Suggest Treatment For Symptoms Of Musculoskeletal Pain In Rib Area
I have a stitch type ache on my left rib which moves to the right rib and then slight pain in the centre of the abdomen. It's been like this for 3 weeks. I also have hemmroid. Now I started to get back pain when I sleep not sure if it's because I am lying down too much.
Additional information required
Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Mr XXXX
It would be very helpful if you could provide me with the following additional information for me to be able to assist you
1. Is the pain in the ribs continuous pain or its intermittent type of pain associated with any aggravating factors ?
2. Do you have associated heartburn?
3. Do you have any nausea ot vomiting
4. Is there any pain in the ribs on applying pressure or dies pain aggravate on pressure ?
5. Do you presently have any symptoms attributable to hemorrhoid like bleeding per rectum ?
6. Does the back pain increase in any posture ?
Awaiting your response
Take care
Best regards
Dr Deepak Kaltari
Consultant Surgeon
2. Heartburn not really
3. No vomiting
4. Its more like a stitch than a pain or a dull ache. Yes in some places it does but it moves.
5. No bleeding right but there was a week ago.
6. If I am lying down.
Been feeling fatigued as well not sure if that is because I think i am suffering with my sinusitis.
I also had a small bowel resection 15 months ago from trauma from an accident.
Likely to be musculoskeletal pain
Detailed Answer:
Dear Mr XXXX
Going by description given its likely to be fatigue and malaise associated with viral prodrome especially involving respiratory tract .
I would suggest you the following
1. Hot water fomentation : Either by using cloth soaked in hot water or using hot water bag. It will relieve the pain and muscle spasm . It wil help relieve the rib and back pain
2. Analgesic like Ibuprofen will be helpful
3. Also do take acid suppressant like Pantoprozole
4. Adequate rest and avoid sleeping on back. Sleeping on side either left or right will be helpful
Do get back to me if you need any further assistance, will be glad to assist you.
Wishing you and your family a very happy and healthy life.
Take care
Best regards
Dr Deepak
Unlikely to be Pancreatitis
Detailed Answer:
Dear Mr Deevashan
Pancreatitis or issue related with bowel resection will usually have other associated symptoms like nausea / vomiting, loss of appetite or features of adhesion of bowel. Do isolated complaints of vague pain is likely to be musculoskeletal pain. I would also suggest you to maintain your hydration and nutrition by adequate intake of water and meals.
If the pain worsens or you develop new gastrointestinal symptoms then do consult your physician for further assessment.
Wishing you a very Happy New Year 2015
Take care
Best regards
Deepak
Thanks but i have not been alot over the last few days abd have been having this gurgling noises on the left side past my ribs.
Kindly follow the advise
Detailed Answer:
Dear Mr XXXX,
Kindly follow the advise and things will definitely improve.
Take Care
Best Regards
Dr Deepak
I went for xray, it showed up nothing
Normal X ray is reassuring
Detailed Answer:
Hi
Normal X ray is very reassuring. I hope you are relieved of your symptoms.
Take care
Best regards
Dr Deepak
I am not feeling better from the advice. What do i do? Should the xray have not showed up anything?
Further assessment by Ultrasound scan
Detailed Answer:
Hi
X ray may fail to reveal many of issues. In such scenario I would suggest you the following
1. Thorough clinical examination from your physician
2. Ultrasound scan of abdomen In consultation with your Physician
Take care
Best regards
Dr Deepak
Kindly get back to me with report
Detailed Answer:
Dear Mr XXXX
Kindly get back to me with the report.
Take care
Best regards
Deepak
Pancreatitis ruled out
Detailed Answer:
Dear Mr XXXX
Negative Lipase test conclusively rules out Pancreatitis. Kindly get a thorough clinical examination from your Physician apart from getting Ultrasound scanning done.
Take Care
Best Regards
Deepak
Negative Lipase test during pain rules out Pancreatitis
Detailed Answer:
Dear Mr XXXX
As I had earlier mentioned to you that pain is unlikely to be Pancreatitis in light of symptoms of only isolated pain in abdomen. An episode of Pancreatitis will usually not last so long. As you are still having pain , negative lipase test during episode of pain rules out Pancreatitis. Ultrasound scan will further confirm it.
Take care
Best regards
Deepak
The pain has been shifting between ribs and the centre.
Isolated pain is pain occurring alone without other symptoms
Detailed Answer:
Dear Mr XXXX
Isolated pain means only symptoms of pain without other associated symptoms like nausea, vomiting or loss of appetite.
Did you get a thorough clinical examination from your Primary care Physician?
What was his/her clinical impression?
Awaiting your response
Regards
Deepak
Look for mesenteric lymphadenopathy
Detailed Answer:
Dear Mr XXXX
Apart from routine assessment, ask them to look for following
1. Free fluid in lesser sac
2. Subphrenic collection
3. Any bulkiness in Pancreas
4. Collection in Hepatorenal pouch (Between liver and renal)
5. Mesenteric Lymphadenopathy
Take Care
Regards
Deepak
Kindly consult your physician if pain still persist
Detailed Answer:
Dear Mr XXXX
If the pain is still persisting then would suggest you to consult your physician for further assessment. Normal Ultrasound scan is very reassuring.
Take care
Best regards
Dr Deepak
What do you mean is assuring?
I am having a scope tomorrow to rule out possibilities.
What is your general feeling?
Likely to be acid peptic disease
Detailed Answer:
Dear Mr XXXX
Normal Ultrasound is reassuring means there is unlikely to be significant intrabdominal pathology as cause of symptoms. In my opinion possibility of Acid peptic disease with Gastric /Duodenal ulcer is likely cause of symptoms.
Do get a clinical examination from your physician
Take care
Best regards
Dr Deepak
What was the clinical opinion of Physician
Detailed Answer:
Dear Mr XXXX
What was the opinion of Physician on clinical examination?
Awaiting your response
Take Care
Kindly get back to me with report
Detailed Answer:
Dear Mr XXXX
Kindly get back to me with the report.
Wishing you a very happy and healthy life.
Take care
Best regards
Dr Deepak
The scope revealed i have inflammation in my stomach.
Start on Proton pump inhibitors like Pantoprozole
Detailed Answer:
Dear Mr XXXX
As I previously mentioned to you that acid peptic disease with ulceration is likely cause of your symptoms. I hope H Pylori infection was ruled out during a scopy.
Were any acid suppressant medicine started by your Physician?
I would suggest you the following
1 . Ensure intake of meals at regular intervals.
2. Do not skip meals
3. Avoid carbonated / alcohol / caffeinated beverage
4. Antacid like Pantoprozole will be helpful
5. Liquid antacid containing Sucralfate will be helpful
Do keep me updated about progress.
Take care
Best regards
Dr Deepak
Even though it cganges with posture.
Likely to be acid peptic disease
Detailed Answer:
Dear Mr XXXX
Acid peptic disease could have variety of presentation. It definitely explains your symptoms.
Take care
Best regards
Dr Deepak