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Pain in middle of rib cage, taking laxatives for bowel movemens. Trapped gas or indigestion?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
I have, not severe pain, but constant dull pain at the top of my stomach right in the middle of my rib cage? I was have some problems with a bm and took a laxitave and that helped some but it is still there very dull. When I eat is when it is the worst. Could this be trapped gas or indegestion or what?
Posted Wed, 12 Sep 2012 in Abdominal Pain
Answered by Dr. Mayank Bhargava 39 minutes later
Thanks for posting your query.
Do you have exacerbation of pain with respiratory movements?
Do you have fever/ vomiting/ yellow discoloration of sclera and urine/ itching in body?
Pain on eating indicates only 3 disease: Peptic ulcer disease, acute cholecystitis, acute pancreatitis.
Dull pain on right side of abdomen with increasing on respiration indicates "Murphy's sign", a sign very specific for acute cholecystitis.
In acute pancreatitis, patient may have epigastric pain which is radiating to back.
In peptic ulcer disease, patient has acidic belching, burning sensation in stomach, abdominal heaviness and bloating.
So you are most likely suffering from acute cholecystitis. Acute cholecystitis is diagnosed by ultrasound imaging (Gall bladder wall thickness > 4mm). Acute cholecystitis may be due to stone in gall bladder or at times no stones is present in gall bladder (such condition is called as acalculous cholecystitis, but this entity is common in old age bed ridden patients).
You should also consult with physician/ gastrophysician and go for ultrasound imaging.
You should also go for following blood investigations: Complete blood count, liver function test, serum lipase and amylase, serum electrolytes and renal function test.
Indigestion include acidic belching, abdominal heaviness and bloating, excessive gas formation, burning sensation in abdomen. Do you have all these mentioned symptoms?
I think I have answered all your query.
If you have any other query, let me know.
Get well soon.
Dr. Mayank Bhargava
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