Hi Dempsey, I understand your concern. Your case: - solid bowel movement in over a year - lump/bulging under left rib case, sometimes painful, sometimes not Solid bm is suggesting constipation. Fecal mass remains for longer inside your bowels causing them to enlarge. The enlarged bowel is clinically expressed with lump/bulging under your left rib case. The pain is due to distented bowels putting pressure on the nearby nerves and most probably due to accumulation of gas (if you feel also bloating). I advise to: - try to ease constipation problems: increase fluids/fiber intake; take probiotics to stabilize intestinal flora; take gentle laxatives to help soften the stool and ease bowel movement - if this is not helping, then, further tests are required: physical examination by your physician, abdominal ultrasound Hope this helps.