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discomfort in upper ab area with fatigue
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discomfort in upper ab area with fatigue

I am a 41 yr old female who has been in excellent health (had -gall bladder removed 3/02, lap chole) until about 4 months ago.  I noticed a slight discomfort in my upper right ab area, not a bad pain just an uncomfortable feeling.  Then I started having mild pain in my upper back, more in the rib cage. (right side also) I also have alot of tenderness in my last rib and in the area of my sternum.  The worst part is I feel tired alot, my energy level picks up at night but during the day it's awful.  Sometimes when I'm standing my upper back feels like it's having a spasm, when I sit down it's better.  I've been to my doctor about this, he thought I may have adhesions from the surgery and also a muscle/skeletal problem.  I have a follow up appt on 12/30, I will insist on further testing.  Even with all of the above symptoms I still look ok, haven't lost any weight and no jaundice.  My ex-husband was just diagnosised with Hepatitis C, we haven't been intimate in over 15 yrs.  That's way past the incubation period, isn't it?  Any insight would be appreciated.
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Avatar_n_tn
Thank you for visiting the Family Practice Forum.

Yes, adhesions are a possibility. There are others including a "common bile duct stone". Essentially, you can have stones which may partially block the main duct that emptys bile from the liver. The pain associated with this can be very similiar to gall bladder pain. Other possibilities are gastroesophageal reflux disease, hepatitis or possibly some inflammation of the pancreas.
In this situation, I would typically get an abdominal ultrasound and blood tests to rule out the possibility of liver and/or pancreas inflammation. (i.e. liver function tests, amylase, lipase). If no results are found with these tests, the next thing to do would be to have a Gastroenterologist do an Esophogastroduodenoscopy (EGD) to look into the stomach and intestine to check for an ulcer or other abnormality.

The last step to take if all the above measures failed to give you answers would be to do a CT scan to see if there are possibly some adhesions. These can be "lysed" or removed laparascopically in many cases.

I hope this helps!
3 Comments
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Avatar_n_tn
So strange...  I have been having the same pain in the ribcage on my but on my left side and in the middle.  Just had a negative ultra sound and tested for an insulinoma due to low blood sugar (50 to 60).  Test was negative also. I dont have liver problems but they did find Hashimoto Thyroiditis.  Have been on Synthroid and now I have high blood pressure (150/106).  Ive been having heart problems for about three years, arythmia and shivers and pain at night. Have been tested and nothing significant.  I  spend every day light headed and I have pressure in my head( feel drunk most of the time). I am exhausted tired all the time and ready to give up.  

The pain in my ribs is sometimes so bad when I wake up in the morning I cant get up for a while.  And like yours my bottom couple of ribs are very tender.  My doctor says its from coughing.  I dont have a cough.  I also have endometriosis and have heard about the effects of too much estrogen.  Pancreatitis/gall bladder/blood clots/ stroke.  The doctors think Im nuts for having all these wierd and unrelated pains and problems.  Im only 33 and I go to bed at night wondering if Im going to wake up.  I hope you find some resolution to the rib pain and if anyone knows what this is, please tell.
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Avatar_n_tn
I too have the same problem with my rib cage and now it's moved up to my neck and head.  Very painful.  I was dianosed with myofascial pain syndrome.  Some days I feel good and other days the pain is so bad I can barely function.  I am going to physio and massage therapy for trigger point therapy.  I am not sure if it is truly working but I do feel better than I did 7 months ago.
check out the web site on myofascial pain syndrome.  If may be what you have.
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Avatar_n_tn
Small world after all. I have this pain in my left rib cage right under the breast area. They have run all kinds of test and nothing has come back as of yet. I have been dealing with this for atleast 6 mths now. They have run all kinds of xrays, blood work.  
    The pain is sharp and I can only describe it as When I was Preg with my oldest she lived in my ribs and would just push so hard I thought for sure she was coming out of the ribs. My doc told me to try going without a bra for 2 wks (did it but I'm big busted and did not like it) this did not work even switched to sport bras this as well did nothing.
Any ideas on what this could be. They have suggested maybe a breast reduce but I'm keeping other opps open
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Avatar_n_tn
Small world after all. I have this pain in my left rib cage right under the breast area. They have run all kinds of test and nothing has come back as of yet. I have been dealing with this for atleast 6 mths now. They have run all kinds of xrays, blood work. The pain is sharp and I can only describe it as When I was Preg with my oldest she lived in my ribs and would just push so hard I thought for sure she was coming out of the ribs. My doc told me to try going without a bra for 2 wks (did it but I'm big busted and did not like it) this did not work even switched to sport bras this as well did nothing. Any ideas on what this could be. They have suggested maybe a breast reduce but I'm keeping other opps open
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Avatar_n_tn
Small world after all. I have this pain in my left rib cage right under the breast area. They have run all kinds of test and nothing has come back as of yet. I have been dealing with this for atleast 6 mths now. They have run all kinds of xrays, blood work. The pain is sharp and I can only describe it as When I was Preg with my oldest she lived in my ribs and would just push so hard I thought for sure she was coming out of the ribs. My doc told me to try going without a bra for 2 wks (did it but I'm big busted and did not like it) this did not work even switched to sport bras this as well did nothing. Any ideas on what this could be. They have suggested maybe a breast reduce but I'm keeping other opps open
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Avatar_n_tn
I too have had pain in my upper ribcage area.. sometimes it goes into my back and when I sit down it hurts worse.  I experienced spasms this weekend in my back from it.  The pain under my ribcage causes nausea sometimes too.  Sore to touch most of the time and when I lie down at night especailly on my right side.. it feels like there is something there that should not be there.  I try to move around for comfort and eventually fall asleep.  I notice that some things I eat make it feel worse....like roughage (carrots or bran cereal etc)  I have been having these pains for a long time now and it seems to be getting worse.  Most of the time it's a dull pain but, its always there.. I have thought about going to have an ultrasound but, didn't know if that would help them diagnose me?
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