Pain in upper right quadrant of abdomen

[Liverpatient]

Hi Community, I've now had a continuous pain in the upper right quadrant of my abdomen, that is also felt in the lower right side of my back and right shoulder for some time. The pain is always there and never goes away. The liver monitoring that I've been taking/fibroscan and ultrasound have not yet revealed any damage or injury to my liver. This situation has led me to think that may be the doctors are not getting the correct information, may be they are interpreting the results from the fibroscan and ultrasound wrongly. I feel something serious is going on in my liver beyond the natural replication of the hbv virus in the liver cells as seen by my 3000IU/ml hbv dna.
Do you guys also have this constant pain in the area I mentioned; if so, how have you dealt with it?

[Jatashankar]

I simply think this is related to excessive colonic gas formation and increase in intestinal microbial flora. U can check it by not remaining empty stomuch for too long, taking small meals frequently, antacid pill for a couple of weeks and some short term antibiotics course after prescribed by a good doctor. And ofcourse good herbs help.

[cosbyosomo]

Thanks Jatashankar but is this excessive colonic gas formation or intestinal microflora related to the liver or HBV.And plz name a gud antibiotics and antacid.I think ur right becos my stomach become full,bloated and the pain goes after digestion or wen goes down the colon. Waiting for ur response

[Bm2016]

may i ask what level of pain?
i read the dull pain in upper right quadrant abdominal is the liver pain, could be a sign of liver diseases, such as cirrhosis, fibrosis, fatty liver, etc. although liver has no pain nerves, last time the doctor inserted a long needle into my abdomen to do liver biopsy, and i asked why i feel the pinching pain, and she said it was from the diaphragm.

liver pain can be easily confused general abdominal pain, back pain, kidney pain. consult the doctor to do a blood test, ultrasound, or biopsies to pin point the cause of the pain.

in july, i have a sharp pain in my belly and back pain after a greasy meal, so painful  that i would not lay down, or stand, neither position feel comfortable, luckily it went away after a few hours.

i went and told the doctor about it, the doctor teased me saying he doesn't have x-ray vision to see my organs, so he ordered blood test, urinalysis  and ultrasound.

ALT 38 IU/L
AST 22 IU/L
BILIRUBIN, TOTAL 0.3mg/dL
Apolipoprotein A-1 132mg/dL

glucose, serum 90mg/dL
cholesterol, Total 193mg/dL
triglycerides 55mg/dL
HDL cholesterol 52mg/dL

albumin, serum 4.6g/dL
creatinine, serum 0.93 mg/dL

hep B surface antigen screen  negative
hep B surface antibody reactive
hep B dna quant not detected

[Liverpatient]

Hi, have you had a quantitative anti-hbs test? I remember you told us before that your doctor told you it is not important. But in my opinion it is wise to know how much anti-hbs you have, because may be if you get a hbv vaccine then that could back up your antibody level if it is under 10miu/ml. If your doctor doesn't want to do the test, I would try with another one.

[Liverpatient]

I've also always had the stomach pain due to abdominal bloating/lots of gas,a nd my abdommen looks quite distended; it has been like this since my early childhood, but the situation worsened as I aged.
But the pain that I feel below the breast in upper right side of abdomen is not similar to pain from bloating, so I suspect it has another reasons.

[Bm2016]

I still test for anti-hbs, hbsag, hbv dna every 6 months, and anti-hbs has been always reactive, so my anti-hbs must have been 10 iu/ml or higher,  since i was a chronic hbv carrier, i don't think getting hbv vaccine will do me any good.

[Jatashankar]

Liverpatient cunsult a gastrologist for checking H.pylori infection. Ur bloating abdomen, acidity and discomfort might be due to chronic infection of it. Better discuss a good doctor and get the treatment. I ve seen a lot of people treated for this infection and resolving most of the problems.

[Liverpatient]

Thanks Jatashankar, I think issues that are related with the stomach and intestines are very complicated, often there is no help, one has to live with them, unfortunately. One of my observations about stomach ache and bloating is that it gets worse if I do not get enough night's sleep or if I'm stressed. But I believe my hepB could also be a complicating factor, because, already I've been diagnosed with chronic kidney infection and small fiber neuropathy, which the doctors attribute to my chronic hepB. Regarding H.pylori, thanks God i've been tested negative on that.
Unfortunately, the doctors really do not care about these issues, it is hopeless to get help from them. Do you think some kind of cleaning the intestines could be of help? Thanks again.

[Liverpatient]

Hi BM2016, but how do you know your anti-hbs is above 10mIU/ml; didn't you tell us that you've not done anti-hbs quantitative test? Also I've read somewhere that hbv vaccination may help boost the immune system to generate more anti-hbs in those chronic patients who become hbsag negative.

[Bm2016]

as i stated before, i've been checking my anti-hbs every 6 months, along with hbsag and hbv dna, lipid panel, for more than 2 years now, has not been taking any drug for more than a year now,  the hbv test result has been consistent,

HBV DNA undetectable
hbsag: negative,
anti-hbs Qual: reactive,


blood work was conducted by labcorp.

there is an explanation of the anti-hbs result,
non reactive: inconsistent with immunity, less than 10 mIU/mL
reactive: consistent with immunity, greater than 9.9 mIU/mL

I've never tested anti-hbs quantitatively.

[Liverpatient]

Ok, now it is clear; before, you never put any numbers to your anti-hbs result, but now i understand that your lab considers reactive to mean more than 9,9mIU/ml anti-hbs, which is very good.
I congratulate you once again with your clearance of the hepB diseease, just be careful of drugs that could suppress your immune system as we discussed before, becasue even though you've cleared the virus from the blood stream, there is always some integrated hbv dna lingering in the nuclei of the liver cells, waiting opportune moments to attack.

[Liverpatient]

*I mean the cccDNA

[Bm2016]

Thank you,
I've been told by doctors, any drug/product contain steroid, and immune suppression may have a chance to reactive the hep b virus, and need to retake viread during those period, and pain killer such as Tylenol is not immune suppressive, but may damage liver.

[cosbyosomo]

There is no fibruo scan here in nigeria but we have abdominal USS and biosis but i dont want to do biopsis

[cosbyosomo]

PLease i need answers to my last comment on If USS scan can replace fibroscan or biopsis

[Jatashankar]

No

[cosbyosomo]

Thanks alot i but can abdominal USS scan substutute for biopsis and fibro scan becos fibro scan is not available in nigeria and i dont want to do biopsis.I screened for HBV and the lap man initially said from d beginning and later called me that its very faint almost undetectable becos the reactivity line was very hard to see.

[cosbyosomo]

....the lab man initially said negative from the beginning and later called me that....i was like dat also in december 2016 before i stopped drug and noe its more than 8 months still very faint and almostensibly unseen,I mean HBV test

[Jatashankar]

There is no need to attribute every pain in right upper quadrant to hbv. Hbv is a silent chronic disease which manifests mostly in advanced liver damage. Most people here are carriers and with minimal inflammatory reports of fibroscan,usg and liver biopsies. This means u are as simple as other uninfected men and this pain can be due to multiple other possible reasons than hepatitis b. Mostly it is due to unhealthy dietary habits and irregular routine of living habits. Hbvers should not get overweight, avoid junk and oily food, avoid overfeeding, should regulate bowel habits and eat fresh food. Cunsult good doctors if still intractable. Most pains can easily be dealt with. Lastly remove the unnecessary phobia of attaching anything with hbv. In today's world hbv can easily be dealt with antivirals when required and thus complications can be prevented very significantly. Live ur life peacefully.

[cosbyosomo]

THanks so much Jatashankar and Still. Am sure its from my feeding habits.Its a dull pains and that comes once in awhile when i eat unhealthily. PLZ is true HBV does not harm or do any harm in some individuals.

[Jatashankar]

Keep a check on hbv DNA it should not rise more than 2000iu/ml in hbeag negative individuals. Most of the time this is controlled by our body itself and sometimes antivirals are needed for this. Keeping hbv DNA in limits reduces the harm by hbv to very little or even none. Do check biopsy or fibroscan annually because in some hbeag negative individuals it is seen that intermittent flaring of immune response cause scarring and fibrosis of liver tissues.
Overall all u need to do is just live healthy wisefully and keep your eye on hbv DNA.

[Ram1982]

I too had few months ago for 3-4 months continuously.  I stopped doing exercise and started drinking lemon juice with honey everyday.  It disappeared after 1 month.  I started doing exercise once it was OK.

[Liverpatient]

Thanks for the reply. I will try this also. After you told me, I searched it on the internet and found out that it gives much better result if you drink the mixture in the morning in empty stomach.

[cosbyosomo]

I Feel that pain too under my rib especially after I eat but I Dont know why its there becos my HBV DNA is 61.5 and HbeAg is 0.06(negative) in June.And my doctor said its psychological and that am an inactive carriee.I advice me in what to do.

[Liverpatient]

You need also to check your liver function tests such as alt, ast, fibroscan and ultrasound. Just follow all the advices I'm getting from other forumers in this thread, in addition to drinking upto four or even five cups of coffee each day. Check your vitamin d3, and if you are defficient, supplement with upto 10000IU vitd3 each day.

[cosbyosomo]

@Liver patient the last time I checked my LFT was in Jan my AST and ALT were 19(range<45)and 12 (range<48)respectively,while Albumin is 42g/l( range 35-5g/l),total proteins 90g/l(range 60-80),but Bilirubin Direct 14.5umol/l(range<4.3),bilirubin total is 27.5umol/l(range <17),my abdominal USS I normal in Feb. Plz all advice me on this test results and the pains. Though I feel d pains after I eat sometimes and dissapear wen I do exercise and rest.

[Mehepb]

I used to have that pain until I changed my diet lost few pounds and taking milk thistle plus dandelion everyday I am feeling very well now

[Liverpatient]

Hi, thanks for the reply and nice to know you are feeling better, it is a good encouragement for some of us. In my case, I always try to eat as healthy diet as I could, and I almost do not eat so called junk food, or ready made frozen food. So I would say my diet is not that bad, though I've been struggling with my bad appetite. My weight is also normal, may even need to increase little bit. I've tried milk thistle for about three months without any improvement that I could notice; however I'm going to try it again together with dandelion and other liver friendly herbs, so thanks for the tips:)

[Lobsangg]

I always have that too but I've never detected it I just felt it is the inflammation that's doing it but thanks for the help I'm gonna try this too