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Excessive Burping And Upper Right Side Abdominal Pain Under Ribs

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Posted on Fri, 12 Jul 2019
Question: Excessive burping and upper right side abdominal pain under ribs and also side of the ribs.
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Follow up: Dr. T Chandrakant (0 minute later)
Excessive burping and upper right side abdominal pain under ribs and also side of the ribs.
doctor
Answered by Dr. T Chandrakant (50 minutes later)
Brief Answer:
Please give additional information

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well and understood the concerns.
Please give additional information for me to assist you better. Proper history sometimes gives the best clues as to the proper diagnosis as you have undergone almost all related tests which have been normal as per your history.
Since when have you got these problems?
No vomiting?
Is the pain severe enough to say that it is almost killing you or so (when in attack)?
How often is the pain?
Any association with constipation?
Any history of an incidence that caused trauma to the mid-back like an accident, fall or hit on back?
Any plain X-rays of abdomen ''in standing position'' during pain?
Is Omeprazole, Sucralfate helping?
Any other details please.

Awaiting.
Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
Please give additional information

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well and understood the concerns.
Please give additional information for me to assist you better. Proper history sometimes gives the best clues as to the proper diagnosis as you have undergone almost all related tests which have been normal as per your history.
Since when have you got these problems?
No vomiting?
Is the pain severe enough to say that it is almost killing you or so (when in attack)?
How often is the pain?
Any association with constipation?
Any history of an incidence that caused trauma to the mid-back like an accident, fall or hit on back?
Any plain X-rays of abdomen ''in standing position'' during pain?
Is Omeprazole, Sucralfate helping?
Any other details please.

Awaiting.
Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (8 minutes later)
Since when have you got these problems? Since Februrary 2019, the burping started last year in september but it was normal but very acidic burps.

No vomiting? Vomited some bile in January, thats it.

Is the pain severe enough to say that it is almost killing you or so (when in attack)? Pain is dull, feels more like gas under the ribs. On a scale of 10 I would say 2-3 XXXXXXX

How often is the pain? I get these everyday usually in the night after dinner beforing going to bed, its been consistent and not getting worse since April.

Any association with constipation? Constipation has been on and off for the past 5-6 years.

Any history of an incidence that caused trauma to the mid-back like an accident, fall or hit on back? I started using a wedge pillow and ever since I having the back issues, not sure if its related to the abdominal issues or its independent.

Any plain X-rays of abdomen ''in standing position'' during pain? No.

Is Omeprazole, Sucralfate helping? No.

The incident started in XXXXXXX after eating eggs which were 3-4 weeks old. I burped for 1 week straight like 200-300 burps in a day and it went away after I ate a bland diet. It came back again in Feb and has not gone way. The abdominal discomfort and back pressure started in April and has not gone away.

I also, have heartburn during nighttime before going to bed but its very rare. I often feel gas stuck in my chest which gets relieved with burping.
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Follow up: Dr. T Chandrakant (0 minute later)
Since when have you got these problems? Since Februrary 2019, the burping started last year in september but it was normal but very acidic burps.

No vomiting? Vomited some bile in January, thats it.

Is the pain severe enough to say that it is almost killing you or so (when in attack)? Pain is dull, feels more like gas under the ribs. On a scale of 10 I would say 2-3 XXXXXXX

How often is the pain? I get these everyday usually in the night after dinner beforing going to bed, its been consistent and not getting worse since April.

Any association with constipation? Constipation has been on and off for the past 5-6 years.

Any history of an incidence that caused trauma to the mid-back like an accident, fall or hit on back? I started using a wedge pillow and ever since I having the back issues, not sure if its related to the abdominal issues or its independent.

Any plain X-rays of abdomen ''in standing position'' during pain? No.

Is Omeprazole, Sucralfate helping? No.

The incident started in XXXXXXX after eating eggs which were 3-4 weeks old. I burped for 1 week straight like 200-300 burps in a day and it went away after I ate a bland diet. It came back again in Feb and has not gone way. The abdominal discomfort and back pressure started in April and has not gone away.

I also, have heartburn during nighttime before going to bed but its very rare. I often feel gas stuck in my chest which gets relieved with burping.
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Follow up: Dr. T Chandrakant (1 hour later)
I can also hear gas bubbling or moving noises in my stomach and under the right side of the ribs. The gnawing sounds, that’s what it feels like, it’s not loud but I can listen to them
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Follow up: Dr. T Chandrakant (0 minute later)
I can also hear gas bubbling or moving noises in my stomach and under the right side of the ribs. The gnawing sounds, that’s what it feels like, it’s not loud but I can listen to them
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for the detailed feedback.
After recollecting the history you have given and additional feedback my opinion is as follows:
Since all the relevant tests are normal, there are few investigations I would advise to be done when you have pain and symptoms of gurgling and so on:
- X-ray of abdomen in standing position when the symptoms are acute. This simple investigations can show whether there is any gas trapped in any part of GI system. May need to be done a few times and well studied by the Radiologist and a General Surgeon.
- MRI of the thoracic spine to rule out any problem with the spinal cord and nerve roots that can mimic the symptoms that you have.
- Feeling gas going up and getting stuck in esophagus, burping, heartburn after dinner all indicate the lax lower esophageal sphincter. This can be helped with medications like Domperidone or Metoclopramide but strictly needs a prescription after discussing with your Doctor.
- Stress and/or anxiety can be the most important cause of your symptoms. Please look into it and discuss with your Doctor/General Surgeon/ Gastroenterologist and get treated accordingly. Most of the times you can get control over these on your own and get a tremendous relief.
- Take stool softeners or laxatives when needed to avoid constipation and hard stools. Take probiotics.
- Also watch for the foods and beverages that instigate or enhance your problems and stopping such things may help you further for permanent relief. This again is to be found by keep observation by you as such intolerance is individual specific; meaning differs from person to person.
Please get all these things done and give me feedback so that we can discuss further towards cure.

Take care.
Dr T Chandrakant.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for the detailed feedback.
After recollecting the history you have given and additional feedback my opinion is as follows:
Since all the relevant tests are normal, there are few investigations I would advise to be done when you have pain and symptoms of gurgling and so on:
- X-ray of abdomen in standing position when the symptoms are acute. This simple investigations can show whether there is any gas trapped in any part of GI system. May need to be done a few times and well studied by the Radiologist and a General Surgeon.
- MRI of the thoracic spine to rule out any problem with the spinal cord and nerve roots that can mimic the symptoms that you have.
- Feeling gas going up and getting stuck in esophagus, burping, heartburn after dinner all indicate the lax lower esophageal sphincter. This can be helped with medications like Domperidone or Metoclopramide but strictly needs a prescription after discussing with your Doctor.
- Stress and/or anxiety can be the most important cause of your symptoms. Please look into it and discuss with your Doctor/General Surgeon/ Gastroenterologist and get treated accordingly. Most of the times you can get control over these on your own and get a tremendous relief.
- Take stool softeners or laxatives when needed to avoid constipation and hard stools. Take probiotics.
- Also watch for the foods and beverages that instigate or enhance your problems and stopping such things may help you further for permanent relief. This again is to be found by keep observation by you as such intolerance is individual specific; meaning differs from person to person.
Please get all these things done and give me feedback so that we can discuss further towards cure.

Take care.
Dr T Chandrakant.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (17 minutes later)
I have had the MRI of spine done, it came back as normal.

I have seen a gastro doctor last week and he has ordered a BRAVO Endoscopy (48hr).

Do you think the issues could be due to SIBO or BILE DUCT ISSUES? I am concerned that this could be some bile duct issue.

Why do i burp a lot in the night before going to bed and after getting up in the morning?
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Follow up: Dr. T Chandrakant (0 minute later)
I have had the MRI of spine done, it came back as normal.

I have seen a gastro doctor last week and he has ordered a BRAVO Endoscopy (48hr).

Do you think the issues could be due to SIBO or BILE DUCT ISSUES? I am concerned that this could be some bile duct issue.

Why do i burp a lot in the night before going to bed and after getting up in the morning?
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Follow up: Dr. T Chandrakant (0 minute later)
Also, do you think this is something serious?

I have gained around 1-2 kgs while these issues have been going on with me.
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Follow up: Dr. T Chandrakant (0 minute later)
Also, do you think this is something serious?

I have gained around 1-2 kgs while these issues have been going on with me.
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your feedback.
Great thing is that MRI spine is normal hence rules out any problem related to spine.
Bravo endoscopy will help to determine the ph value of the esophageal contents.
Less likely to be due to SIBO and can be diagnosed by tests; get this done after discussing with your Gastroenterologist.
Bile duct issues are already seen in Ultrasonography and CT scan hence less likely.
You can go for HIDA scan as this will tell more about the functional aspect of gallbladder, bile ducts.
Late night and early morning burping: As mentioned earlier the stress and anxiety can be a contributory factor. Lower lax esophageal sphincter is another cause.
Weight gain: Gt thyroid function tests done, if not yet done.
Serious: Should be taken seriously to have a proper diagnosis and management to get a cure.

I hope this answer helps you further.
Please feel free to give feedback after investigations and ask for further relevant queries if you feel that there is a gap of communication.

Dr T Chandrakant.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your feedback.
Great thing is that MRI spine is normal hence rules out any problem related to spine.
Bravo endoscopy will help to determine the ph value of the esophageal contents.
Less likely to be due to SIBO and can be diagnosed by tests; get this done after discussing with your Gastroenterologist.
Bile duct issues are already seen in Ultrasonography and CT scan hence less likely.
You can go for HIDA scan as this will tell more about the functional aspect of gallbladder, bile ducts.
Late night and early morning burping: As mentioned earlier the stress and anxiety can be a contributory factor. Lower lax esophageal sphincter is another cause.
Weight gain: Gt thyroid function tests done, if not yet done.
Serious: Should be taken seriously to have a proper diagnosis and management to get a cure.

I hope this answer helps you further.
Please feel free to give feedback after investigations and ask for further relevant queries if you feel that there is a gap of communication.

Dr T Chandrakant.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (7 hours later)
Serious: Should be taken seriously to have a proper diagnosis and management to get a cure
What are you trying to say here?

Does my symptoms indicate more of GERD/Gastritis issue or could be bile ducts issue?
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Follow up: Dr. T Chandrakant (0 minute later)
Serious: Should be taken seriously to have a proper diagnosis and management to get a cure
What are you trying to say here?

Does my symptoms indicate more of GERD/Gastritis issue or could be bile ducts issue?
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
As detailed below.

Detailed Answer:
You have symptoms, not getting relief.
Hence it is necessary to get a proper diagnosis.
Proper diagnosis can guide for proper management.
You may have a combination of both as per the history and follow up history that you have mentioned above.
Get the additional investigations.

Please mention about the level of stress and/or anxiety that you have and any additional problems.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As detailed below.

Detailed Answer:
You have symptoms, not getting relief.
Hence it is necessary to get a proper diagnosis.
Proper diagnosis can guide for proper management.
You may have a combination of both as per the history and follow up history that you have mentioned above.
Get the additional investigations.

Please mention about the level of stress and/or anxiety that you have and any additional problems.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (12 minutes later)
Doctor,
I also have been having light colored stools like 2-3 light color stools in a month. With you permission I would like you to have a look at it and let me know if this is normal color?

Let me know if I can attach the image of the stool
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Follow up: Dr. T Chandrakant (0 minute later)
Doctor,
I also have been having light colored stools like 2-3 light color stools in a month. With you permission I would like you to have a look at it and let me know if this is normal color?

Let me know if I can attach the image of the stool
doctor
Answered by Dr. T Chandrakant (11 minutes later)
Brief Answer:
surely yes

Detailed Answer:
Surely yes.
Please attach the clear and focused photos.
Try to remember what you ate a day before having light colored stools.
Were the urine dark yellow colored when you get light colored stools.
Get the Liver function tests along with GGT and Alkaline phosphatase when you get light colored stools.
Do the symptoms increase at such times?


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
surely yes

Detailed Answer:
Surely yes.
Please attach the clear and focused photos.
Try to remember what you ate a day before having light colored stools.
Were the urine dark yellow colored when you get light colored stools.
Get the Liver function tests along with GGT and Alkaline phosphatase when you get light colored stools.
Do the symptoms increase at such times?


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (13 minutes later)
I have had GGT and LFT done. No dark urine, the light color stools are random, yesterday I had all leafy vegetables in my food. I have attached the image in the view reports section.
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Follow up: Dr. T Chandrakant (0 minute later)
I have had GGT and LFT done. No dark urine, the light color stools are random, yesterday I had all leafy vegetables in my food. I have attached the image in the view reports section.
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Follow up: Dr. T Chandrakant (0 minute later)
The symptoms are random and vague
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Follow up: Dr. T Chandrakant (0 minute later)
The symptoms are random and vague
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Follow up: Dr. T Chandrakant (39 minutes later)
I got GGT and LFT done in April and they were normal
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Follow up: Dr. T Chandrakant (0 minute later)
I got GGT and LFT done in April and they were normal
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
Get the stool tests done when such changes are noted.

Detailed Answer:
Thanks for your photo and feedback.
You are correct, the stool has 3 different shades and can be due to various reasons:
Stool is not formed by a single meal or so, hence can have such layered appearance.
The possibility of having no sufficient bile in a particular time can cause such pale stools, send the sample of such stools for lab to test for bile salts and pigments.

It is good that the liver functions were normal.
As discussed above please talk to your Gastroenterologist to get additional information.
Second opinion of a Surgical Gastroenterologist may help you further.

I hope this answer helps you further.





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
Get the stool tests done when such changes are noted.

Detailed Answer:
Thanks for your photo and feedback.
You are correct, the stool has 3 different shades and can be due to various reasons:
Stool is not formed by a single meal or so, hence can have such layered appearance.
The possibility of having no sufficient bile in a particular time can cause such pale stools, send the sample of such stools for lab to test for bile salts and pigments.

It is good that the liver functions were normal.
As discussed above please talk to your Gastroenterologist to get additional information.
Second opinion of a Surgical Gastroenterologist may help you further.

I hope this answer helps you further.




Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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Excessive Burping And Upper Right Side Abdominal Pain Under Ribs

Excessive burping and upper right side abdominal pain under ribs and also side of the ribs.