hi. thanks for posting query at HCM. yes, gallstones or liver inflammation may result in pain below the rib cage on the right side. cause of high liver enzymes should be properly investigated. viral causes should be ruled out. fatty liver disease should be ruled out. advise : advice : - abstinence from Alcohol ( if alcoholic) - LOW fat diet should be followed, AVOID junk food and beverages - decreased oil consumption (oily food) - NO red meat - green vegetables should be ingested daily - use lemon juice (lemonade) once in a day - reduce weight if overweight/obese - recheck liver enzymes after 6 to 8 weeks and/or ultrasound. if gallstones are seen on ultrasound and pain is frequent, then visit a general surgeon for advise. 1. Medical therapy is an option for gallstones , though a vast number of surgeons around the globe prefer removal of gall bladder- surgical intervention. Medical therapy includes intake of ursodeoxyholic acid ( UDCA) for a period of 12 to 24 months. UDCA has been shown to inhibit biliary secretion of cholesterol, reduce intestinal absorption of cholesterol, increase hepatic bile secretion, and improve gallbladder emptying. Medical therapy is useful if mild symptoms, stones are smaller in size ( weight reduction and low-fat diet is also a part of medical therapy. 2. Surgery lasts for less than one hour ( usually half an hour). Laparoscopic surgery has greatly reduced surgery time duration and surgical complications. You may travel 7 to 10 days after surgery, though the surgeon may indicate precise time. I would also like to mention that gall bladder is removed completely in surgical intervention which may impair fat digestion. You maybe asked to cut fat completely from your diet ( or keep to minimum) after gall bladder surgery. any further questions are welcomed. hope to answer your concern. wish you good and sound health. regards, Dr Tayyab Malik