Have Acid Reflux, Rectal Bleeding And Discomfort Below Rib Cage. No Fever. Suggest Some Cure

Posted on Fri, 4 Jan 2013

Question: My father was diagnosed with colon cancer when he was 52, he is now 64. Due to his history and I had some rectal bleeding, I began receiving colonoscopies at 37, am now 42. The doctor found a polyp when I was 37 and another at 40. I get colonoscopies every three years. For the past 2.5 years, I have had occasional discomfort right below the right rib cage. My blood work has always been normal as was the ultrasound. I also seem to have acid reflux from time to time. Prilosec does help, if needed. What could the discomfort be? No pain, fever, or bowel issues. It is more like a weird pressure. No medical emergencies.

Answered by Dr. Dr.P.Ratnakar Kini (4 hours later)

Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini, Gastroenterologist and I am pleased to answer your query.

Discomfort on the right side below the rib cage could be due to gallbladder issues, liver issues, peptic ulcer disease or sometimes a simple muscle and nerve pain.

Since ultrasound and blood tests were normal, gallbladder and liver issues are less likely.
I would suggest that an upper GI endoscopy be done to rule out peptic ulcer disease.
If that shows normal stomach and duodenum, then the discomfort may be as mentioned earlier a muscle or nerve pain.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (15 minutes later)

If I chose to not have the endoscopy, what are my other options? As I mentioned before, Prilosec does help. Can a person be on Prilosec for life? One thing I failed to mention, sometimes with the discomfort, I have very mild pain that seems to travel to my right side. It also seems that the pressure travels as well. Very strange. One thing I should mention, the ultrasound results showed some thickening of the gall bladder wall. I am not sure if this is related to the intermitten pressure after eating.

Answered by Dr. Dr.P.Ratnakar Kini (10 hours later)

Hi,
If you do not want endoscopy, the other option is to take prilosec and see the response.
Since you find improvement with Prilosec, continue taking it. Take it for 8 weeks.
If symptoms recur on stopping it, you can be on low dose maintenance dose. You may not require it for life. In addition to prilosec the following should also be done.
1. Weight reduction if obese
2. Avoid alcohol, smoking, coffee, citrus, tomatoes, fatty food, onion, carbonated beverages
3. Eat smaller but frequent meals
4. Avoid bedtime snacks
5. Go to bed at least 2-3 hours after food

Thickening of the gallbladder wall may indicate cholecystitis which can cause pain in the area you have specified especially after a fatty meal. You can also have a HIDA scan done to assess the function of your gallbladder.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar