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Suggest Treatment For Pain Under Right Rib Post Injury
Question: I had a series of test at the hospital yesterday due to pain under my right rib. This pain started on January 9th, after being hit from behind by a car while walking. I thought it was a cramp, and dismissed it. But it has come and gone. They did an ultrasound of my gallbladder and of my liver yesterday. My gallbladder is normal, with no stones, but I have an enlarged liver to just over 17 cm. I have been diabetic with uncontrolled sugars for about 25 years. I have a history of morbid obesity, but have lost over 100 pounds, and now weigh 222. I had a heart attack in 2007. I am NOT much of a drinker--less than a dozen drinks per YEAR. My liver and kidney blood tests came back normal. Last week, I suffered a 24 hour bug where I had a lot of diarrhea and some vomiting. I was released from the emergency room by a doctor who said he really did not know what was going on. Should I be worried about my liver?
Brief Answer:
Costocondritis as cause of pain - intestinal bug and obesity for liver
Detailed Answer:
Hi.
Thank for your query.
Read and understood your history and problem.
History of hit from behind by a car while walking on January 9 th is suggestive that the pain under the right rib can be due to the trauma unless proved otherwise.
You already have undergone ultrasonography and shows the gall bladder to be normal and liver is enlarged- just over 17 cm. There is also a history of bug with lot of diarrhea and some vomiting.
The possible reasons for enlarged liver are the intestinal infection that caused diarrhea as all the blood in circulation in intestinal tract is filtered through the liver and hence liver can get enlarged. Another reason is morbid obesity with uncontrolled diabetes.
Since your liver and kidney function tests are normal, do not worry much. Get the proper treatment of 5 day course of antibiotic, metronidazole, probiotic and review the liver by ultrasonography after a few weeks.
As for the pain under the right rib, the probable reason can be costo-chondritis.
This means inflammation of the lower ribs by the direct or indirect trauma the ribs and the muscles must have suffered. This becomes chronic if not treated in time and you had already dismissed it. There are specific test other than the clinical evaluation and actual physical examination by putting a pressure on these points can tell the diagnosis. Once confirmed you need to get the proper treatment under the prescription of your treating Doctor. Oral steroids are the wonder drugs in this condition, BUT you can not take it as this is contraindicated in diabetes. Please get checked on this line and discuss this in detail with your treating Doctor.
I hope this answer helps you in decision making and understanding the causes of all the problems you noted me for.
Please feel free to discuss further the relevant points if you need to or if you feel that there is a gap-of-communication
Wishing you early diagnosis and permanent cure.
Costocondritis as cause of pain - intestinal bug and obesity for liver
Detailed Answer:
Hi.
Thank for your query.
Read and understood your history and problem.
History of hit from behind by a car while walking on January 9 th is suggestive that the pain under the right rib can be due to the trauma unless proved otherwise.
You already have undergone ultrasonography and shows the gall bladder to be normal and liver is enlarged- just over 17 cm. There is also a history of bug with lot of diarrhea and some vomiting.
The possible reasons for enlarged liver are the intestinal infection that caused diarrhea as all the blood in circulation in intestinal tract is filtered through the liver and hence liver can get enlarged. Another reason is morbid obesity with uncontrolled diabetes.
Since your liver and kidney function tests are normal, do not worry much. Get the proper treatment of 5 day course of antibiotic, metronidazole, probiotic and review the liver by ultrasonography after a few weeks.
As for the pain under the right rib, the probable reason can be costo-chondritis.
This means inflammation of the lower ribs by the direct or indirect trauma the ribs and the muscles must have suffered. This becomes chronic if not treated in time and you had already dismissed it. There are specific test other than the clinical evaluation and actual physical examination by putting a pressure on these points can tell the diagnosis. Once confirmed you need to get the proper treatment under the prescription of your treating Doctor. Oral steroids are the wonder drugs in this condition, BUT you can not take it as this is contraindicated in diabetes. Please get checked on this line and discuss this in detail with your treating Doctor.
I hope this answer helps you in decision making and understanding the causes of all the problems you noted me for.
Please feel free to discuss further the relevant points if you need to or if you feel that there is a gap-of-communication
Wishing you early diagnosis and permanent cure.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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