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tenderness under left rib
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tenderness under left rib

This has been going on for at least 8 months and it does not seem to go away.  Under my left rib cage there seems to be a small lump and there is tenderness when you start to press in. Afterwards I almost feel  a sick feeling to my stomach. I have had an x-ray and the Dr. said that the x-ray showed nothing in that area. I went for a second opinion and he thought it was my gallbladder. I thought that was down in the lower right side but he wanted an ultrasound done and he said that there were a couple of polyps in my gallbladder so he had me get a hydroscan done. They told me that it showed nothing. So what am I to do?? I know that this is not in my head. I have other syptoms (symptoms) as well but I do not know if they pertain to what is going on with the rib problem. Does anybody have any insites to this?? Thanks much
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Avatar_m_tn
Hi,

Barring the occurrence of a rare condition called situs inversus (which means that your internal organs are arranged as a mirror image of the normal, meaning what should be on the left is on the right), You are correct that the gall bladder is on the right side. The organs that are on the left side would be the stomach and the spleen.

Gall bladder disease may present with pain in the midline, some would even have symptoms such as vomiting, as the stomach may be affected as well. An evaluation of the gallbladder would be among the things to do, and it seems that nothing suspicious came up with yours.

Was the lump itself included in the ultrasound? Chances are, the ultrasound may only have been for liver, the gallbladder, and their connections. These are all on the right side. I would be interested in a description of the spleen. However, it is also unlikely for the spleen to act like a trigger to make you feel sick in the stomach. While the spleen may increase in size, it may produce a mass effect. Since it is getting bigger and hence occupies space, you may notice that you feel like you’ve eaten your fill earlier though you haven’t as much as you are used to. Another thing to consider is the stomach itself. This could be evaluated with a dye that you can swallow and repeat X rays are performed or better yet with a scope bearing a camera to inspect the stomach.

An opinion of a gastroenterologist may be important, especially if you would consider getting the scope done.

Stay positive.  
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Avatar_f_tn
Hello,
The ultra sound was mainly for the internal organs. When she used the wand on my left side to get more on the rib cage it hurt. She was very gentle but when she kept having me hold my breath in I had to try a few times with that side because of the pain. The pain starts mainly on the bottom half of the rib cage and goes under the cage. I know at times I need to sit more up right or move a little becuse it feels like there is pressure inside pushing the rib forward. If I hold more daugter who is about 30 pounds on the left side then the pressure will seem to build up and get tight so I just put her down. In the past 21/2 years I did have 2 surgerys. One to remove my uterus which was very overlarged and then later for the removal of my ovaries and bladder repair for a prolapsed bladder. I have had back problems off and on since a car accident when I was about 22 and I am now 42 but this pain in my back is different then the pain from the accident. I think it stems from whatever is going on inside my body. That is one of the reasons why my ovaries were removed. The Dr. thought when I layed down to sleep my bladder would fill up then the bladder some how press agains the ovaries which then would give me pain. The pain would be so bad I had to have my husband pull me up out of bed because I felt like I could not move because of the pain. I still have pain, not as bad but in the same spot always. The pain in the back is almost if you go straight back all the way through from the belly button.  I do get a dry cough that will seem to just catch me every once in awhile and I noticed that probably started about 5 or 6 months ago.

I do no ever feel like vomiting it is just a sickly feeling that goes away after 10 to 15 minutes. I do not get heartburn and I do not have reactions to any certain foods that I may eat. Sometimes I feel bloated and sometimes not. I still have my appetite and I have not loss or gained weight. I have stayed the same weight for about the last year.

Also, if polyps are in the gallbladder does the gallbladder need to be removed?

I will be seeing another Dr the first week in September who is a specialist but do you have any other ideas? I thought maybe I had a problem with the small intestines which lays back in that area but I just do not know what is wrong.  

Thanks for your help and yes I stay very positive.
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Avatar_m_tn
Hi,

The pain you described seems distinctly limited over the area of the rib. There is a nerve that runs along the bottom margin of each rib. If there is a pain in the back where the rib meets the spine, then the investigation would focus on the back. A deformity along the spine may be compressing on the nerve, such as a slipped disk (you can think of the disks as cushions between the bones of the spines, they could potentially lose their shape and occupy spaces that houses nerves). A slipped disk however, happens mostly in the lower spine, close to the pelvis.

Have you ever had shingles over the affected area? These are little lumps which look exactly like chicken pox (they have the same organism causing the disease). The virus inflames the nerves and some patients get chronic pain long after the skin eruptions have cleared.

While you have had surgeries, they involve lower areas of the abdomen. It doesn’t seem likely that nerves high up on the chest would also be involved.

Polyps in the gall bladder would need removal when there is pain. If the size is around 10 mm, or if there is an associated stone, or it is seen to be growing over subsequent monitoring periods, then removal would also be reasonable. The pain over the rib doesn’t sound like it is a projected pain from the gallbladder. If the same symptoms occurred on the right rib margin, then this may be related.

A second opinion may be a good step to take. Make sure your new doctor would be informed of all the tests you’ve already been through.
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Avatar_f_tn
Hello,
No I have never had Shingles or Chicken Pox only the hives for 2 days when I was about 5 years old. I have a very high immune system when it comes to different sicknesses. I do have a back problem but no slip disks or bulging disks. I see my Chiropractor every couple of months for adjustments. I do have a Scholeosis but it stems from my right shoulder and down to the the upper mid back area.

The nurse made copies of all of my chart records for the Specialist so hopefully he will find out what is wrong. Do you think a CAT or MRI would show anything?

Thank you for your thoughts
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Avatar_m_tn
Hi,

The selection of tests would generally be based on what the suspect disease is, going on a fishing expedition by doing a CT or an MRI, may not be helpful. If nerves and the spine are suspect, the MRI would be better than the CT. If the bones are suspect, then the CT may be sufficient.

Does the pain improve after you visit the chiropractor?

An opinion of a neurologist may be important.
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