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Dr. Andrew Rynne

Family Physician

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Can stress cause pain under the right Breast?

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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 2674 Questions

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Posted on Tue, 5 Aug 2014 in Digestion and Bowels
Question: Good Morning, Over the last 2 days I have experienced right shoulder tip pain which comes and goes and a constant pain under the right breast, if you were to look downwards to the breast as a clock with the bottom being number 12 then the pain would be located around the number 1. I have been told in the past that I have a hiatus hernia but have not suffered reflux etc. Gallbladder was removed 11 yrs ago, numerous pancreatitis until some surgery 2 yrs ago. Can this be happening from stress? The pain can be a constant 2 up to a painful 7. Your help would be appreciated. I am 53yrs old. XXXX
doctor
Answered by Dr. Prasad 10 hours later
Brief Answer:
Unlikely to be directly from stress...

Detailed Answer:
Hi,

I am sorry if my brief answer is confusion. Let me explain it here.

The pain that you describe on the shoulder can be a referred pain when you also have right upper abdomen pain. Therefore I would think of right sided organ pain irritating right phrenic nerve to cause referred pain over the shoulder. I understand your gall bladder was removed. But some patients have come back with similar pains. The causes may be stones within common bile duct, gastritis/ulcers and hyperacidity.

Since this pain is recurring in nature, I would treat you antacids and proton pump inhibitors +/- panadol and see if you feel better. If not an ultrasound scan and endoscopy may be needed.

Stress and anxiety are considered as a cause in many chronic pain. However without evaluating further, I would not point it as the direct cause of such pain.

In a nutshell, if you have not consulted your treating surgeon, it would be worthwhile to plan the visit now.

Hope this helped. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 3 days later
Can you please tell me: What sided organ would be causing this pain and how could I have gall stones? Also what is a proton pump inhibitor?

Thank you
doctor
Answered by Dr. Prasad 1 hour later
Brief Answer:
Common bile duct stones...

Detailed Answer:
Hi,

In most cases gall bladder removal prevents stone formation. However in a small subset group of people stones are formed within the common bile duct (which is not removed) leading to pain. This is not common occurrence though.
Similarly such pain can be experienced if there is some fluid accumulation within the peritoneal cavity. I would look forward for ultrasound scan and endoscopy to confirm the causes.

A proton pump inhibitor is a drug that's is very effective in controlling acid secretions which can be a cause of right under rib pain.

Without an opportunity to physically examine you, it would be difficult to arrive at a cause. Therefore if you are in acute pain, I recommend you see a doctor and discuss about these options.
Alternatively try the drugs and see if you feel better. We can plan the next course of treatment based on your response to those medicines.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 9 days later
Thank you Dr. XXXXXXX I still lean towards a stress trigger as I have been reasonably good since our last discussion but today had a very stressful phone call and upon hanging up I had the shoulder tip and abdomen pain near the right ribs, should I still see about the stones?
Kind regards,
XXXX
doctor
Answered by Dr. Prasad 17 minutes later
Brief Answer:
Crampy pain needs to be addressed..

Detailed Answer:
Hi,

If you will call the right under rib pain as crampy in nature, then you should check about the stones with the doctor. Nevertheless, stones in the common bile duct after gall bladder removal are not very common.

At this point of time, the effects of stressor cannot be ignored completely. So until you see your surgeons, manage those stressors adequately. Transcedental meditation and yoga are effective methods to keep yourself stress free.

Hope this helped you. Write back for clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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