Rib,back pain, nausea

I am 50 yo female who has experienced intermittant pain in my right  rib area (suggestive of gall bladder problems) and pain in my back behind rht shoulder blade.  Pain moves around ribs and abdomen-lower right and back-sometimes shoulder then lower flank.  Pain in rib first started about 1 yr ago - sometimes stabbing, stinging, burning, or ache.  Pain in abdomen is sometimes stabbing, sometimes spasmodic sometimes just hurts. Recently, started experiencing nausea, anorexia and quick fullness when I do eat.  Often experience a wave of nausea upon awakening. Having difficult time maintaining weight.  Just discovered, after a message that a lot of muscle in the right side of my back has atrophied (do have degenerative disc disease).  Also recently started experiencing rib pain on left side as well.  I've had a negative abdominal ultrasound, CT, hida test (97% ejection fraction-no pain with cck inj) and colonoscopy.  EGD showed mild gastritis, next up small bowel study.  Very anxious and depressed...worry about pancreatic problems as grandmother/uncle died of pancreatic ca.  GI doc will not do EUS due to potential risk of injury without any CT finding.  Not sure if back/gi problem related.  Is there such a thing as hyperactive gall bladder and what symptoms can result?   Where do I go from here..docs are at a loss???? (btw - I am not overweight, minimal consumption of wine.)  THANK YOU

[Kevin Pho, MD]

I agree with the testing done thus far, and it has been comprehensive.  With a negative CT scan and upper endoscopy, as well as a HIDA scan that was non-revealing, you may want to look outside of the GI system.

This can include musculoskeletal disorders, or a bone disorder of the rib area.  A bone scan would not be unreasonable, and further imaging can be followed-up depending on the results of the scan.  

To further evaluate for a muscular cause, a referral to a physiatrist (a rehabilitation physician), can be discussed with your personal doctor.

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 Pho, M.D.
www.kevinmd.com
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