Tightness/pain beneath right rib radiating to mid and lower back

[revjr]

I'm a 37 year-old male. Approximately 6 weeks ago, I started feeling a tightness and pressure under my right rib. No fever or nausea accompanies it and it doesn't seem to worsen after meals. In the last few days, the tightness, which makes me visualize a golfball under my rib cage, seems combined with a pain in my mid and lower back. I also noticed that the area in my right rib is slightly tender to the touch now. It's most noticeable when I'm lying down. Really a ratcheting up or tightening sensation. My GP ordered a chest CT scan and RUQ ultrasound, both of which showed no "abnormalities." Now he wants to order a HIDA scan. I had a kidney stone in 2006 with radically different symptoms than those I'm experiencing now. My question - is it appropriate at this point for me to ask for a referral to an internist, gastroenterologist, or urologist? Each time my GP orders a test it takes about two weeks to get it performed, and I'm anxious about the length of time this is taking to narrow down and whether I might be in danger of a blockage or infection (if that's not what I'm already experiencing). I mean, what do I do next if the HIDA doesn't show anything wrong with my gallbladder other than wait for him to suggest yet another procedure?

[JimK3145]

I also have experienced the muscle strain in my lower back on the right side. During the day, the stiffness is very low but when I wake up after sleeping, I often note that the stiffness is more pronounced. After I'm up for about an hour, the stiffness returns to the low level state. Like I mentioned in my earlier post, my primary care doc thinks it might be related to IBS, but I would think that if it was, the stiffness would come and go rather than be present all of the time. Lets keep our fingers crossed that one of us three gets some good explanation!

[Leslie44]

The tight uncomfortable feeling is constant for me except while asleep, but it makes it very difficult to get into a comfortable position at night.  Yesterday it seemed that this uncomfortableness was more moderate and is now not half as bad as it was in the beginning, but still there.  I also noticed that it feels like I have some muscle strain in my lower back right side, maybe due to the continuous clenching.  Hope we can all resolve this sooner than later! Regards

[Kevin Pho, MD]

I agree with the CT scan and ultrasound.  The HIDA scan with CCK stimulation can evaluate the gallbladder ejection fraction.   A low number there can be an explanation for the symptoms.  

Another consideration would be an upper endoscopy, which can exclude GERD or inflammation of the upper digestive tract.

A referral to a GI physician would be appropriate in this case to discuss the aforementioned options.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[mikcin]

Maybe you should find a gastro doc and go thru some further testing.  There could be some after effects from your gall bladder removal.  The pain should not be waking you up.  Could it possibly be a hernia?  Does there appear to be a lump around your naval area?  Just an idea.  Also I don't know if you read my posts but I had stones in my CBD that finally were removed thru an ERCP, but my pain was in the URQ area, not the naval.  I would not put off getting checked.  Also I was told that your appendix can cause symptoms such as this.  I know some doctors look at you like you have two heads, but don't give up.....Get to the bottom of it.

[Leslie44]

I'm back, hello all.  After having the CT Scan, they found cysts on my kidneys that could have been there, well, forever, and surprisingly enough not long after the scan, the pain disappeared, at least for now.  It's a mystery, I'll just have to put it down to deferred pain from the cyst on my ovary or simply STRESS which we all feel far too much of these days. I wish you all the best and pray you get some relief and answers soon.

[tpdillon]

Reading all these post show me that I'm not alone in this. I'm 46 and had my gall bladder out about 10 years ago. I still have the pain inder my ribs which radiates to my back. Can last for a few minutes to hours. This comes and goes. Sometimes pain free for weeks to months. When it returns it's daily.
My main concern is a pain that wakes me almost every morning between 4 and 5 a.m.
It's in and around my naval. The only way to get rid of it is to sit up. If I try to lay back down to soon it returns. I dont sleep well anyway but this wakes my almost daily.
I also have had all the test as well as 3 colonoscopys within the last 8 years. My gd is
stumped. Any ideas??