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PAIN UNDER RIGHT RIB CAGE "EVERY" MORNONG !!!!!!

I am 57yrs. old and for the last 2 months I have been having this pain in the morning that starts in the center of my stomach and works its way to my right side. I have Barrett's espohagus, a hernia, acid reflux, IBS, and diverticulitis.  But I have never had a pain like this before, it wakes me up, but after I have a bowl movement then the pain goes away until the next morning. I am taking Nexium 40mg., and it has helped greatly with the acid reflux and I guess the Barrett's espohagus. I have been to my GI doctor and and he just feels my stomach and says, your fine. Well, something is causing this pain ! I would go see another GI doctor, but I live out in the country and the nearest other GI doctor is 87miles away and isn't always there since he has another office thats over 100 miles away. If anyone has any idea what might be causing this pain, their input would be greatly appreciated.
13 Responses
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4851940 tn?1515694593
My husband is in the same boat as you regarding the Hiatus Hernia not being bad enough for surgery.

So he takes  Pantiprazole and occasionally Gaviscon.  He would be in agony with the Pantiprazole.

Best wishes
Helpful - 0
Avatar universal
Yes its a Hiaus Herna, my doctor has had me checked about 3 times and he doesn't believe its bad enough for surgery. But he is keeping an eye on everything.
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875426 tn?1325528416
So, while the GI doctor sounds like they have done/are doing a couple of very important things- keeping an eye on your esophagus and having given you a G.E.R.D. diet, did they neglect to tell you there are also special dietary measures a patient should take when they have irritable bowel syndrome and special dietary measure to take when they have diverticulitis?

In case the answer is yes to either or both of these, please see private message.
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4851940 tn?1515694593
When you say you have a hernia, is this a Hiatus Hernia that you are referring to?

Or a hernia that you get when the bowels protrude and this can be seen as lump on the belly?  This type of hernia can be repaired if it is too bothersome.

My husband has a really bad Hiatus Hernia which he has had for many years, and has never been offered a repair for that.  I have recently researched and have found that a laparoscopic repair of hiatal hernia is available, I am wondering if this is a fairly new procedure.

Although laparoscopic repair of hiatal hernia is available, I am wondering as to the reason you may not have been given this option.  Is it because of your Barrett's espohagus?

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Avatar universal
Yes my Gi doctor checks my Barrett;s everytime I see him. I also have a diet for the acid reflux. And he did not say anything about repairing my hernia.
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875426 tn?1325528416
Is your GI doctor regularly checking with EGDs on your Barrett's esophagus?  Have they given you a diet to follow regarding the acid reflux, the irritable bowel, and diverticulosis and did they treat your inflammation  (diverticulitis)?  Did they say if your hernia should be repaired?
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4851940 tn?1515694593
What you have written to me sounds like excellent advice that your doctor has given your and your own thinking on the matter.

Anxiety is a horrible thing and can cause gastric problems (you will know with having IBS).  I used to be really ill running to the loo every minute before I appeared on stage to sing solo.

Wind too travels round the digestive tract and when it is blocked it is extremely painful.  One year my aunty was taken to hopsital as an emergecy with suspect heart attack - it was wind.

Follow the good advice that you have been given by your doctor and avoid any foods that give a lot of wind.  Have a word with your sister-in-law explaining the problems you have, so that when you eat the foods she cooks, she can modify them.  I do that a lot.  I know what you mean though, because I love to cook, experiment with food and baking and I just love to eat.  Unfortunatley I have put on a lot of weight which is no good for me or my arthritic body.  I keep kidding to myself that nothing is wrong, when in fact I too have all sorts of problems.

It is important though to make sure your bowel movements are regular so that you do not get blocked up as this will start of a very painful bout of diverticulitis.  My daughter who is 32 has suffered really badly with that causing such severe pain that at one point she nearly had her appendix whipped out.  She refused to stay in hospital and still has her appendix.

Taking each day at a time is a great idea.

Best of luck and best wishes.
Helpful - 0
875426 tn?1325528416
The right side of the transverse colon is a notorious place for gas pockets to collect, so the mentioned possibility of gas along with your relief when you have a b.m. makes it a likely suspect.  You might try taking some simethicone (which I hear can take about thirty minutes to work)- an over the counter medication for gas and see if that helps.  

If you are sleeping a certain way that is irritating your musculoskeletal system in that area, like if you sleep with your fist in that area, which I think has happened to me on a number of occasions, you might consider costochondritis, though that pain would be likely to remain and not leave after you get up and have a b.m..

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Avatar universal
I just had all my blood work done and everything was normal. I have diveticular, and a Hiatus hernia. I have been eating yogurt my doctor told me about that, and yes I have a lot going on in my life so thats why the IBS acts up now and then. I try to stay away from fatty, fried and foods with a lot of acid. My sister-in-law is a great cook so it is hard to stay away from what she cooks. I have been checked for gallstones and there were none. I do remember my doctor telling me I had a lot of gas moving around in my stomach and intestines. I don't feel sick or have jaundice, my blood pressure is 120/78 which is great. I do suffer from anxiety and that doesn't help. I do sleep on a real soft feather bed, and a friend told me maybe I should go back to just the boxspring and mattress and see if that helps. I do drink a few beers now and again. Maybe 8 bottles in a month. My doctor did suggest that I try eating warm oatmeal and take some fish oil and see if that would help. I am starting to think that maybe my anxiety disorder might have a lot to do with it, I'll have to ask my doctor about it the next time I have to see him in May. I read up on Anxiety and it can cause a lot of problems. So I am going to take it day by day and see what happens. Thanks for the information.
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4851940 tn?1515694593
I don't have a problem with my liver or gall bladder, but to help you I have copied and  pasted below the information for you to decide whether it is a gallstone problem.

What I do know from friends who have had gallstones and had to have them surgically removed is that they were in excrutiating pain and going to the toilet to open their bowels did not settle the problem.  They also were very jaundiced (yellowy tinge to the skin).  They (two of my friends had them, one was a middle aged person and the other a young perons) they used to describe their  pain like a screw driver being drilled under their right rib cage.  They were not able to eat anything fried or highly spiced foods because it made things much worse.  One of the friends had loads of little gall bladder stones surgically removed (they were a lovely brown orange and yellow colour that she kept in a jar).  The other friend just had one big stone the size of an egg.  But with pain I would supposes everyone experiences different levels of discomfort.

When I was in hospital many years ago having my kidney stone removed as a matter of medical urgency, I did talk with other patients on the surgical ward  and quite a lot of them, different ages and sexes that had their gall stones removed showed me.  I was amazed at all the different sizes and colours that I saw.  Some were very small little pebbles and others quite large.  I couldn't beleive that a gallbladder stone could be the size of a large hen's egg!

*******

Symptoms of gallstones
The most common symptom of gallstone disease is biliary colic, which is caused when a gallstone temporarily blocks one of the bile ducts.

Bile ducts are tube-like structures that carry bile from the liver to the gallbladder and then into the digestive system.

Biliary colic
Biliary colic is a sudden, intense pain that usually lasts for over an hour (although sometimes it can last just a few minutes). The pain can be felt in:

•the centre of your abdomen, below your breastbone and above your bellybutton
•the upper right of your abdomen, with the pain travelling towards your shoulder blade
The pain is constant, dull and is not relieved when you go to the toilet, pass wind or are sick.

The pain can be triggered by eating fatty foods and it may wake you up during the night.

Biliary colic usually happens infrequently. After an episode of pain, it may be several weeks or months before you experience another episode.

In addition to the pain associated with biliary colic, a number of people also experience:

•feeling sick
•being sick
•excessive sweating
Doctors sometimes refer to biliary colic as uncomplicated gallstone disease.

The progression of symptoms
If you do develop symptoms of biliary colic it does not necessarily mean you will go on to develop a more serious form of gallbladder disease such as acute cholecystitis or acute pancreatitis.

It is estimated that only around one in 20 people with biliary colic will then go on to develop more severe symptoms.

Doctors use three categories when describing gallstone disease:

•gallstones without symptoms – asymptomatic gallstone disease
•gallstones that cause episodes of abdominal pain (biliary colic) – uncomplicated gallstone disease
•severe forms of gallstone disease – known as complicated gallstone disease
When to seek medical advice
If you think you may be experiencing episodes of biliary colic you should make an appointment with your GP.

You should seek immediate medical advice if you experience any of the following symptoms:

•jaundice – yellowing of the skin and eyes
•abdominal pain that lasts longer than eight hours
•a high temperature combined with chills
•abdominal pain so intense that you cannot find a position to relieve it

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Avatar universal
Just a guess, but a pain under the right rib cage seems to me to suggest the possibility of an irritated gall bladder and/or gall stones. But whether the pain would move from the center of the stomach to just under the rib cage, I can't say. Maybe you could search "gall stones, gall bladder problems" on this website or some kind of diagnostic search engine to see if that might be it.
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4851940 tn?1515694593
When you see your doctor next time, it may be worth asking him to take a blood test to check your liver function.

Also an ultra sound of the gall bladder and liver.

With all the other problems you have I trust you are avoiding all fried and highly spiced foods.  If you do drink alcohol and can't stop, you need to keep it to a minimum.

It could be trapped wind.

Best to keep a diary of what you eat and drink and a record of when these symptoms occur.  I know you said you experience this pain in the evening and it is gone after a bowel movement, so suggests that it could be connected to your bowels and may be trapped wind.

Diverticulitis is inflammation of the diveticular in the intestines.  It only becomes diverticulitis when there is inflammation of the protruding bowel that forms a little pocket (just like a side street off the main road)..  Most people over the age of 40 (so my doctors says) have this condition.  Your bowel movements need to be kept regular otherwise when you get constipated, the feces can get forced into the diveticular (pocket) and cause inflammation and extreme pain.  

When you say you have a hernia has this been repaired, or is it a hiatus hernia (the flap that closes off the stomach from the esophagus?

I suffer from Acid Reflux, I have a deviation in my esophagus.  I find eating little and often and not overindulging helps.  My husband has a hiatus hernia, and although he is on medication (can't remember which one), I still have to be careful with regard to how I cook our food.  Anything fried is no good for both of us.

As you have IBS, (I get that when I am nervous), are you OK with taking live culture yogurts?  If you are, it may be beneficial to help with your gastric problems.  

Also avoid any acidic foods and those that cause you a lot of wind, like sprouts, brocoli and cabbage (even though they are good roughage).  

If you like porridge and can eat it, that may help.  My husband is fine with porridge and adds raisins to it.  Athough he cooks it with milk, you can also make it with water if your have an alergic reaction to milk.

Best wishes
Helpful - 0
Avatar universal
Do you still have your gall bladder? My gall bladder attacks were in my right side and would move around toward my back. They woke me every night.  My doctor overlooked it because I wasn't vomiting and didn't run fever.   An ultra sound will show gall stones.
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