Can Gout Cause Discomfort Under Right Side Rib Cage?
I can understand your concern about this right rib and abdominal pain. Occasionally, people with untreated gout develop tophi, which are nodules of uric acid crystals that can be found in a variety of places, including the soft tissues around your ribs. Most tophi that cause symptoms are big enough to feel or see, though, so if you don't have any obvious lumps beneath your skin in the area of your discomfort, it's not likely your symptoms are due to gout.
Your history is somewhat concerning for a couple of other problems:
Gallbladder disease is a classic cause of discomfort in the upper right abdomen. Gallbladder pain is typically felt just beneath the right ribs, although it can radiate to the right mid-back or even the right shoulder. Gallbladder pain often increases after eating, too. (By the way, your liver enzymes don't have to be elevated if you have gallbladder problems.)
Another possibility here is peptic ulcer disease. Although ulcers usually get better after eating, I've had many patients whose ulcer pain actually increased following a meal. In addition, ulcers frequently get worse when people ingest something that irritates the stomach lining, such as spicy foods, aspirin or alcohol. Conversely, ulcer pain typically improves with antacids, so that's something to try if you haven't already done so. (I recommend liquid antacids, such as Maalox or Mylanta, rather than chewables.)
All things considered, it would be a good idea to see your doctor again if this pain persists. He/she can take a look to see if you have any gouty tophi or other problems that could be attributed to your gout. A quick abdominal exam is usually all it takes to allay (or confirm) suspicions about gallbladder disease. If your doc thinks that's what's going on, you'll probably be sent for an abdominal ultrasound. If ulcers top the list of possibilities after an initial evaluation, a test to rule out Helicobacter pylori infection (the most common cause of ulcers in developed countries) will be the next step, and you'll probably be started on acid-reducing therapy.
I hope that answers your question, and I hope you get to the bottom of this issue soon. I'll be available if you have further concerns.
Good luck!
If the sensation gets worse when you push on your upper abdomen, gallbladder disease is still a good bet.
Your doctor can help you sort this out.