Conversation: The conversation between human and AI assistant.
[|Human|] 55 yr old female. I have been having pain in the upper right abdominal area under and below ribs also to the back - 4 days now. The pain is worse when I burp or hiccup (diaphragm spasms?). Deep breaths also are difficult. Pain sometimes radiates or refers to the collar bone area.
[|AI|]  HI. Thanks for a perfect book-picture type symptoms you have noted. There is an inflammation of the Liver and / or under-surface of the diaphragm. The most common cause of an abscess in the upper part of the liver. Another causes are irritation on the diaphragm by abscess. There is a possibility of a Cancer of the liver. This is also causing the referred pain to the collar bone area, worsening on burping or hiccough. I would advise the following:Blood tests - routine, WBC for infection, blood sugar to rule out diabetes. Kidney functions, liver function to determine the damage to the liver. Urine StoolUltrasonography to start with and may be necessary as a guidance for biopsy and / or aspiration of the abscess / mass. CT scan to confirm and to plan the treatment.