What Causes Pain In The Ribs?

Posted on Fri, 3 Nov 2017

Question: My husband had a fall of about 10 feet. He did not break any bones according to the ER Xrays, but he has not had a bowel movement since then (5 days ago). He has pain in his ribs when he coughs but otherwise doesn't have much pain. He is 81

Answered by Dr. Ramesh Kumar (14 minutes later)

Brief Answer:
MRI to be done to rule out nerve damage.

Detailed Answer:
Hello Dear,
Thanks for query.
Xray can only show damage done to bones or any structure having calcium in it however as your husband is unable to defecate since last 5 days its suggested that a MRI scan of Brain and Spinal cord should be done to rule out any nerve injury.Signal of defecation are controlled by brain and spinal cord and there are possibilities of damage to some of these nerves after fall leading to moderate to severe paralysis of intestines.Hence as there are no signals from level of brain or spine he can't pass stools.

Proper investigations should be done.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramesh Kumar (15 minutes later)

He is walking around fine. He is up on a scaffold outside my window now. Wouldn't a paralysis be more than just the intestinal tract? Could the muscle relaxant have slowed up the peristalsis of the bowel?

Answered by Dr. Ramesh Kumar (12 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Can you please mention the name and doses of muscle relaxant given to him.If he is walking fine then chance sof major injury are less..Easy way out is give him some lactulose.Its a laxative.If intestines are fine and he is just constipated or intestines are under the effect of muscle relaxant lactulose would cause motions.

Alternatively stop relaxant and see if he passes a bowel in next 24 hours.
Thanks!

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Above answer was peer-reviewed by : Dr. Prasad