnostic process and, for better or worse, hope that it's all in my head too.
Keep up the good work and take care.
“You're under no obligation to be the same person you were 5 minutes ago.” – Alan Watts
I need to learn how to relax. Tonight my pain has become much worse with no trigger and moved to the front. I think it’s got to be in my head at this point, who knows!
Hopefully you can learn to relax as well and enjoy you’re new and healthier lifestyle 😎
Like today for example, I went to the gym and ran 5 miles no problem. I have since left and every time I yawn I feel a pain radiate from my lower back upwards. My only thought is that this must be a muscle. I’ve removed bad food and alcohol for well over a week, there is no way it could get worse and move all around, right?
Yes if I’m sitting it does radiate with a deep breathe. Maybe a muscle though, my massage therapist told me my back is filled with them today. Probably stress 😔 it does hurt like a muscle knot when I touch it, but it’s not tender around the area only one small spot. Again no pain when lifting, scrunching, turning. Nothing else...
I thought pain was in my head as all tests negative- eventually I was found to have gallstones like shards of glass. It took 20
Years before it was found.
I now have a hernia 8 years.
Ruq pain solid 6 months diagnosis erosive gastritis- I am having ct scan 13/12 and signed up for a trial to get fibroscan. With RUQ pain I gasp for breath. I have a fatty liver too. Lost 4 stone this year. Not a drinker. Pain increased.
I would pursue gallstones as I have always had low cholesterol- the ultrasound people are always looking for large stones. Sometimes they are not and just as painful.
I understand that some people on this forum (including myself) have a tendency to read between the lines and I believe that specificity matters. So, I may respectfully – I want to emphasize respectfully – challenge you for some additional detail.
When you say all your tests were negative, which tests did you receive (e.g. ultrasound, CT scan, HIDA, etc.)? I understand that few tests are 100% accurate but, based on a 3-D ultrasound and a CT scan, my doctor wasn't able to find “evidence of gallstones, obvious gallbladder wall thickening, nor biliary tree dilatation”.
Likewise, when you say “eventually I was found to have gallstones”, how exactly did you find out? Was there a specific test that proved the diagnosis?
Lastly, in reference to your symptoms – and it sounds like you have a few additional ailments (e.g. hernia, gastritis, and fatty liver) – how would you describe your RUQ pain? In other words, my discomfort has never been debilitating nor have I experienced nausea, indigestion, unusual bowel movements, etc., are those the kind of symptoms you are referencing?
Again, sincere thanks for sharing your story. It's ultimately what make this community so effective.
More toward the back side or more towards the front? Mine is very vague, it’s not stabbing, it doesn’t hurt when I breathe, it doesn’t radiate elsewhere. Just seems different then what other people have reported having.
While not diagnosing, I can say that my own reactions to gluten and dairy sensitivities have resulted in similar pains.
Yeast overgrowth in intestines has also caused those pains for me. A course of strong antibiotics years ago started this. If I have too much sugar....ouch.
Your kidneys are in good shape? Know from my father's experience that kidney problem can refer pain to near shoulder blade. Doesn't mean serious problem. Infection or even kidney issues referred pain to shoulder blade area.
I would not say I consume “a lot” of dairy or gluten. My diet is largely plant based but I do not consider myself a full-fledged vegan.
As I mentioned before, I've kept a food diary for a few months and haven't been able to identify any triggers – that includes something like the occasional slice of pizza.
Likewise, my kidneys were visible during my CT scan and nothing was out of the ordinary. Additionally, I have nothing to report as it relates to my urination – all normal, as far as I can tell.
Thank you for your question, I really appreciate you taking the time.
Welcome! your issue is identical to mine. This is going to be a long reply. I consider myself a moderate-heavy drinker (4-6 drinks a night) starting in my early twenties and picked up more into my late twenties. I first experienced the same pain in my RUQ, just tucked underneath my rib cage at the age of 29. I'm 31 now and have been dealing with it for the past 19 months. To make a long story short, I have had multiple blood tests (including a liver panel test). Make sure your doctor tests for auto immune diseases, GGT, things that are more specific to the liver. I noticed that my earlier blood tests did not test for tumour factors or GGT. So far, i have had 2 ultrasounds, an endoscopy, a ct scan, a fibroscan(5.9), and an mri that all have come out normal. I've stopped drinking all together for about 4 months now , hardly drank once the pain started.I have been taking milk thistle since the pain started, and have always exercised regularly (i'm 6 foot 2 and 195lbs). Still the pain persists, especially when sitting in the car. Feels like my liver is pressing against the rim of my ribcage causing the pain, which radiates to the back and side as well. I'm at a point now where i don't feel modern medicine can help figure this out why my liver feels big swollen and tender.
I took a look at my ultrasound reports and saw that my liver was on average about 15.6-15.8cm big. this is considered normal but when i did some research, i found out that there a "normal" liver size is different for everyone. Not just based off gender, height, weight, but also ethnicity. My liver being around 15.8cm is normal but is towards the upper limit of normal. My original size could have been 12cm and ballooned to 15.8 and it would still be considered "normal". I know you are a vegetarian, but i adopted a vegan diet, drank a lot more water, and ate the heck out of beets, garlic, and onions. I lost 10 lbs and for the first time, 19 months later the pain is slowly starting to go away. I also drank a lot of black coffee too (look into black coffee enemas). We are all genetically different. Don't use lab parameters to tell you what normal is.
Nice to meet someone in the same boat, sangeethshan. Likewise, thank you for the detailed reply – I'll try to respond in kind.
Yes, our histories sound very similar and congratulations on your four months of abstinence.
So far, I've had two comprehensive metabolic panels, two complete blood counts, and two blood draws for lipase and amylase – all “normal”. Similarly, I've had several scans (excluding an MRI and Fibroscan) – all “unremarkable”.
I find the kinship of experiencing pain while sitting in the car interesting. For me, I believe it's one of the few activities that can consistently replicate the sensation. In other words, food, drink, or physical labor don't appear to aggravate it – but sitting in the car does.
I mentioned in another reply that, while I still occasionally eat animal products (mostly yogurt, eggs, honey, and a little cheese), my menu is actually mostly plant based (including beets, onions, and garlic). Likewise, I drink between 70 to 90 ounces of water and one or two cups of black coffee per day. So, while not perfect, I like to think that I've got a decent diet.
And, while I am admittedly frustrated with the lack of answers, I trust that this is all part of the diagnostic process and remain healthily skeptical of alternative medicine. In other words, I may not be quite ready for a black coffee enema but – should the opportunity arise – I will definitely look into the other tests you mentioned in the beginning of your reply.
Lastly, I think most of us understand that what is normal for one person is not necessarily the case for another – there are simply too many factors. But I also believe that normal “ranges” are the best thing we have. In other words, if not for averages, what would we be left with?
Thanks again and I hope to hear more about your journey as you and I appear to be cut from the same cloth. Likewise, I'll keep you posted.
P.S. Out of curiosity, have you ever experienced any of the other symptoms associated with liver problems e.g. nausea, fatigue, weight loss, indigestion, etc.? I have not – which makes this whole situation all the more bewildering.
TSManning may not see this answer because you have replied to me rather than to him/her. May I suggest you cut it out and reply directly to his/her post?
Two, stop taking the PPI. There are studies that show that PPIs may facilitate bacteria crossing the gut barrier into the liver.
Three, stop taking all supplements and just eat healthy for a month. If the pain goes away, it may be a supplement. If you really want to keep taking them, add them back at this point one at a time. Supplements can be very hard on the liver.
In reference to your first point, I'm way ahead of you. Alcohol simply no longer plays a major role in my life. I began practicing abstinence in late October and have no plans to return to my previous lifestyle. Until my doctors and I can figure out what's truly going on, I believe abstinence the one thing within my power that simply cannot exacerbate the situation.
As it relates to your second suggestion, I have stopped taking the Prilosec. In fact, I was only on a two week prescription – once nothing improved after starting the medicine, I stopped taking it.
Lastly, I am not taking any supplements at the moment – save for a daily multivitamin that I've been taking for years (mostly for the vitamin B12 as I am a vegetarian). However, to your point, I stopped taking all “non-essential” supplements after my self-induced trip to the ER I mentioned in my original post – so, no more milk thistle or turmeric for now.
Ultimately, I've been embracing a very “let food be thy medicine, and let medicine be thy food” approach.
I noticed you are supplimenting with turmeric. Does it have black pepper extract? I had copious amounts of bile in my stomach and esophagus because of a chemical reaction. I was taking tummeric with the black pepper extract and Nexium. And when I had sudden hearing loss, docs added prednisone. Awful result was severe reactive gastropathy.
3 years later, docs still insisting I'm fine & I need to get my anxiety in order.
NO, I THINK SOME DAMAGE HAS BEEN DONE, AND I COULD USE SOME HELP.
To be clear, I'm no longer taking a turmeric supplement – I stopped taking it about a month ago and, even then, I was only taking it for about two weeks.
Also, it did not contain any black pepper extract – just turmeric powdered extract and organic turmeric root. Likewise, I'm no longer taking a proton-pump inhibitor. Generally speaking, I don't take many medications or supplements which could cause a reaction.
I'm sorry to hear about your situation and really wish I could be more help.
Did you get an update yet I wonder? I'm having the same pain and had blood work, sono and a CT with contrast and only been told possible stones, but it feels like liver.
Yes I have, Gp told me the liver is in a caspule & when your liver is enlaged the caspule stretchers, that is the pain! My pain goes though satges to. I have pain after I eat! Sometimes it is not to bad other times it falres up! I hope this helps
Yes, after reading many posts on this forum, I have heard several people mention Glisson's capsule, the tissue surrounding the liver. I also understand that, while the liver has no pain receptors, the capsule can stretch and signal pain if the liver is enlarged.
However, after reviewing my ultrasound and CT scan, neither of my doctors mentioned anything my liver being larger than normal. I know there's been some debate about what “normal” means. In this case, the normal size of a liver is relative to the individual. As a result, what could be an enlarged-sized liver in one person may be completely normal in another. So, I understand that I could simply have a larger-than-normal liver compared to what's normal for my body – which makes this all very tricky.
With that in mind, can I ask you a follow up question? If you have been diagnosed with an enlarged liver, what tests lead you and your GP to that conclusion e.g. ultrasound, CT scan, MRI, etc.?
As always, the insight is much appreciated. Thank you.
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