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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Pain Lower Rib Cage In Night, After Dinner, Constipated, Gastritis, Taken Antacid, No Relief

Hi. Every night, I have a sharp pain on my right lower rib cage. I just wonder why it happens only during night. I'm okay during morning. Also, I notice that when I don't eat dinner, then I don't experience that pain but when I have dinner, pain occurs like 4 hours after I ate. In the morning, I can eat anything but no pain occurs. I'm constipated and every time I go to the toilet to poop, I always fart. I tried to take medicine for hyperacidity but it doesn't help in decreasing the pain.
posted on Tue, 23 Apr 2013
Twitter Tue, 23 Apr 2013 Answered on
Twitter Tue, 23 Apr 2013 Last reviewed on
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General & Family Physician,  's  Response
Hello,

Thanks for posting on HCM,

Pain around the epigastric region/retrosternal pain could not just be as a result of acid reflux or PUD and you should now consider the possibility of consulting a gastroenterologist. From your description if you are suffering from constipation and epigastric pain, then GERD or acid reflux is likely and your medications may be inappropriately taken or not rightfully indicated. If you are only on antacids then you might require combination with a protein pump inhibitor to treat the acid reflux. Reason why you might be experiencing this only at night after dinner is because of the nature of your dinner which helps encourage the secretion of gastric acid into the stomach and hence the pain (plus the fact that you lie flat when sleeping).
Other possibilities based on your description are bile disorder, pancreatitis, coronary artery diseases (less likely).

Hope this helps
I find this answer helpful
General & Family Physician,  Dr. Saloni Shah's  Response
Hello & thanks for your Q on HCM
Pain on rt side of abdomen & lower part of rib cage may be associated with gall bladder problems - i.e gall stone which will cause pain after eating with sometimes associated nausea & vomiting
USS will rule out possibility of gall bladder D - it may be worthwhile getting blood test done (blood count, live & kidney function test)
Also issues re constipation need saddressing - you will benefit from laxatives & bowel aperients to help get toileting habit more regular as untreated constipation may cause pain in lower abdomen & also nausea & loss of appetite at times
I feel you must book appointment to see a Dr & get relevant examination doen with appropriate blood test & USS

Hope that helps
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Have Pain Lower Rib Cage In Night, After Dinner, Constipated, Gastritis, Taken Antacid, No Relief

Hello, Thanks for posting on HCM, Pain around the epigastric region/retrosternal pain could not just be as a result of acid reflux or PUD and you should now consider the possibility of consulting a gastroenterologist. From your description if you are suffering from constipation and epigastric pain, then GERD or acid reflux is likely and your medications may be inappropriately taken or not rightfully indicated. If you are only on antacids then you might require combination with a protein pump inhibitor to treat the acid reflux. Reason why you might be experiencing this only at night after dinner is because of the nature of your dinner which helps encourage the secretion of gastric acid into the stomach and hence the pain (plus the fact that you lie flat when sleeping). Other possibilities based on your description are bile disorder, pancreatitis, coronary artery diseases (less likely). Hope this helps