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Severe pain under right rib cage
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Severe pain under right rib cage

I've been having pain and fullness under the right side of my rib cage for the past 5 days. Pain also radiates to my back under shoulder blade. It feels like something is really swollen (like my liver) or as if a balloon is inflated underneath my ribs.  Stools are normal, no nausea/vomiting.  I went to the urgent care clinic today, and they sent me straight down to the ER.  My CBC, liver and pancreas blood labs were perfect, as was my CT scan to check for a kidney stone (I have a known history of stones). My gallbladder was removed in May 2004 due to a low ejection fraction (13% as shown on HIDA scan) and since that surgery have had no symptoms until now.  The ER dr. gave me a prescription for Prilosec (in case it's an ulcer)and also a script for Vicodin for the pain.  She also scheduled an appointment with my gastroenterologist for me next Monday.  She was going to order a HIDA scan, until she phoned the surgeon who did my GB surgery, and the surgeon told her that the HIDA would not show anything of value at this time, and that an ERCP would be more appropriate. How likely is it that I could have a gallstone stuck in a duct?  Even though I never had gallstones before (even when I did have my GB!)??  This pain is moderate to severe and waxes/wanes and doesn't seem to change with eating.  The only other odd thing I have noticed is that when I drink something cold it feels very strange going down and "coating" my stomach.  Could I have an ulcer?  Is this what ulcer pain feels like?  I highly doubt it's IBS, as the pain is localized and I have no diarrhea.  Thank you for your thoughts.
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I agree with the ERCP.  This can be done in conjunction with a Sphincter of Oddi (SO) manometry to evaluation SO dysfunction.  This can also determine whether there is a stone in the bile duct.  

An MRCP can also be considered to look for a stone in the bile duct.  

If these tests are negative, an upper GI series or upper endoscopy can be done to rule out an ulcer.

These options can be discussed with your personal physician.
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_
11 Comments
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With the pain under the right rib, and what feels like a balloon is placed underneath it; with shoulder pain, and pelvic aching, WHAT IS THIS?
I have had blood work ups, bone scans, specialists and everything keeps coming back normal, and my husband and I just remain in disbelief.  How can something this painful be normal?
I am holding the meds down to a half aLortab every other day, but my Dr. thinks I'm a loon.  Despite the fact that I rarely see him, and he has always been my doctor.  I am 42, with my gall bladder removed.  Does anyone have any ideas?
Thanks!
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Avatar_n_tn
I am having a similar problem.  I began having pain under my right rib cage and in my back this summer.  In October, I was diagnosed with gall stones and had my gall bladder removed.  Many of the symptoms I had beyond the initial pain (nausea, balloon in the chest after eating) are gone, but the pain is still present.  I recently had a sonogram, an MRI w/MRCP and all results were normal.  I don't have other issues that would indicate increased ductal pressure, so there is doubt that this could be Sphinchter of Oddi...so I'm at a loss, as are my doctors.  I've been referred to a specialist who may get back to me in a few weeks..yikes....who would possibly do an endoscopic examination...

Any suggestions????
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Avatar_n_tn
Severe pain under right rib cage, along with pain/ache around to the back. I am 42 and have had this pain on/off since i was approx 12 years old. i have had my fair share of doctors and tests etc, whilst i am unaware as to what the medical term for this complaint is i have found a way to deal with the pain, prevent it from happening and think i know what can cause it.

DEALING WITH THE COMPLAINT :
when it first comes on  . . . . . cease eating. Drink only still water - (nothing else), as much as you can ( two pints min ) wait approx 15-30 mins then stick fingers down throat until bile comes up, then approx another two pints of water and repeat above, after the 2nd or 3rd try of induced vomiting take a measure of gaviscon and or asprin, eat only fruit(apples or bananas) not oranges for next 12 hours and get at least nine pints of water drunk in the next 24 hours.

PREVENTING THE COMPLAINT
do not go without breakfast if you do eat slowly and small amounts.

do not allow yourself to dyhdrate if you do avoid fatty, smoked,dairy or spiced foods.

CAUSE OF THE COMPLAINT
DYHDRATION, tiredness, skiping breakfast, lack of fibre, fatty or spiced foods etc.
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Avatar_n_tn
I think I have got your answer.  I have had and still have the same exact symptoms...SAME....the bloating like a balloon under rib cage, and pain....and I was diagnosed with "H. Pylori". I felt exactly like you and I was put on a round of 2 different anti-biotics which helped tremendously but now its back so tomorrow I go back to the dr. The test for H. Pylori is simple and cheap, just a ***** of the finger and in 10 minutes you will have your answer. The #1 symptom is pain under the right rib cage.  I thought it was my liver and gall bladder, but when the tests came out positive for H. Pylori the dr. explained that the stomach is right in that area also.  Good Luck.

Kat
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Avatar_n_tn

Oh my gosh, I just re-read your post and Im so freaked out by the similarities, even down to the Loratab.  I have never taken pain pills before, but now with the pain of the H. Pylori (dull gut pain, pain on right side under ribs, bloated stomach) I have been taking (not prescribed) 1 loratab in the morn and one in the evening.  Gosh, it really helps me to feel like a normal person for awhile. I can function just fine until it wears off.  By the time my H. Pylori is cured I am going to have to get off the loratab, which I hope isnt too hard since I only take 1-2 a day.
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Avatar_n_tn
I think that you also need to be tested for H. Pylori...you have exactly the same symptoms also that I had before I was diagnosed.  It is an infection that causes peptic ulcers.  Read up on it, you may be glad you did!
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I've been all over the internet trying to search about the intense and many times unbarable burning pain under my right rib cage that the doctors just can't seem to figure out and came across this posting. I'm a 36 year old female and been having this issue now for a few years. I've been thru a multitude of tests from GI docs to gyno docs. The "attacks" hit random with no real pattern at times then will hit harder about a day before my period. I don't know if this helps but after an exploritory surgery and many adhesions were removed around that area built up from previous surgeries, including gallbladder removal, I was finally diagnosed with interstitial cystitis, or IC. After a few treatments for this and maintaining the diet my doctor put me on to help control it, the attacks are not as frequent. Also try using a lower acid coffee. Pureroast coffee seems to be the best that I've tried but I have to order it off the internet. I'm still unsure if this pain is related to the IC because I'm on Prilosec OTC for acid reflux and reglan, but the treatments for IC and the restricted diet helps. IC is a condition of the bladder but has many effects to the entire digestive system. My other symptoms ranged from vomiting, diarrhea, sometimes constipation, elivated white cell count and blood in the urine. The best thing to do is stay away from spicy foods among a few others. Another thing is to drink a lot of water and cut back on fruit drinks (including wine) because the acid in them as well as soft drink with carbonation. If your at the end of your wits with this pain (believe me, I've been living it too) do some research on IC and doing abdominal streching exercises regularly. I found that helps too. The attacks still do hit, but like I've said...not as intense and much fewer. Another thing I've been looking into is the effects of some diet pills I had taken a few years back as well (I'm not saying the name - I don't want to get sued!!!) but it's just a thought.
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Have you thought about adhesions? Your gallbladder operation could have caused them, and they hurt like h...! You could try visiting http://www.adhesions.org. They have a great site with lots of information.
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Try a chiropractor...MAYBE.  I have had the same symptoms for years...on and off.  and EVERY time it happens, my chiropractor can "fix" it in a ouple of visits.  My situation is a floating rib that moves too much...and pokes into things it shouldn't.  My GP was SHOCKED after many tests/scans barium stuff etc showed nothing but a visit ot the chiropracter did...and has noted it. Can't hurt to trry...Just explain what you are feeling...and what you've been through.
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I have similar symptoms, all intermittent and sometimes quite nasty: nausea, diarrhea, cramps and gas, right side dull ache and fullness at the ribcage, easily over-full, and lactose intolerance. I had an US, and my organs are lovely.  I'm 1 yr successful post interferon treatment for Hep C, with very little damage from the HCV.  The treatment was very very very hard on my digestion, and it has not returned to the old days. It is worst if I drink wine, but as I don't do that much, yet have the problems anyway.  I'm to get colonoscopy.
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Ok...after doing a lot more research I found semething that may actually be the cause of the issue...celiac disease or gluten intolerance, not adhesions. There are many sites for information and after reading everything I have, it just makes sense. Make sure you read about other names for gluten on labels when purchasing food. It's hidden, but it's practically in EVERYTHING!!!!! Try it or ask your doctor to order the blood test for this. NO MORE scopes, x-rays, surgery, medications (unless the disease has gone too far then some medications may be given), missing work, missing life!!! I'm trying the gluten free diet myself...things are looking up!!!! Sure it's a life style change but it's worth it for no more pain! I had to post this, people need to know about it. GOOD LUCK!!
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A related discussion, nuasea vominting post H phylori infection was started.
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