Pain in lower ribs

About 2 years ago I began to feel intermitant pain in the upper right side of my abdomen (directly below the bottom rib).  Occassionally the pain would come in the same place on the left side as well.  I underwent both an ulrasound and Hida scan.

The ultrasound showed that I had 2 echogenic rounded foci  in the gallbladder that "do not dispay definite posterior acousticshadowing", and are most likely noncalcified gallstones.  The HIDA scan showed a normal gallbladder with no duct obstruction.

In the two years that I first started feeling the symptoms, the pain has come and gone, sometimes I go months without feeling it.  Lately the pain is back, and it is as present on the left side as the right.  I also feel some slight pain in my upper back.

If it were the cysts in my gallbladder causing the pain, would I feel the pain on the left side as well?

Is it worth undergoing these scans again?  

If there is no obstruction, do doctors ever perform a cholecystectomy?

And if not, is there any danger of just living with the symptoms indefinately?

Thank you.

[Kevin Pho, MD]

To answer your questions:
1) It is possible that the cysts may be causing the left sided pain.  However, you may want to evaluate the pancreas as well as upper digestive conditions that can also cause left sided pain.

2) A CT scan or upper endoscopy can be considered for further evaluation.

3) With a normal ultrasound and HIDA scan (with CCK stimulation), I cannot see an indication for a cholecystectomy.

4) It would depend on what is causing the pain.  I would consider the tests mentioned above before resigning yourself to living with the discomfort.  

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.
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