dietician question:

Lately I have had severe pain in my upper right quadrant, just beneath my ribcage. The pain is "rolling", "cramping", "hard" pain. The onset is almost exactly 2.5 hours after eating a normal meal. For example, a meal of white chicken breast (no skin), baked potato chunks with very little cheese sauce, kale and a root beer float for desert was finished at 7:35 PM. By 10:10 PM, the pain described above occurred. This pain lasts for about 3 to 4 hours, during which time it is always constant although of varying intensity. It seems to radiate toward my back on the same side (right). No aspirin or other commercially available painkillers have any effect. I have used some PERCOCET and this seems to do the trick.

Now. this same pain occurred four years ago. I saw a MD who suspected gallstones. I had a sonogram that showed nothing (all normal).

Question: What the heck is going on??




Well rather than playing doctor whom is not my specialty or yours, I would suggest you get a second opinion. Chest pain is not something to wait around to go away. Actually symptoms of a gallbladder attack mimic a heart attack.

Your description of food eaten, delay in pain after a meal and pain below the sternum with radiation around to the back describes common symptoms of gallstones. I would suggest that you go back to see your doctor rather that waiting out the pain. Newer tests are available to help diagnose the cause.

The above meal contains baked potato skin, cheese sauce, kale and the ice cream portion of the root beer float, which would aggravate gallstones along with large portions of any of the other foods. Until the cause of the pain if found, I would suggest you follow a low fat, low fiber diet with 20% of calories from fat,. Also, avoid foods with seeds or skins, limit whole grains, fresh fruits and vegetables to the cooked version. Also, don't overeat at meals.

Your liver produces bile, which is stored in the gallbladder until a meal. Bile is an emulsifies that pushes fat molecules apart to allow enzymes from the pancreas to break down fats prior to absorption. If you have gallstones, especially if they block the duct coming out of the gallbladder or going down to the intestinal tract, that could be the source of your pain, which will not be, relieved with aspirin or other painkillers. PERCOCET is a prescription narcotic that increases the amount of enzymes from the pancreas in the blood and probably providing you some relief. Go see and doctor.