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What Causes Pain Below The Ribcage Radiating To Abdomen And Back?

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Posted on Sat, 3 May 2014
Question: Hi, Over the past few days I've started getting a dull ache in my right side just below my rib cage. Sometimes the pain radiates to my left side abdomen and back. It reminds me of the aches I would get prior to having my gallbladder removed in July of 2013. It comes and goes in intensity, but there's always a slight ache there. I've read about sphincter of oddi dysfunction and wondering if that may be part of the issue. I also had a 10mm kidney stone last year that needed removal via laser lithotripsy in November of 2013. The CT scan at the time reported approximately 30 smaller stones that have not broken free, but I'm wondering if maybe one of them has now. I also started taking amitryptiline 25mg for nerve pain five days ago. I read that this medicine can cause issues with the liver, so I'm not sure if that may be playing in to this as well. Just a bit confused and frustrated at this point, as this is one more in a line of health issues over the past year. Any information is greatly appreciated - thank you.
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Answered by Dr. Grzegorz Stanko (49 minutes later)
Brief Answer: Stone in bile ducts. Detailed Answer: Hello! Thank you for the query. As the symptoms are similar to gallstones, most probable reason is a stone in bile ducts. Please note that gallstones which you have had, have appeared because you are prone to stones creation. Removing the gallbladder, you have stones removed, but the tendency to its creation has not changed. Some patients after gallbaldder removal, will have stones in bile ducts. Sometimes, the gallbladder is not removed completely, so the small part of it is left. In such small part stones can be present as well. So the first thing you should do is to have abdominal ultrasound and liver tests. This is more probable than Oddi sphincter dysfunction. Kidney stones can give similar symptoms, however frequent urinating, burning while urinating or blood in urine should be also present. Amitriptiline can affect liver indeed. But liver itself does not hurt, especially when it is caused by medicines. Hope this will help. Feel free to ask further questions. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (27 minutes later)
Thank you - this helps me prepare for talking with my primary doctor. I appreciate your time. Have a good day.
doctor
Answered by Dr. Grzegorz Stanko (0 minute later)
Brief Answer: . Detailed Answer: You are welcome. Get well soon.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5798 Questions

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What Causes Pain Below The Ribcage Radiating To Abdomen And Back?

Brief Answer: Stone in bile ducts. Detailed Answer: Hello! Thank you for the query. As the symptoms are similar to gallstones, most probable reason is a stone in bile ducts. Please note that gallstones which you have had, have appeared because you are prone to stones creation. Removing the gallbladder, you have stones removed, but the tendency to its creation has not changed. Some patients after gallbaldder removal, will have stones in bile ducts. Sometimes, the gallbladder is not removed completely, so the small part of it is left. In such small part stones can be present as well. So the first thing you should do is to have abdominal ultrasound and liver tests. This is more probable than Oddi sphincter dysfunction. Kidney stones can give similar symptoms, however frequent urinating, burning while urinating or blood in urine should be also present. Amitriptiline can affect liver indeed. But liver itself does not hurt, especially when it is caused by medicines. Hope this will help. Feel free to ask further questions. Regards.