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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain Below The Rib Cage Along With Nausea?

I am experiencing pain on the left side of my trunk beneath rib cage. I didn t do anything physical to cause muscle pain. Feeling crummy - nothing specific. Nauseous but not vomiting. The discomfort started in my lower back a few days ago but has moved around & up the side. Didn t start feeling poorly until yesterday. No fever. Should I just wait it out and see if it goes away? I have medical insurance and can see my N.P. if necessary.
Sat, 27 Feb 2016
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Anesthesiologist,  's  Response
Thanks for the question posted by you to HCM website,

Looking back to your chief complaint, you are suffering from pain around rib cage while feeling Nauseous.
There are many causes my mimic chest and rib cage pain symptoms and signs including:

1.     Cardiac( about 25% of cases) such as Heart attack,
2.     Gastrointestinal ( about 40% of cases) such as reflux disease, Gastritis, Esophagitis,
3.     Musculoskeletal( about 25% of cases) such as Rib fracture, Tietze's syndrome or osteochondritis, Radiculopathy,
4.     Others such as Pneumonia, pleurisy, Herpes zoster, Panic attack, Anxiety, Breast conditions,

In relation to the information posted by you and my experience, my recommendations are:

1.     Take an electrocardiogram (ECG) and blood cardiac enzyme tests such as Troponin, Creatine Kinase (CK-MB) and Lactate dehydrogenase (LDH) tests.

2.     You may need more advanced tests after visiting your doctor and physical exams performed such as cardiac stress test, chest x rays, angiography, serum lipase or amylase to rule out acute pancreatitis, Sonography and CT scan.

Hope you get well soon,

Regards
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What Causes Pain Below The Rib Cage Along With Nausea?

Thanks for the question posted by you to HCM website, Looking back to your chief complaint, you are suffering from pain around rib cage while feeling Nauseous. There are many causes my mimic chest and rib cage pain symptoms and signs including: 1. Cardiac( about 25% of cases) such as Heart attack, 2. Gastrointestinal ( about 40% of cases) such as reflux disease, Gastritis, Esophagitis, 3. Musculoskeletal( about 25% of cases) such as Rib fracture, Tietze s syndrome or osteochondritis, Radiculopathy, 4. Others such as Pneumonia, pleurisy, Herpes zoster, Panic attack, Anxiety, Breast conditions, In relation to the information posted by you and my experience, my recommendations are: 1. Take an electrocardiogram (ECG) and blood cardiac enzyme tests such as Troponin, Creatine Kinase (CK-MB) and Lactate dehydrogenase (LDH) tests. 2. You may need more advanced tests after visiting your doctor and physical exams performed such as cardiac stress test, chest x rays, angiography, serum lipase or amylase to rule out acute pancreatitis, Sonography and CT scan. Hope you get well soon, Regards