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What Causes Pain Under The Right Rib?

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Posted on Mon, 10 Aug 2015
Question: Hi,

This is related to my last question about the pain under the right rib and the iron deficiency that they found on the analysis. So, I have been to the ultrasound and the doctor didn't see anything suspicious. However, the pain persists, especially in positions where my ribs seem to hit whatever that is that is causing the pain.
The pain is usually dull, but yesterdqy, when I was laying on my left side, it turned to sharp pain. Do you have an idea of what it could be, as it is not the liver or gallblader? Is it somehow linked to my iron deficiency?
Thank you in advance for responding.
Best regards,
XXXX
doctor
Answered by Dr. Grzegorz Stanko (2 days later)
Brief Answer:
Gastroscopy should be done.

Detailed Answer:
Hello.

Thank you for the query.

Do you have low hemoglobin level or just low iron level? What is the MCV and ferritine level?

As the gallstones are ruled out, second on the list is stomach and duodenum. Peptic ulcer especially in duodenum can give similar symptoms. The pain is usually aggravated by foods intake or when you are hungry. Nausea can appear. Peptic ulcer can be related to low iron level as ulcers can bleed.

I suggest you to have gastroscopy as the next step.

Hope this will help. Feel free to ask further questions.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (10 minutes later)
u for answering. Only the ferritin level was low: 11ng/L, while the rest was normal. I do not have any nausea. I eat well. The only symptom beside the pain is that I am tired and have dizziness. My stool was dark, but I am currenyly taking iron supplements, so I am not sure if the stool is dark from that or the blood. The doctor prescribed that I do the oculd bleeding test from the stool, but I will wait for my period to pass. I have an additional concern, the doctor saw on the ultrasound that I have free fluid in the XXXXXXX pouch (it was also on my last gynecological ultrasound). Is it somehow linked to this pain and low ferritin?
I have to mention that I have IBS and gastritis (last upper endoscopy was done in November 2014). If my ferritin wasn't low, I wouldn't be so concerned, but the two combined worry me a lot.
Best regards,
XXXX
doctor
Answered by Dr. Grzegorz Stanko (5 minutes later)
Brief Answer:
Gastroscopy should be repeated.

Detailed Answer:
Gastritis can be the reason of low ferritin. And the pain can be related to it as well. Stool is dark from the iron supplements for sure. So the gastroscopy has to be repeated for sure.
Free fluid in the XXXXXXX pouch is not related to your current issues. If its a small amount of the fluids, no need to worry as this is normal thing.
Lots of fluid can be a sign of inflammation in the pelvis or lower part of the abdomen. But still not related to low ferttin level.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (11 minutes later)
So, gastritis can cause pain so low and on the right side? I was always linking the pain more toward the breast bone to the stomach. Now, I am feeling pain in the area that would be covered if I put the hand below my right breast (so right rib cage area), although it is hard to localise, since it doesn't always hurt on the exact same point. Sometimes it is higher and more toward the middle and sometimes it is below right ribs.
Best regards. XXXX
doctor
Answered by Dr. Grzegorz Stanko (42 minutes later)
Brief Answer:
This is where duodenum is located.

Detailed Answer:
When you put your hand in the mentioned area you hold tge liver. Stomach is to the left of this hand. Duodenum is right below your hand.
Stomach and duodenum is connected with spinal diferrent pain nerves than skin for example. This nerves wont tell the exact pain source. That is why you are unable to localize the pain. This just confirms that the stomach or duodenum can be the case.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5798 Questions

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What Causes Pain Under The Right Rib?

Brief Answer: Gastroscopy should be done. Detailed Answer: Hello. Thank you for the query. Do you have low hemoglobin level or just low iron level? What is the MCV and ferritine level? As the gallstones are ruled out, second on the list is stomach and duodenum. Peptic ulcer especially in duodenum can give similar symptoms. The pain is usually aggravated by foods intake or when you are hungry. Nausea can appear. Peptic ulcer can be related to low iron level as ulcers can bleed. I suggest you to have gastroscopy as the next step. Hope this will help. Feel free to ask further questions. Regards.