Given the fact that you have a history of endometriosis I'd suggest you consider endo to be a contributing factor in your current situation until proven otherwise. Until I found a doctor that specialized in endo and I traveled across country for surgery with him I spent many years going from one treatment or surgery to the next in an attempt to relieve the chronic, debilitating pain. Endo was found at each surgery, often binding one organ system to another, creating adhesions etc. Surgery with an endo specialist finally helped. You say your RUQ pain is cyclic...that really sounds suspicious for endometriosis in my humble opinion. A specialist in endo is really the only way you'll likely get help in sorting out the possibility of endo of the diaphragm which can cause the type of symptoms you describe with your RUQ pain.
There are a group of doctors in Atlanta that specialize in the treatment of endometriosis, pelvic pain and pelvic adhesions. They are the Center for Endometriosis Care. Dr. Robert Albee, the founding member of this practice, would be someone I would contact if I were living in Atlanta in your situation. While I don't have personal experience with Dr. Albee, I saw a different specialist due to geography, I have heard many, many positive outcomes from women with endometriosis and pelvic pain who have had surgery with Dr. Albee, too many to count, and, as I said, if I were in Atlanta or the surrounding area that's where I'd go for a consult.
While I don't have problems with endo any longer thanks to the skill of the endo surgeon I selected a few years ago I still have ongoing issues with RUQ pain. I have no gallbladder, it was removed in 1999. At a surgery I had in 2003 the RUQ was thoroughly inspected due to the ongoing complaints of RUQ pain, sometimes severe. The surgery demonstrated that my liver is attached to my diaphragm by adhesions. I have no idea whether or not this accounts for all the pain I still live with but I'm certain it must be a factor to some degree. At the time of the surgery the surgeon deemed removing the adhesions too risky due to the close proximity to the hepatic vein.
So here I am with pain similar to what you describe and wildly fluctuating liver enzymes. Like you, I have pain that starts in the RUQ region and wraps around to my back and even extends to my collar bone and shoulder at times. Sometimes the ribs on my right side are sore. Sometimes movement makes the pain worse; I feel something pulling. For the past 4 years I've gone from doctor to doctor trying to determine the cause of this constant RUQ pain but have found no answers and, therefore, no relief yet.
I hope you'll find answers and get the relief you deserve. A good place to start, as I said earlier in this post, is with a consult with a good endo specialist and you've got some of the country's best right in your backyard.
Best wishes to you, Debbie
At Mon, 25 Jun 2007, Lisa wrote:
>
>Hello all,
>
>After three surgeries--first one for gallbladder removal and ovarian
>cysts, second for ovarian cysts and endometriosis, and the final surgery
>for a complete hysterectomy.
>
>During the last surgery, I had adhesions all over the place. My right
>ovary was adhered to my bowel. Basically, my surgeon said it was a
>mess. But he did not re-check the gallbladder area, where I was having
>a lot of pain.
>
>Since my hysterectomy, things have only gotten worse. I have cyclical
>RUQ pain, right under my ribcage, wraps into back/kidney area. It hurts
>in my right shoulder sometimes, and sometimes the pain is all over my
>right side from shoulder down into thigh.
>
>Sometimes the RUQ and wrap-around pain is so bad, I just want to stay in
>bed until it passes. I have head a CT Scan which showed nothing, I have
>had multiple ultrasounds with nothing remarkable found, endoscopy found
>that I had an ulcer that had healed on its own, and I had the H-Pylori
>bacteria. I had to do the anti-biotic treatment twice.
>
>The ulcer medication did not seem to help, and my bowel habits have
>changed. So, we tried the colonoscopy,which only revealed a few spots
>of diverticulosis. They just ultrasounded my right kidney and
>ultrasound on pancreas this morning.
>
>At this point, I need an MD like TV's "Dr. House." There are so many
>things this pain could be, but it doesn't seem like any doctor can
>figure it out, or will take the time to figure it out. Meanwhile, I
>struggle with the chronic pain and useless medical tests.
>
>I am starting to think it's adhesions, since all blood tests for liver
>and pancreas issues have come out negative.
>
>I got diagnosed with Diabetes II, last summer, along with the on-going
>PCOS issues I've had forever.
>
>At this point, I don't know whether to think this is a muscle, joint,
>bone problem, or if this is adhesions.
>
>I'm just tired of living this way. It's been way over 10 years. I am
>not making up this pain, but for the life of me, I cannot find a doctor
>who gives a rat's patoot about helping me figure out what it is.
>
>Have any of you experienced RUQ pain, which starts in the gallbladder
>area, wraps around into the right flank, right kidney area, up in the
>shoulder, and sometimes all the way down into the right thigh?
>
>Thanks for letting me vent.
>
>--
>Lisa
>Atlanta, Ga