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Having constant ache behind rib cage. Blood tests and scans are normal. Take diet with low fat and no sugars. Should I be worried?

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General & Family Physician
Practicing since : 2009
Answered : 3041 Questions
HI I am a 55 year old woman 68 kilos very healthy - one drink a night running 3 times a week I have a constant ached behind right rib cage - for over 4 years now - have had blood tests and scans all normal - no reflux or anything - I experiment with food and mainly keep it low fat and have no sugars. I find that grains can annoy me .
I worry about it - what is it can you have a sludgy gut and is it something you have to put up with all your life? I was going to have an mri but thought it was a waste of money, as I said otherwise I am in great health, bowels are great - could it be a sign of chrones my brother has it I don't know if this will help , I used to drink chronically in my 20's but really cut down in my 30's and really reduced by age 40 plus now I cant tolerate much alcohol
hi how is my answer coming?
I meant to say the dull ache is behind my right
rib cage up behind the bottom rib
Posted Thu, 29 Aug 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the query,

I am afraid what you describe might actually have nothing to do with Crohn s disease. It really is not related to that and you might not have to be worried with regards to that.

I think you might to consult an internist with respect to this issue. Its reassuring other major paraclinical tests have revealed no major findings. However, I would love to suggest that common diseases that could cause this pain should be carefully examined for. Its true that classical signs of reflux might not be seen. A formal exclusion of reflux and peptic ulcer disease is mandatory in this case (pH measurements and an endoscopy are important).

I would really find it a bit difficult ascribing this pain to the fact that you took alcohol. The gall bladder needs a careful evaluation. Pain from here arising from stones could be referred or falsely projected to the chest. This is due to the natural nerve supply in this region.

Salient cholecystitis and screening for liver disease through blood tests and an abdominal ultrasound could be helpful. Local causes like rheumatologci or inflammatory spine disease should be considered. A careful clinical local examination and simple X rays of the spine could be more helpful in this comprehensive assessment.

I think you should consult a gastroenterologist. He should also do a local examination, spinal X XXXXXXX formerly exclude peptic ulcer disease and reflux, get an abdominal ultrasound done and a good liver function evaluation, especially to exclude salient gall bladder stones.

Irritable Bowel syndrome, IBS, in some rare situations, does presents itself as such. However, all other organic diseases as cited above must be formerly excluded before IBS could be considered and treated. I am happy with your health food lifestyle. Continue with vegetables, fruits and exercise, and do your best to be positive about life, appreciate what you have (blessings) and think and feel good always being positive. This have tremendous consequences on your health.

Wishing you the best of health and kind regards.

Bain LE, MD.

Thanks and hope this helps. I am h
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