Upper right quadrant pain

Hi everyone, i had a query
Does CHB ever cause pain ?
Lately I have been experiencing mild discomfort in back behind right side of my ribs.
How do we differentiate between pain related to hepb or something other?

PS : didn’t know under which thread should I post this , so posted here.

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Dear @Kevin,

Thanks for your question. Definitely a lot of people with Hep B report abdominal pain in the upper right hand side. And it is true that inflammation of the liver can press up against surrounding tissues and cause pain. But, of course, there are multiple reasons that may be causing your pain that you might want to consider (muscular injury, indigestion, poor posture, etc.).

The way to find out if you have liver inflammation is to get a liver function blood test; this would test your ALT levels which are increased if your liver is inflamed. Another option is to get an ultrasound to look at your liver directly.

Hope this helps,
Thomas

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Thank for the information @ThomasTu

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Dear Thomas,

I am grateful for Kevin’s question. In summary (not sure if you remember all the conditions of participants): Diagnosed as chronic HBV carrier in March 2021 after detection from donating blood, 52 year old male with high blood pressure treatment, primary and gastro theorize vertical transmission at birth based on lab work and other factors, 2 years of blood work prior to March 2021 normal, colonoscopy in May 2021 was fine, ultrasound in June 2021 shows no damage to liver or other vital organs (“unremarkable” results), viral load 325, gastro did not advise medications at this time because of viral load and other lab work and ultrasound, and both tell me I’m fine and to stop worrying.

Now, very strangely, two months later, I worry something is wrong because I have been and am experiencing the following:

. no pain but discomfort in all angles of abdomen: top, bottom, side, middle. When I apply slight pressure, no pain but seems “gassy.” A bowel movement, passing gas, or burping make me feel better and “relieved.”

. no pain but discomfort down sternum (maybe indigestion but not sure)

. no pain but a sensation on both sides of rib cage when I apply pressure to the area to massage my side

. no pain but discomfort in lower and middle of back and on both sides of the spine (right now, sensation is on the right side)

. no pain but ever-so-light sting in abdomen area after eating some foods or drinking acidic beverages

. “mild ‘shooting’ sensations” on both sides of chest and tingling pins-n-needles sensation in both hands, both feet, toes, finger tips

. some mild body aches which go away after taking ibuprofen or tylenol

Most of the above occur while standing or walking. I feel hardly anything when sleeping or lying down.

Having said all this, none of the above interfere with work, intimacy, exercise, driving, eating, etc. I just massage my abdomen and chest area a lot to feel better.

I do not want to freak-out over every strange feeling or when I get sick nor do I want to blame HBV for every odd sensation or feeling in my body.

Your thoughts and experiences will be appreciated. Thank you for your time.

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Dear @hopefulone ,

Great question. These sort of sensations are difficult to diagnose (especially over the internet), so the best thing would be to go to your doctor for any worries you have. Sorry I can’t be of more help, but it doesn’t sound like something that would come about specifically from Hep B infection.

Thomas

Thank you Thomas for your quick reply. My symptoms just seemed really odd after getting good results on ultrasound. Some of my symptoms are quite similar to @kevin. But also some symptoms I get are just all over the place. I just relocated to a new executive job in another state where resources/options are limited (2 hours to major city!). I need to reestablish health providers again. May it’s all related to “relocation stress.” But the good news is that I am a few hours from Mayo Clinic.

  1. Are there key symptoms of an “inflamed” liver that we should watch out for?

  2. When I read about pain in the right upper quadrant, what might that feel like? I only ask because I read about all these degrees of pain from “dull” to outright “stabbing” pain. What I feel is definitely “dull.” I just never know if the pain is “referent” pain – coming from one area but felt in another. The brain is a tricky thing. :grinning:

Thank you.

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Hi @hopefulone , just like you I have also been experiencing pain / discomfort in the upper right side of the body just below the chest. I consulted my Hepatologist and she informed me that the pain is not due to liver condition. She asked me to take some meds to get rid of any worms in the stomach, which is pretty common in South East aisa. I also regularly take rice husk with warm water at night before sleep which helps me in my acidity and keeps the stomach clear. I have realised on days when the stomach is clear the discomfort is less / unnoticeable. As you also said may be it is all in the mind because after diagnosis I have become very sensitive about my health.

Best, as suggested by @ThomasTu is to get a Liver Function done and if there is any inflammation ALT levels will be elevated. Chances are very less if you have done the test recently as I have come to understand these things do not happen overnight.

Just like you and many others I am learning new things about this disease and trying to embrace it rather than think of it as a major speed braker in life.

Responses from Thomas and Joan to various threads in this community give a lot of strength to live normal lives.

Best// CG

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Dear @hopefulone, the only way to really be sure that you have an inflamed liver is an ultrasound or ALTs.

It’s quite tricky because the liver itself doesn’t have any nerves, so you can’t really feel the pain directly. Flare-ups (which are associated with inflammation of the liver) can be felt as vague symptoms, such as fatigue, pain in surrounding muscles, or flu-like symptoms. They could just as well be from any other number of infections (e.g. a cold) or stress.

Great that you could find a potential cause of your discomfort @CGNepal. I hope it helps you to a bit less anxiety about your health.

Thomas

Dear @CGNepal,

Thank you for your feedback. I really appreciate it. Communicating with others “living” with chronic hepB is really important for all of us I think: good for our mental health and physical health.

I hope you continue to share more about your experiences as I intend to share mine.

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Dear @ThomasTu,

Thank you for your feedback and time with this community. I will continue to share how much you, @Joan_Block, and @john.tavis you are appreciated. You and this community are really helping me to learn a new way of living with chronic hepB.

Your response does two things: (1) reminds me of the flaws in our great health care system and (2) makes angry that all of the “vague” symptoms I’ve had in my lifetime COULD have also been indications of having the hepB. But I am also so grateful that I am 52 years old and good ALT and enzymes blood work and “unremarkable” results on ultrasound for major organs.

Assuming that I indeed contracted at birth, I am doing pretty damn good! I want to celebrate that and send that positive energy throughout this community.

In closing, as a precaution, I will expedite finding a new physician and hepatologist where I now live.

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Great attitude @hopefulone, and thanks for your positive thoughts. It’s great that you have maintained good health despite the Hep B and I think that should be celebrated! It shows to all of us that we can live pretty normal lives with hep B.

Yes, there can be gaps in the health care system, but it’s important to recognize that it could be worse as well.

Of course you can feel angry about missing the symptoms, but really I am not going to the doctor every time I feel tired or under the weather otherwise I wouldn’t be able to live my life. Same to for the medical community: out of everyone that complains of some mild ache in their side, the proportion of people that are hep B positive is probably quite low. I think you can see the problems on their side too as they are squeezed for time.

Good luck with your search and hope it all goes well,
TT

I discovered my hepatitis B status a year ago with the the following Lab results:
HBsAg #Reactive
HBsab #Nonreactive
HBeAg #Nonreactive
HBeAb #Reactive
HBcAb #Reactive
And I have not taking any antiviral drugs even no ultrasound till date but now am having some discomfort in my right side rib cage,the right shoulder blade pain, sometimes the whole of right back, and it’s extending to the whole back for weeks now. Just want to know if it’s related to liver condition or any other known illness. Thanks

Dear @DMs,

Thanks for your question. As mentioned above, it’s hard to assign a particular symptom to Hepatitis B specifically or know if it’s from something else. It might be helpful to get a liver function test to see if your ALTs are high.

In any case, you should see your doctor about this long-term pain to see if you can find the source of the problem and try to treat it.

Thomas

Dear @DMs and others,

I have been experiencing similar symptoms for about a month now but they do not prevent me from doing anything, especially exercise. For me, it’s just the nagging sensations and discomfort in back, sometimes right side, sometimes left side, sometimes right smack in the middle, and sometimes lower back region. I also feel discomfort that feels like being bloated. Sometimes I get these quick bursts of sharp pain on both sides of my chest or other parts of the abdomen.

I was diagnosed in March 2021 after donating blood at work. All my blood work prior to March 2021 has been good so no sign of problems at all, ultrasound results are good (June 2021), viral load was 325 (April 2021), colonoscopy was fine (May 2021). Since the diagnosis, I have been experiencing a considerable amount of stress and abdomen discomfort. My gastro and primary both told me I’m fine and to stop worrying and that “it’s probably stress”. In addition, I experienced a lot of anxiety because of work stress AND from the joy of a huge new job. Yes, in the midst of getting a great new job, I received the diagnosis. Talk about life punching you in the face! But maybe this is when I needed to know.

I am a bit concerned because I have experienced symptoms as yours (and others on this site). But I also worry that my mind is playing tricks on me (could all this be happening right AFTER the diagnosis?). I also need to STOP googling symptoms and conditions every time I feel a discomfort or ache or read or hear about someone suffering or passing away from a disease. My diagnosis has made me hypersensitive to so many things that I never really paid attention to. I do not want to blame my condition for every ache or pain or sensation.

Now, I am in a part of the country where it is so hard to get immediate care locally. Getting an appointment to see a gastro is 3-4 months out in a few places! Thankfully, my 6 month check-up is around 3-4 months.

This site has been incredibly helpful. @ThomasTu, @Joan_Block, and @john.tavis have been God-sends and such a blessing.

Well, forgive the long story but I think it’s so important that we share how we are living and what we are experiencing in real time a long the way to help others and to even advance understanding about living with chronic HepB.

Stay encouraged!

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Thanks bro. I went for an ultrasound and the result came out good

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Thanks. I went for an ultrasound and this was the results

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Hi @hopefulone, thanks again for sharing your experiences. I think it is important to keep this context in mind. Hep B is something that we can manage long-term and shouldn’t have to take over your entire life.

Not relying on self-diagnosis via Google is good advice. A real-life doctor is usually going to have a better overview of what’s likely and what isn’t compared to Dr. Google. Everyone’s mind is primed to focus on the more exotic and high-impact possibilities, rather than the more mundane and more likely reasons (particularly when they’re already stressed or their own health is at stake). Having an independent and experienced person there is really important. Doctors know this, and go to their own physicians themselves rather than treat themselves (@Suwang88 can probably share her experiences).

Great to hear that your liver looks fine, @DMs. ALTs should be able to confirm this.

As I’ve mentioned above and in other threads (e.g. Titling feet and pain on the righ shoulder blade), it may be worth considering other reasons that may be causing your right side discomfort.

Hope this helps,
Thomas

Hi Thomas,

Just want to say thank you for your insightful response: “Having someone independent and experienced there is really important. Doctors know this, and go to their own physicians themselves rather than treat themselves.” I can’t tell you how many times I misdiagnosed myself or scared myself witless by consulting Google.

TM

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Dr google can be your best friend or worst enemy. When I first diagnosed with hep b about 4 years ago, I looked up all kinds of stuff. Now I just live with possible outcomes.

I was like 1 out of 10-12 Asians might be chronic hepatitis b patient and then realized I was making up the 1 out of every 10 people lol.

Stay positive

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@DMs,

Thank you so much for sharing your ultrasound results. Congrats on the results! They give me hope since you and I had some similar symptoms. Unfortunately, where I live appointments are out 3-4 months which, thankfully, is around my regular 6 month check up.