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Stabbing pain under ribs, on upper left quadrant, occur while bending, sore to touch. Treatment ?

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Internal Medicine Specialist
Practicing since : 1998
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recently i have had severe stabbing pains under my ribs on the left upper quadrant. They occur when I bend over. The spot is sore to the touch currently. I am six foot tall and weigh just under 300lbs
Posted Mon, 23 Apr 2012 in Abdominal Pain
Answered by Dr. Jasvinder Singh 35 minutes later

Thanks for posting your query. Five possibilities are coming to my mind which need to be evaluated. These are:

1)Muscle strain: This may cause localized tenderness and pain when bending over. It responds to warm compresses and left upper quadrant pain is caused by peptic ulcer disease.

2)The second possibility is of peptic ulcer disease or hiatal hernia. Diagnosis can be confirmed by upper GI endoscopy. Try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors.

3)     The third possibility is of pancreatitis as it may cause upper left abdominal pain which is worse when bending over or sitting. Pancreatic enzymes like serum amylase and lipase should be measured to rule out any pancreatic cause.

4)     The last possibility although less likely is of pleuritic chest pain which is caused by inflammation of pleura and irritation of pleura may cause pain which is worse when one bends over or on XXXXXXX inspiration.

I suggest you to consults a physician and get an ultrasound upper left abdomen, pancreatic enzymes and a chest x-ray done to rule out these causes.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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