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Ask Dr. Cawlfield Your Own Question
Dr. Cawlfield
Dr. Cawlfield, Doctor
Category: Health
Satisfied Customers: 400
Experience:  Doctor of Medicine 2004, Colorado medical license; Family Practitioner
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I have types II diabetes and a pain in my side. Is the pain ...

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I have types II diabetes and a pain in my side. Is the pain related? Will it go away? It somethimes radiates to my back.

Thank you for your questionCustomer

Can you tell me more specifically where you're having side pain? How long has your side been hurting?

Are you having any other symptoms like trouble breathing, chest discomfort, weakness, urinary problems, etc.?

What medications do you take?

Do you have any other medical problems?

Customer: replied 8 years ago.
NO trouble breathing,chest discomfort, or urinary issues. I have weakness but it is more like fatique, profound before diagnosis and much less now that I am taking medication.

Thank you.

Can you tell me where you're hurting in your side, how long?

What medications are you taking?

Any other health problems?

Are your blood sugars controlled?

Customer: replied 8 years ago.
R side, under rib cage. Meds are hydrochlorothiazide - 25 mg, metformin 2x day, and zoloft - 100 mgs a day. I have had the pain about 2 years. We thought it was gall bladder but the ultrasound showed no stones or blockages. Sugar is not yet under control - normal during the day but high in the mornings. I am seeing my doctor on Monday - looks like I may have to start insulin. No other health issues I am aware of. Have lost 20 pounds in last 6 months since diagnosis. No jaundice.

Thank you. Just a few more questions, ok?

Is the pain under your ribcage more in line with the nipple or more in line with the armpit?

Does anything make this pain better or worse?

Have you been treated for acid reflux?

Have you ever had problems with your pancreas? Ever had pancreatic enzymes checked?

Customer: replied 8 years ago.
More in line with the nipple. No acid reflux. Carbonated beverages, rich foods, and standing for long periods makes the pain worse.No enzyme testing so far - I think I will suggest it.

The pain that you are describing is called right-upper quadrant pain. Three kinds of problems that I can think of cause right-upper quadrant pain and radiate to the back.

The first is gallbladder disease. It sounds like this has been thoroughly evaluated.

The second cause is peptic ulcer disease. Often times an ulcer can develop in the first part of the intestine called the duodenum. This duodenum is located very near the gallbladder and could not have been detected unless you had an endoscopy recently. The most common cause of this type of ulcer is from a bacteria called H. pylori. I would recommend getting checked for this. Also, it wouldn't hurt to try a 4 week course of a medication like protonix or prilosec (both available over the counter) and see how your symptoms go.

Another possibility is chronic pancreatitis. This disease also has pain very near where the gallbladder is and can radiate to the back. Like a duodenal ulcer, this pain is often related to food. Checking for pancreatic enzyme levels in the blood can help detect this problem. If this is your problem, taking pancreatic enzyme pills with your meals can help.

That's about as much as I can think of. Let me know if you have any questions or need any clarification.

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