When referred to a gastroenterologist for intermittent pain in the upper right quadrant of the abdomen (slightly under the rib cage), my friend was told that she probably had an ulcer and the doctor needed to do an endoscopy to confirm.
My friend has gone to two doctors so far regarding intermittent but intense pain in the upper right quadrant of her abdomen (slightly under the rib cage). Her GP considered it to be possibly gallstones and referred her to a gastroenterologist to get an ultrasound and further treatment. The gastroenterologist, however, thought it was most likely an ulcer and that he would need to do an endoscopy.
I'm not looking for an internet diagnosis for her :) Her primary concern is that an ultrasound is less expensive and doesn't involve sedation or require a day of fasting, and she wonders whether the gastroenterologist has chosen a less likely avenue to pursue since he would get paid much more for it. To that end, she wants to know what symptoms can distinguish the two conditions, and potentially consult another specialist before undergoing an endoscopy.
These are the symptoms we think we know:
- Pain in upper right abdomen
- Hurts when you push on it
- Constipation, diarrhea, burping, bloating/gas
- Pain in upper central abdomen
- Pain goes away with antacids (n/a in her case)
- Burping, bloating
Beyond the symptoms, the risk factors appear to be really different: