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Rib pain, post nasal discharge - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2358 Questions
User :   Hello Doctor.Sorry to bother you but i cant seem to get any sense from my own GP over this issue.I have a nagging pain immediately below my bottom rib on my right hand side right on the side of the body as if i am being grabbed inside, sometimes worse than others, slightly nauseaus but not been sick , somewhat tired but could be due to over work but this pain is worrying yet my GP keeps telling me not to worry it will go away??
any ideas sir
User :   Hi
User :   Good afternoon doctor
User :   my age if it helps is 45 years old
User :   I am a non smoker for over 10 years
User :   i do not drink at all
User :   ok
User :   and have no other medical issues other than post nasal drip
User :   Ok
User :   if i place slight pressure on my bottom right rib right on the side it is not a sharp pain but a numb pain if that makes sense sir
User :   Did you get the chest ray
User :   i had one approx 5 months ago which was clear sir
User :   also if i lean over to the right hand side it feels as if something inside is being trapped , squashed
User :   but not to the left when the same stretch is done
User :   could this be gall stones?
User :   I need to ask more questions .
User :   Do you have any fat intolerance/
User :   I mean do you get belching , bloating after you eat a fatty m,eal
User :   not any different to normal sir that i can detect, however i am a little overweight anyway
User :   approx 2 stone overweight
User :   all around the midrift really
User :   ok
User :   middle age laziness i guess
User :   Please answer the questions- i would like t find out the reason
User :   always been fairly fit and sporty though
User :   fire away sir
User :   i will just answer your questions my friend
User :   ae you still there?
User :   Your descriptions sound like problem in the liver or Gall bladder or ascending colon
User :   I will recommend initially Ultra sound of abdomen
User :   Also get liver function tests done
User :   if it were a colon issue would it effect movement and substance etc
User :   because that seems fine
User :   OK
User :   You need to make sure these organs are OK
User :   can i demand this from my GP
User :   only investigation will make sure the organs are free from disease.
User :   if it is one of those issues are they treatable?
User :   You can request him to get these tests done
User :   Yes
User :   not life threatening then as a rule
User :   it is very unusual for me to be ill you see hence this has taken me back a little
User :   it is not life threatining
User :   Thank you for that sir, may i ask another qestion
User :   Sure.
User :   thank you sir
User :   Post nasal drip i suffer
User :   Do you have cough/allergies
User :   This has left me with a constant cough which my GP says is something he can do nothing about as its a side effect of the constant dripping is this correct
User :   this cough has lasted for over a year now
User :   quite cronic now
User :   Do you have heartburn?
User :   no sir
User :   Do you have phlegm?
User :   I cough some tiny bits up ocassionally when coughing which is clear see through orwhite
User :   but not all the time, usually i cough nothing up
User :   Post nasal discharge comes from allergies / common cold/ pharingitis
User :   chronic sinusitis
User :   i am constantly having to clear my nose, every morning it is blocked solid
User :   You might have choronic allergic rhinitis which is the common cause chronic post nasla discharge
User :   ocassionally bloody
User :   maybe due to the constant blowing huh
User :   Yes
User :   because of dryness of nasal mucosa and blowing the nose it can happen
User :   Did you consulted ENT
User :   no not yet again my gp says its not needed, he says there is no cure for this he said its "one of those things"
User :   but it is making me cough so much it feels like a chest infection at times
User :   You can apply normal saline nasal drops so that nasal mucosa is wetty and it does not bleed
User :   You get take Cetrizine tab daily for some months.
User :   It will help u if it is allergic
User :   can i ease the cough ? as its taking up my life now this constant coughing
User :   Cough is coming from post nasal discharge on to the throat whcih is causing cough
User :   may i ask are you based in the UK?
User :   Steroid nasal spray work very good for nasal problems
User :   Sures
User :   *sure
User :   just trying to find out if this cetrizine tab is avaialbe over the counter sir or on prescription only
User :   and steroid spray sir]
User :   Check with your pharmacist if it available on OTC
User :   If not Cetrizine , u can take any anti histamine
User :   ask pharmacist for OTC antihistamine
User :   They cause sedation, so take at night
User :   will do
User :   may i go back to the liver issue a moment sir
User :   Regarding the steroid nasal spray , it require prescription
User :   Ok
User :   sorry i know your busy sir
User :   Fine, I am here to help u.
User :   if this is a fatty liver issue in the end, is it possible to have some of the fat i carry removed on the NHS
User :   to help the situation
User :   Fatty liver is like an obesity
User :   It is an acumulation of fats in liver
User :   could this be the cause of the pain maybe?
User :   It is like an obee person getting skin fat
User :   It does not cause pain
User :   It need less fatty diet to correct
User :   my gp has viewed my diet and says he cannot understand why i am putting weight on as my diet is very good
User :   Ok
User :   Then you need exercise
User :   You need to burn calories
User :   difficult with a spare tyre isnt it, its a real rock and a hard place especially now with this pain in the side
User :   Do minimum 30-45 min walk/jagging/any aerobic activity daily
User :   'I understand. It is easy for me to say do exercise. But honestly. it need mental training. Schedule your day. Motivate your self. Build up will power. make it a habit. If think exercise is going to hekp us we need to do that
User :   Just 30 min in 24 hours
User :   will do sir, must plan it in every day, so were looking in reality at a colon, liver,gall bladder issue then and all are treatable and non life threatening
User :   Yes
User :   It is not threatening
User :   you have settled my mind , i was becoming worried as internal pain is not a good thing huh
User :   Yes,
We are planning to look at colon, liver,gall bladder issues first.
User :   Ultra sound is basic cheap test
User :   If it is abnormal we ca pursue other things
User :   can i do this privately/#
User :   You mean u have to pay out of pocket
User :   Thank you for consulting
User :   It seems you have moved out of the chat window. Please log in back if
you have medical queries.
User :   It seems you have moved out of the chat window. Please log in back if
you have medical queries.
User :   still here
Doctor :   Ok
User :   ah glad i got you again, it seems my payment ran out sir sorry
Doctor :   Not a problem
User :   if there is an issue with the colon or liver what is the next step i will encounter
Doctor :   I suspect liver and gall bladder first
Doctor :   and then colon
User :   here is a sympton i didnt mention which may help you sir
Doctor :   Obesity / Overweighted ness can lead to enlargement of liver called fatty liver
User :   when i sleep on my front it feels like there is a cricket ball under my right hand side does this shown enlargement
User :   well i am overweight thats for sure
Doctor :   yeah
User :   if this is so and i get my weight under control can this situation be rectified
Doctor :   Did I ask you if you consume alcohol or smoke?
User :   non smoker ofr over 10 years since my boy was born and dont drink more than 1 unit per month if that sir
User :   i was a professional sportsman hence my somewhat clean lifestyle you see
Doctor :   Ok, that is good to know
Doctor :   yes coming to the fatty liver, yes if you reduce weight
Doctor :   the fatty liver is reversible in 6 to 8 months
User :   wouod this fatty liver syndrome have this nagging pain senario ??
Doctor :   yes it can
User :   so could be litterally the liver that is somewhat swollen and thats what i am squashing when i lean over to the right ?
Doctor :   I am not exactly sure but it is a good possibility
Doctor :   Hence I suggest an Ultrasound of the liver
Doctor :   and gall bladder
User :   apart from losing weight etc what can be done short term to help relieve it sir?
Doctor :   Losing weight is the definite management at this stage
Doctor :   Check the lipid profile now as it can also tell your cholesterol status
User :   i shall book myself in for the ultrasound today sir, as a rule would the person doing the ultrasound be able to diagnose it to me whilst i am there?
Doctor :   Radiologist / Sonologist shall be able to say if it is enlarged
Doctor :   but he always puts infront of the treating doctor as benefit of doubt
User :   so it would not be just a nurse doing the ultrasound
Doctor :   I do not think so
User :   it would be helpful for the person doing the ultrasound to say what they thought which i guess from daily experience would be something they could do huh
Doctor :   yes
User :   may i ask could this liver complaint be why i am tired also
Doctor :   Yes
User :   ah so it could be connected then ???short term is it worth using pain killers?
Doctor :   Paracetmol should be restricted in liver problems
User :   what would be ok to use?
Doctor :   Other mild pain killers which are prescription based
Doctor :   Tramadol is good
User :   ok , would a course of decent anti biotics help also , with the cough too??
Doctor :   yes
User :   wouldnt bother the liver tho
Doctor :   No only few classes are not prescribed during liver problems
User :   ok thank you i shall use your advice sir, you have been more use in an hour than my gp in 6 years
User :   very worrying it is hence my constant questions you see
Doctor :   Please speak to me whenever you have such doubts
Doctor :   I am more than happy to suggest you
Doctor :   Let me summarize before we end
User :   ok
Doctor :   1) Ultrasound of the liver and Gall bladder
Doctor :   2) Lipid profile test for Cholesterol screening
Doctor :   3) Low fat diet , the next wt loss goal is 10% reduction of your current weight
Doctor :   You can take the help of my dietitian
Doctor :   who can design a good diet chart if you feel like
Doctor :
Doctor :   4) Use saline drops in the morning to soften the nasal crusts
Doctor :   so that they do not injure the nasal mucosa and bleed
Doctor :   I think that finishes our discussion
User :   thank you sir
Doctor :   Pleasure speaking to you
Doctor :   Bye for now.
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