
What Causes Abdominal Discomfort Below Rib Area?

i have abdominal discomfort, right side just below the rib area. When drinking warm water, i feel the heat of water more towards the right side. i visited a doctor and asked for certain test and accordingly, i had done LFT, KFT and whole abdomen Ultrasound ,and reports were normal. However, when thumping ,while standing or sitting, with hand at the back-right side around rib, i feel some kind of pain within(right side), but it is less felt when i stand and bend forward. It has been almost a year or so.
The expert with the Ultrasound equipment asked me if i have constipation. i feel i have some problems with this, but not sure. He suggest me at that moment that i may have some colitis problem.
Six months before i had taken the CT scan of whole abdomen and there also it is normal. i had appendix removed in 2005 and since then this problem has been in and out.
Your advice is sought.
Thank You.
XXXXX XXXXXXX XXXXXXX
Possibilities as mentioned.
Detailed Answer:
Hi XXXXX XXXXXXX XXXXXXX
Thanks for your query and an elucidate history.
To recapitulate :
History says appendectomy in 2005 - pain as described by you since then - all tests done reported as normal - discomfort just bellow the right rib area- feeling heat on drinking warm water - elicitation with thumping for about a year - USG expert thinks of colitis-
From your detailed history I can think of a few possible reasons for such kind of pain: as follows ::
-Amoebic hepatitis: a simple course of Metronidazole or Tinidazole is sufficient as a diagnostic tests and therapeutically curative.
-Colitis : can be due to amoebiasis and treatment is the same as above.
-Gastritis : the feeling of warmth on warn water is indicative; Upper GI Endoscopy and a course of Ranitidine ot PPI, Domperidone and an antacid can be most helpful. Soft bland diet. No aerated colas / soda/ drinks.Early dinner. No late nights. Treatment for anxiety (as prescribed / needs a prescription by your Doctor). Lying in a reclining position. Walk around after dinner. Think of the factors which increased the present problem, GERD, anxiety and try to avoid.
If no relief, get Upper GI endoscopy done and get prescription for added Medicines.
-Costo-chondritis of the lower ribs: there will be a local tenderness ( pain on pressure ).
A good clinical examination by a General Surgeon can hep you to get a diagnosis and get treated as per the clinical findings.
Once the diagnosis is done, treatment can be easy and curative.
I hope this helps you as it helps many of my patients.
Please feel free to ask for more if you need to and you may please rate this answer.
Wishing you an early recovery.
Dr T Chandrakant
ENT and General Surgeon

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