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What is the treatment for pain under my left rib cage and why am I unable to sleep?

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General & Family Physician
Practicing since : 2005
Answered : 2305 Questions
I have a lot of pain under my left rib cage. It started in December with a bad cough. Now the pain is worse. I can't sleep on my left side or turn to the right with out sharp pain that takes my breath away. Have coughed up blood a couple of times in the last month.
Posted Thu, 23 Jan 2014 in General Health
Answered by Dr. Prasad 24 minutes later
Brief Answer: Need some clarifications... Detailed Answer: Hi, I went through your details with diligence. Though you are in pain, I would not be as concerned if you have no other symptoms besides the pain. So let me know if you persist to have cough and breathing difficulties even at rest. Chest wall is made up of bones, muscles and neurovascular bundle. These structure just like any other part of body is prone to injuries. And severe bouts of cough is known to cause injuries to chest wall structure. Based on your description, I would think of musculoskeletal pain as the first cause of your chest pain. I would start you on antiinflammatory pain killers for short period of time under cover of proton pump inhibitors (PPI). You should get both these medicines over the counter as advil (antiinflammatory agent) and prilosec OTC (PPI agent). Both these can be taken twice daily - prilosec OTC before food and advil after food. You may try both the medicines for a week and see if you feel better. I would advice for investigations if 1. You have this sharp untolerable pain with breathing difficulties present irrespective of posture change. In this case, a chest X-ray is recommend to look for serious injuries such as fractures. 2. If you persist to have cough and breathing difficulties. In this case, I would order for complete blood count, ESR and HRCT of chest to rule out infections. One or two episode of bloody cough is not worrisome. You probably coughed blood when you had this infection which seems to have resolved now. Hope this is clear. Write back if you need clarifications. Wish you a speedy recovery... Regards
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