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Had epigastric pain. Started getting pain under ribs. No pain when lying down. What is the cause?

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General Surgeon
Practicing since : 2008
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YYYY@YYYY on my right abdomen which is worse just under my ribs but goes down to the top of the pelvis. The pain increases when palpated or when I move. The pain is worse when I palpate just under my ribs but anywhere on my right abdomen causes pain. I get some relief from the pain when I lay on my right side. The pain has been there for 15 hours and doesn't seem to get better or worse.

Before that pain. I had epigastric pain that was worse than the current pain. That pain lasted for 7 hours prior and I took pepto bismol.

The only thing I ate yesterday was an omelette with mushrooms and edamame soybean for breakfast. The edamame.soybean was only microwaved and may have been undercooked.I have not had a bowel movement since I ate the breakfast yesterday.
Posted Mon, 4 Feb 2013 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 11 minutes later

Thank you for the query.

Pain under the ribs on the right side most common is caused by gallstones. However as your pain goes down to the pelvis and you have had also some epigastric pain, it can be also appendicitis. Especially if you have also increased heart rate and/or nausea. Lac of bowel movement and endometriosis history should always be checked with bowels obstruction as every endometriosis causes adhesions. Ovarian cyst rupture is also an option.
Food poisoning is also possible, however with this condition usually diarrhea appears.
It is advisable for you to have ruled out appendicitis first. To do that, abdominal ultrasound, full blood work and urine analysis should be performed. It will also tell if there is any acute inflammation and will rule out gallstones. Abdominal X-ray will rule out intestines obstruction.

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