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Suggest Remedy For Severe Pain Under The Rib Cage

Posted on Thu, 2 Jul 2015

Question: Pain under left rib cage. its at the bottom and does seem irritated by sitting. The pain is more burning than anything else. I work in an office setting and am sitting for 10 plus hours a day. I have had issues with the left side of my stomach for years with no real diagnosis. Had two endo's, blood tests, ultra sound, xray and stress test all came back fine. Endo's came back slight hiatial hernia, and risk of barretts. I am 41, 5/9, 200 pounds. At the bottom of the rib on left side it does feel rubbery and like there might be something stretched there.

Answered by Dr. Dr. Muhammad Sareer Khalil (30 minutes later)

Brief Answer:
Likely to be related to GERD/ Gastritis

Detailed Answer:
Hello and Welcome

I appreciate your concern

Based on your description the pain is most likely not cardiac. However, an EKG should still be done as even in non cardiac chest pain, tightness or discomfort, the heart has to be ruled out first. In my opinion the pain is related to the hiatal hernia predisposing to esophagitis and barretts esophagus. Patients with hiatal hernias , commonly have recurrent gastritis /GERD episodes that can mimic as chest discomfort or pain. In the presence of risk of barretts esophagus, you should be on PPIs like esomeprazole at optimum dose. If the risk was documented then you should discuss your doctor about the option of starting you on these medication. In the acute discomfort phase, sucralfate, bismuth subsalicylate and metoclopramide should also be added to relieve the current episode and PPIs should continue till the next endoscopy is done to assess progression.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

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

Follow up: Dr. Dr. Muhammad Sareer Khalil (4 minutes later)

my last two EKG came back the same, blood work in Oct was good, lost 10 pounds since. I do have back pain but more concerning is there any tendons ect that connect to bottom of the rib cage on the left side that when I touch it feel rubbery? Burns when sitting, could this be more IBS related

Answered by Dr. Dr. Muhammad Sareer Khalil (2 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hi.

Yes, Costochondritis related to localized rib tenderness is also a possibility and is treated with NSAIDs alone to see for improvement. IBS is unlikely as its more commonly associated with lower abdominal pain. There is also a vivid association with disturbed bowel movements. I would still maintain that its more likely to be related to the gastritis.

Let me know if you have any query

Thanks.

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