Hello, On 2/1/15, I had several mixed drinks, (rum &

Patient

Q: Hello,

On 2/1/15, I had several mixed drinks, (rum & coke), & the next morning, I woke up with upper right quadrant pain. It felt like I had an inflated beach ball underneath the bottom of my right ribs. It wasn't necessarily painful, it was just extremely uncomfortable from all the pressure. I figured it was either my liver or gallbladder, so I began a very healthy diet, took lots of vitamin supplements & drank only water. A week passed, & the pain still had not subsided, so I ended up going to the hospital. They did blood work, & everything came back normal. My ALT was 17, my AST was 24 & my Biliruben total was 0.4. They also did an abdominal ultrasound. It checked my liver, gallbladder, pancreas, spleen, & kidneys, and it showed everything was normal. They told me to go to a Gastrointestinalist if the problem persisted, but they didn't find anything that would be causing me to have that pain. In another week, the pressure almost completely went away, however I still felt some pain in my back at the bottom of my right ribs. I abstained from all alcohol until 3/17. I had a few beers, & I didn't feel any pain whatsoever the next day. The next time I had alcohol after that was on 4/6 at a baseball game. I had probably 4 beers, & a few mixed drinks afterwards. The next morning, I felt that abdominal pressure underneath my right ribs again. The pressure wasn't half as bad as it was that time in February, and it only lasted 1 day. I still feel some pain in my back though at the bottom of my ribs to this day. I'm so confused as to what this could be. 2/3 times I've had alcohol this year this has happened, so obviously alcohol is a trigger. I only drink on special occasions, maybe once a month, but I admit when I do drink, I tend to drink a lot. It seems the problem is occurring when I have hard liquor. I'm terrified I have something wrong with my liver, but my blood test was normal, my ultrasound was normal, & they stated my liver was a normal size & had normal echostructure, with no evidence of a mass or biliary ductal dilation. I'm willing to never drink alcohol again, however, I feel like there's an underlying problem that needs to be addressed.


I'm a 26 year old female, 5'7 & 130 pounds, if that info's useful at all.

Thank you so much!

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Hello,   On 2/1/15, I had s...-1
Doctor

A:   Welcome to Ask The Doctor. I understand your concern.

It seems you are suffering from Acid Peptic Disease or Acid reflux.
Pancreatitis should always be considered in case of pain abdomen following alcohol consumption, but since your doctor's have ruled it out, so chances are very less. We usually perform Ultrasound Abdomen and Serum Amlyase and Lipase to diagnose pancreatitis. If they are normal, the Pancreatitis is virtually ruled out.
In that case, we treat our patients for Acid reflux and most of them respond to treatment. For acid reflux, i advise my patients to take a combination of Pantoprazole and Domperidone.You should also take soft, bland diet. In case you have persisting acidity, loose stools, weight loss then you would require evaluation for Malabsorption syndrome like Celiac disease. Upper GI endoscopy would be required if your symptoms don't respond to this treatment. I would also advise in such scenario to get tested for h.pylori infection and to get it treated.
Share my opinion with your doctor before acting upon it.

I hope it helps.
Stay Healthy

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