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Pain in upper right quadrant under rib cage


Hi I am a 38 year old female and have pain in the upper right quadrant under my rib cage which radiates to the center of my back. I excercise 3 to 4 times a week at the gym with cardio and mild weight. I am still about 15 lbs over weight (I was more over weight 2 years ago). This pain actually started about 8 years ago. About 6 years ago I had my gall bladder removed.
The pain did go away for several years. After the gall badder surgery, the surgeon did make a comment that my liver kept getting in his way and he had to move it a couple of times and that it is big, but he said it did not look abnormal. I was in a lot of pain after the surgery and he kept me overnight in the hospital. The URQ pain started up again about 4 years ago. I have had all kinds of tests in the past year. A hida scan (no CCK since I do not have a gall bladder) was normal, barium swallow (I do have GERD and hiatal hernia). An edoscopy showed no ulcers, ducts all clear, normal liver etc... I also had a sonogram of my stomach, liver and pancreas - all normal. I have had 2 blood tests in the past year for my liver and pancreas- both came back normal. This info is not directly related, but wanted to mention that I had a total hysterectomy in Nov 2003 but this URQ pain had started up again prior to this surgery. Sometimes its a dull ache, sometimes it feels like I have ran for too long (but I haven't), sometimes it feels like a mild charlie horse (it actually spasms).

My doctor has just prescribed Reglan a few days ago (I haven't started it yet). What other tests can be done, do you know what could be causing this pain? It's gotten worse in the past 8 months.

Thank you,

Lena
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233190 tn?1278549801
MEDICAL PROFESSIONAL
One consideration would be Sphincter of Oddi dysfunction.  This is a condition that can occur in those without a gallbladder.  

Typically, Sphincter of Oddi manometry done in conjunction with an ERCP would be needed for diagnosis.  If present, surgery or endoscopic procedures can be done to correct this.  

The upper endoscopy would rule out many of the major upper GI diseases.  You can consider a 24-hr pH study to evaluate for GERD or esophageal motility studies to look for motility disorders.

These options can be discussed with your gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
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Avatar universal

This is a continuation of my earlier post. I should include that I have been tested for H Pylori - negative. I had the upper GI test and abdominal X-rays - all tests came back normal. I have IBS symptoms (bowel symptoms). My appetite is healthy and I have occasional nausea when I miss my prevacid dose (my stomach burns). Thanks, Lena
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Avatar universal
I am a 39yr old women and for the past three weeks I have been having pain in my upper abdoman , ribs and shoulder blades. I have had a CT scan and blood work and they could not find any problems with my Gallbladder ,liver and or Kidneys. I have also had soft stools. has anyone had this before
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131185 tn?1224288876
I have had this exact same problem. I am 22 years old, of average weight and no other serious medical conditions. I have had this problem for a few years now. The pain is in my upper-most abdominal region. The pain is most prevalent when I'm laying down and have to urinate. In the mornings the pain is sometimes so severe it wakes me up out of a sound sleep. Even though I urinate, sometimes the severe pain persists. During the day it is not as painful, but still a dull pain. My doctor doesn't even know where to start since he thinks I am making this up. What should I do?
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Avatar universal
My wife is having similar problems, don't start questioning youself as to if you're making it up.  She had a rude doc say something along those lines while she was in the hospital and it was devastating on her morale.  My wife's problems have not yet been diagnosed but hopefully over time we will solve it.
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Avatar universal
I have had a dull nagging pain under my bottom right rib for several years.  At first my doctor blew it off as nothing.  This year he guessed it was gall bladder related - referring to the  - "fair, fat and forty" connection.  However after an ultra sound - that was not the case. They thought they saw kidney stones but after an x-ray test with dye in the kidneys that was ruled out.  

The only thing they found in the ultra sound was "fatty liver" a lesion on my liver. Liver function is normal.  I've been taking statins for over 10 years for high cholesterol and I have to wonder if this long term use has caused a lesion.

It sounds like this typd of URQ pain is fairly common and hard to pin down the actual source.

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Avatar universal
I have very similar symptoms, except I am a 31 year old male. I first notice symptoms during a long distace car drive (Oct. 2005). It started with back pain directly behind the gallbladder, which felt like muscle strain. Within two weeks, I had a sunburn sensation below my right ribcage that has never ended. The sensation is always there with varying intensity. Two weeks after the sunburn sensation began (about 1 month after the original back pain), a physical, knotting pain in the gallbladder area of my abdomen. It felt as if I had a bloated organ, so I went to an ER. There, they did a complete blood count, urine test, multiple x-rays, and a CT scan only to say that nothing was wrong, other than a small amount of white blood cells in my urine (ie, kidney or bladder infection). Since then, the pain has intensified (knotting internal pain, sunburn sensation, and back pain) and I have went to a second ER. This time at the University of Tennessee Medical Center. They too, took a blood and urine sample and confirmed that all counts were within normal limits. This doctor did however palpate the abdomen and pressed on the exact spot that hurts internally, which caused elevated pain. He identified this spot as the area where the gallbladder and liver is located and said that I may have a growth/tumor on the gallbladder or possibly, gallstones. He suggested I go to a family practioner for ultrasound, since there was no emergency to be addressed at the ER.

I have not noticed an increase or decrease of intensity before or after eating. Also, when I sleep at night, it is more comfortable to sleep on the affected side.

Since Jan. 12, 2006, I have seen my family physician who sent me to a gastrointestinal doc for gallbladder testing and probably removal.  After a hidascan, colonoscopy, an endoscope, and many blood test, there are still no answers- everything was normal.  My GI specialist referred me back to the family doc for musculo-skeletal conditions.  Not sure what other test should be done, will take any recommendations and let you know what we find out!
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Avatar universal
I have been having pain in the upper right side of my stomach and a buldge on the right side at my navel and my right side has been swollen since Sept. 2005. I have had every kind of test that is offered. My Doc. has told me that I may have to have my gallblader removed and I have an appt. with a surgeon, but the Doc. still cannot explain the buldge I have, he told me the 1st time it was probably fat! Well, I'm not overweight. Something is wrong with me & I want rid of it. I have looked on the Web and noticed info. on a Mass, which seems to explain the pain and buldge, it read:usually with a mass-buldge there is some type of infection in the white blood cells and my Doc. told me the 1st time that my white blood count was slightly high,and I recently asked him about this and he still said he didn't know what is wrong with me, except PROBABLY my gallbladder, BUT WHAT ABOUT THIS BULDGE THAT HURTS!? Hopefully I will get a better diagnosis from the surgeon
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Avatar universal
Unfornately - I am so glad I'm not alone. I've had the same URQ pain that everyone is talking about for the past 2 years. I had an utrasound and they determined I had gall stones. I have recently had my gall bladder removed (2 weeks ago) and the pain is now worse.  It's a continuous subtle pain but at times is pretty bad.  The pain actually wraps around to the right side of my back under my rib cage. I guess my only option is to go back to the doctor and start the blood and urine tests all over again.  I also had a CT-Scan that showed nothing wrong with my kidneys or liver.
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Avatar universal
I was looking on this site and found this condition. I suffered with the same pain for years and could not find a doctor to help me. I had my gallbladder removed years ago and still continued with the pain. I finally found a doctor to give me an ERCP and they found I had stones and sludge in my bile ducts. The ducts are connected to where your gallbladder used to be. They performed a sphinctorotomy (?spelling?) - it's when the cut the bile duct and put a stint to drain the bile. It is very minor and done under a local (like an endoscopy - the ERCP is almost the same exact procedure). Good luck.
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Avatar universal
The first time I noticed this pain in the upper quadrant, right side of my stomach was on a 10 hour trip and then again back home, another 10 hr drive.  I have seen 2 doctors about it and one said it was too much stomach acid ( with out any tests) and the other wants me to have xrays and other tests.  I have no gall bladder, also experience no heart burn yet the doc gave me Proactin which I have taken 3 doses of and no help there.
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Avatar universal
The first time I noticed this pain in the upper quadrant, right side of my stomach was on a 10 hour trip and then again back home, another 10 hr drive.  I have seen 2 doctors about it and one said it was too much stomach acid ( with out any tests) and the other wants me to have xrays and other tests.  I have no gall bladder, also experience no heart burn yet the doc gave me Proactin which I have taken 3 doses of and no help there.
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Avatar universal
I have been stuck in this seamingly never ending cycle of testing for very similar problems. I have had horrible pain under my right rib cage that usually causes back pain as well. The pain in my rib cage is constant, burning, and feels like I have swelling of an organ. I have had hyda scans, drank berium, numerous sonograms, blood work, urine work, and test done on my stool (I guess to rule out bleeding ulcers). I am 26 years old, I am within normal height & weight range. I eat healthy and really don't have any other health problems. My most recent doctor thinks I'm nuts and that there is not a problem. He said that my gall bladder works fine and at this point has ordered no further testing. I have had this problem for 14 years. My attacks used to only happen once a year and last for 24 hours, but now they happen once every couple of months and last for 2-4 days. Often times they will cause vomiting and keep me completely unable to eat or sleep. I have tried removing fatty foods from my diet--I rarely eat anything fried. I have tried removing caffiene as well. Does anyone have any suggestions on a test I should press for from my doctor--or how to get him to send me to a gastro-intestinal specialist. Even any suggestions on possible diet changes or herbal remedies that have helped any of you. I am really becoming desperate and will be looking for a new doctor soon for help. Thanks.
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Avatar universal
Is breathing difficulty present?.....I to have the sensation of burning in the rib cage area....other times it feels "knotted up" with the :sunburn" sensation.....anyways it's been 6 months and the pain with the difficulty getting a free deep breath is getting me a little worried.....mostly it's just annoying having to deal with pain from the moment I wake to the moment I fall asleep.......
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Avatar universal
Hi... I have had the same pain in rib cage area about 4 years ago, been to several gastronologist's and they found nothing. My pain in the rib area started about a week after I had an appendectomy, was in and out of the emergency room and they could never find anything no matter how severe my pain was.

I had just had throat surgery about 4 weeks ago, due to swollen lymph nodes in my right side of neck and throat all the time. I went to an ENT and I was diagnosed with an ulcer in the back of my throat. Ever since 4 weeks ago when I had my surgery I have been having bad pain under my rib cage again. Also pain in the chest, behind breast bone, pain between shoulder blades, stomach aches and soreness. Not to add the pinching and stabbing pains in my heart I get to where I can't even breath. I was so scared I was having a heart attack one day that I went tgo emergeny room and they ran some test to check out my heart and the doctor says my heart was fine. I went to my PCP and he has been my doctor since I was a child, and I am now 32 years old. Everything my PCP has ever diagnosed me with he has always been right on. He diagnosed me this time with GERD!! I am still having swollen lymph nodes in my neck though and pain everywhere even after a week after the medicine. Hopefully with more time my symptoms will lessen. I hope this information will be helpful.
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Avatar universal
I too have been suffering from this.
For several years I can only describe the sensation as a balloon being blown up under my right lower rib cage, then slowly the air being let out. It is very uncomfortable for me. It has escalated into ruining my life.
Several months ago I started feeling bad, run down, I would get up out of bed from sleeping several hours, use the bathroom and literally go back to bed for severa more hours. I hurt everywhere. I was throwing up all the time.
That is the worst part, everytime I start to vomit, I have the taste of rotten eggs or sulfur in my mouth.
Last night I had another attack.
I talked to my Mother, she says she thinks it is my gall bladder.
That it sounds like what my sister had happen to her.
Well, I dont know. Because 4 or 5 weeks ago, my symptoms got so bad I could hardly stand it and I wound up in the ER.They did a complete CBC, LFT, X rays; the doctor said the only thing he could find wrong with me was my whiteblood count was slightly elevated. So he wrote me a general antibiotic for Septra and Cipro. ( I thought I had mono it was so bad )
Now, those medicines are really strong combined together.
The fever and extreme tireness are gone.
But, I am still hurting all over, have a horrible taste in my mouth, vomiting.
Short of going back to the ER, I dont know what to do. My doctor already thinks I am a hypocondriac.
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Avatar universal
Hi...I unfortunatley am experiencing similar problems but only for about two months now. For me it's been slightly different though. When it began I felt extremely full and couldn't eat anything for a few days and I tasted copper all the time. I've fought with constipation for about 4 years until a few days after I started feeling full, which all the sudden turned to extreme diarrea but only lasted about an hour. My bowel movements are soft and fairly regular now but there is pain in my upper right abdominal under my rib cage. The pain has continued to 'grow' if you will, jumping around to all different areas, which I did not see mentioned above. At times it's under my right rib cage but other times it's below my stomach on the left, beside my navel on the right and in my back on both sides. At times it hurts to take deep breaths. I went to the doctor and my abdomin was sore in several places but mostly beside my navel on the right during the first exam. He ordered a sonogram of my gallbladder and liver, normal. A hidascan of my gallbladder, also normal. He checked my thryoid and pancreas, also normal. I had a CBC, normal. He checked for hepatitis and a few other things, all came back normal so he's referred me to a GI doctor. The doctor says he believes me but doesn't know what it could be but if the GI doctor doesn't find anything for me to come back and we would keep doing tests until we find the problem. He did give me Nexium to try but it didn't help; he also gave me some meds for IBS but they make the pain worse and last longer. If anyone has any advice or knows anything please let me know! After reading all the messages here I'm wondering if it will ever be figured out. (oh, and just so ya know...it does hurt worse when I eat but also hurts when I've not eaten. I do have the burning sensation and sometimes even a more pinpointed pain. Soemtimes it feels as if my ribs are pushing in on my organs or something...so I know how most of you feel) I had began to wonder if I were crazy or something myself so reading all this makes me feel better. Oh, I've also been referred to a Neurologist for possible Multiple Sclerosis so the doctor said it may have something to do with that but after reading this...I don't think so.
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Avatar universal
I was here earlier while searching for an answer to the pain I have had under my ribs on the right side.  I then went to another site and found an answer that made the pain better in a matter of a minute.  I won't put a link, I'll just tell you what I learned.  I'm not doing an ad :)

First I had my gallbladder out 17 years ago.  

The page I read said it may be something called trigger pain.  It said to feel along the ribs until you find the spot that is tender.  Then massage that area.  I did it and the pain was better with in a minute.  I can take a deep breath now.  I balled my hand into a fist and kind of leaned into my fist on my side, massaging the area.

This will not be the answer for everyone, but why not give it a try.

Texas Star
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Avatar universal
I am also suffering with similar annoying symptoms for months now. Pain/dull ache in right rib cage and below like nad stitch. Comes and goes with no prior warning. Ranges from uncomfortable to excruciating. When it is bad it fels like it is hurting all across my chest and back. Had blood tests on liver and kidney, scan for gallstones and now a chest x-ray. All clear but still waiting on chest x-ray results.

I suffer really badly with my sinuses and getting colds and it appears to be worse when my sinuses are bad, but the doctors have said there is no medical link. Also seems to be worse if my sleep pattern is disturbed?
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Avatar universal
I was having the exact same problem as most of you are speaking about since I was nearly 11 years old. There was never anything anyone was able to do to correctly diagnose any of the problems I had. It seemed that if all I ate was fruit, it would go away for a while, but then inevitably, after some time (maybe months or weeks), it would be back once again. And I was in the category that a lot of you are in where the pain was so bad at times, that if I had a gun, I am sure I would have done something permanent to myself.

For relief, I have found that alternating between almost scalding hot showers and sitting silent on the toilet in the normal position, to work to stop the pain in about 30-60 minutes most times.

Over the years (31 years old now) I have managed to fast a few days, and it would be gone for a while. Through doing my own research and observation, and through sheer cooincidence, a friend that has problems with constipation let me try a few tablets of his. From a place online named GHC health:

http://www.ghchealth.com/health-products/product_info.php?ref=167669&products_id=28

I have now been a full time user of these tablets, and while taking them, I have not had any more occurrences of the pain. When I went through a dry spell, and was not taking them, I found that too many espressos or coffee drinks brought the symptoms right back within a few weeks. But it I just moderated my coffee intake, I could get away with only using the tabs every few months or so.

I have recently bought a Green star Juicer, and have found that I can get the same great results simply by going on a juice fast for one week, every 6 months.

My assumption of this problem is that it has something to do with constipation, or some form of obstruction of the large intestine. The reason I say this, is because there was a time when I was having a nice hot shower, and the pain started shifting from upper-right abdomin, to center, to left, then started to drop as though it was descending towards the backside to be pooped out! The process took about 30 minutes from the start ofthe pain's movement, to ready to dump.

Now combining that experience with understanding what the Oxy-Powder in the above link does,  it makes sense to me that the pain is some form of bowel distress caused by an impaction or adhesion or something with the fecal matter.

Anyhow, I would highly recommend you try that supplement at the link above. It was kinda pricey, but the fact that it helped my pain go away on a semi-permanent basis, I couldn't put a price on that!! Also, a whole body cleansing has done me good as well, to help clean out my liver and kidneys. Here is the link to their cleansing system.

http://www.ghchealth.com/health-products/product_info.php?ref=167669&products_id=197

Please post back here if this information helps any of your conditions.
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Avatar universal
I am going through a similar situation and am awaiting results of bloodwork.  I just wanted to comment that my gastroenterologist tested me for celiac sprue which is inherited and my father and sister have it but it just started getting more recognized in the United States.  When my father got diagnosed I did research and there is another country that tests all children for this.  I remember reading that Irish and Italian descent are prone to it.  Sprue is an allergy to Gluten which is wheat products which can be found everywhere.  Even in chicken broth.  The other poster said that the symptoms subsided when they only ate fruit but maybe it is because they stop eating gluten products.?? My father couldnt hold anything in and the doctors had no clue what was wrong with him.  He always had cramps and other similar problems.  He thought he was dying of cancer and then finally he went to another doctor who recognized it right away because his wife had it.  My sister also has it but did not have diarhea,rather she just had cramps everytime she ate and even when she didnt her stomach and abdomen would bother her.  You may want to investigate this. Like I said I am unsure if that is the reason for all of my pains, hopefully I will find out when the tests come back.
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Avatar universal
I am a 37 year old male and have had this pain off and on for the past 3 years.  I first noticed the burning sensation below my right rib, but then about a year ago, the pain started to appear below my left rib occassionally as well.  Then, the pain would go away for a couple of weeks or months, and then reappear.  Has anyone also had the pain on the left side as well?
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Avatar universal
Hello All...I'm not a doctor but 2 weeks ago I ended up in the hospital following a bout with pain like many of you seem to have.  It was diagnosed as pancreatitis.  I don't know if it was acute or chronic...but it was maybe my 2nd attack.  I saw my regular doctor Monday and she discussed my case with her GI friend at the PolyClinic here in Seattle.  After reviewing recent blood work and her relaying my symptoms to him, he thinks it is a Sphincter of Oddi dysfunction, considering my gallbladder is gone.  This dysfunction can lead to attacks of the pancreas!  There is an invasive surgery they can do to MAYBE relieve the problem, but I'm told it's a bad diagnosis and a bad surgery.  My doctor told me today the idea is to prevent it from coming back.  They believe this can be done via frequent, small, low fat meals.  She suggested I see a nutrionist to assist in my diet.  She left me with the comment that "you will want to be very, very good."  When there is a problem with this organ it is extremely difficult for it to digest fat.  If the sphincter is malfunctioning, the digestive enzymes from the pancreas will back up into the pancreas and it will digest it self.  None of this is good!  If I have another attack, I will be referred to one of two doctors in the Seattle area who deal with a possible Sphincter of Oddi issue.  I'm scared so I will definitely stick to whatever diet I am told to stick to.  So far, so good...I am eating low fat on my own, smaller, more frequent meals and I'm doing pretty good.  I hope all of you find answers to the cause of your pain.  You may want to mention Oddi to your doctors.  I did on Monday and when my doctor called me today she started out by saying, "I wish I'd said what you said on Monday...it would make me look a lot smarter".....Good luck everyone.
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Avatar universal
I am 35 yrs. old and I have had my gall bladder taken out, I am having pain right below my right rib cage, when I bend over adn I am sitting on the floor and I lean over it is like having a charlie horse very sharp pain, if I straighten up and push on it, it feels like it moves out of the way, I am going to the Dr. Wed. but if anyone as had this please responded back please, and my back does not hurt at all.

Thank You
Texas Girl
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