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Have Tenderness In Rib Cage Area. No Nausea And No Vomiting. Liver Ultrasound And Endoscopy Normal?

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Posted on Mon, 28 Oct 2013
Question: I have been having .something like a tenderness that sometimes is on the upper left and upper right area of the ribcage . If the right side bothers me then the left feel ok. When this all started about 8mos ago it was only on the right
side now it happen on the upper left side. I had a liver ultrasound done and an endoscopy and both were ok. my liver enzymes are ok and lipase and amylase is ok. I should also add that i was addicted to laxitives for 30 years and have been off of them now since february. I have no nausea or vomiting, but this is really scaring me.
doctor
Answered by Dr. Anjana Rao Kavoor (58 minutes later)
Brief Answer:
Please find detailed answer below.

Detailed Answer:
Hi XXXXXX,
Thanks for writing in to us.

I have read through your query in detail.
As you have already said that ultrasound reports show normal findings, I would like to reconfirm if the pain is from the bony rib cage itself.

Rib cage pain may be sharp, dull, or achy pain felt at and below the chest and above the navel on either side. It may occur after an obvious injury or without explanation.
Rib cage pain can be caused by anything from pulled muscles to a rib fracture. This pain may occur immediately upon injury, or develop slowly over time.

The most common causes of rib cage pain are a pulled muscle or bruised ribs. Other causes of rib cage pain are:
broken ribs
injuries to the chest
rib fracture
diseases that affect the bones, such as osteoporosis
inflamed lining of the lungs
muscle spasms
inflamed rib cartilage

Rib cage pain may be apparent with no movement, or you may experience sharp pain upon breathing in or when moving into a certain position.

When you see a doctor, describe the type of pain you’re experiencing and what movements make the pain worse. The type of pain you’re experiencing as well as the area of pain can help the doctor determine which tests to run. These tests will help your doctor determine your diagnosis.

If the pain started after an injury, the doctor may order an imaging scan such as an X-ray. An X-ray can show evidence of fractures as well as abnormalities in the bones. If there are any abnormalities on your X-ray, such as an abnormal growth, the doctor will order an in-depth imaging scan like an MRI. An MRI (magnetic resonance imaging) scan gives the doctor a detailed view of the rib cage and surrounding structures such as muscles, organs, and tissue.

Having said all about conditions involving the rib cage, please do let me know if you think the pain is NOT from the rib cage so that I can discuss other possibilities in the abdomen that might be causing your pains.


I hope this helps,
Any further queries are welcome.
Dr. A Rao Kavoor
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anjana Rao Kavoor (36 minutes later)
No the tenderness is not to the ribs , it is just in the area . This all started on the right side of rib cage but now will go to the left side. The doctor did an xray that was the first thing that was done and that was neg. I had a.colonoscopy and that was also neg.. Since the tenderness goes from one side then to the other could this have anything to do with being on laxitives so many years? like my.bowel.are having to work again? I have had no injury and remember the discomfort rotates from left to right.
doctor
Answered by Dr. Anjana Rao Kavoor (8 hours later)
Brief Answer:
Laxative overuse effects in detail.

Detailed Answer:
Hi XXXXX,
Thanks for writing in to us with an update.

You might be right that long term laxative use might have caused your pains.

Overuse, abuse or accidental overdose of laxatives can cause abdominal pain, swelling, bloating and cramping. Symptoms may be slightly different depending upon the laxative being used. The most common type of laxative to cause pain is the stimulant laxatives or combination medication that contains a stimulant. Discomfort can also include nausea, vomiting, diarrhea and bloody stools.

Essentially, whether taken short term or long term, laxatives create and perpetuate the very problem they were intended to correct. Laxatives induce constipation as the tissues become dried out, muscles become weakened and the delicate nerves lining the colon become damaged. This slows down intestinal motility and results in constipation. With long term laxative abuse, the colon becomes damaged and fails to function entirely. This is laxative dependency.

A laxative abuser has diarrhea in place of well formed stools. Long term abusers tend to have weight loss, hair loss, vomiting, abdominal pain, low energy, thirst, puffiness, mood swings, bone pain and suffer symptoms of dehydration. With prolonged use of laxatives a number of serious problems may arise such as fluid and electrolyte imbalances, damage to other organs, and syndromes resembling colitis.

Make sure you stay well hydrated when taking laxatives by drinking plenty of fluids. At least two litres (six to eight glasses) of water a day is recommended. By eating fiber-rich foods, drinking at least 10 8-oz. glasses of water each day and exercising regularly, most cases of constipation will improve.

I hope this helps,
Any further queries are welcome.
Dr. A Rao Kavoor
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Anjana Rao Kavoor

Psychiatrist

Practicing since :2008

Answered : 1197 Questions

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Have Tenderness In Rib Cage Area. No Nausea And No Vomiting. Liver Ultrasound And Endoscopy Normal?

Brief Answer:
Please find detailed answer below.

Detailed Answer:
Hi XXXXXX,
Thanks for writing in to us.

I have read through your query in detail.
As you have already said that ultrasound reports show normal findings, I would like to reconfirm if the pain is from the bony rib cage itself.

Rib cage pain may be sharp, dull, or achy pain felt at and below the chest and above the navel on either side. It may occur after an obvious injury or without explanation.
Rib cage pain can be caused by anything from pulled muscles to a rib fracture. This pain may occur immediately upon injury, or develop slowly over time.

The most common causes of rib cage pain are a pulled muscle or bruised ribs. Other causes of rib cage pain are:
broken ribs
injuries to the chest
rib fracture
diseases that affect the bones, such as osteoporosis
inflamed lining of the lungs
muscle spasms
inflamed rib cartilage

Rib cage pain may be apparent with no movement, or you may experience sharp pain upon breathing in or when moving into a certain position.

When you see a doctor, describe the type of pain you’re experiencing and what movements make the pain worse. The type of pain you’re experiencing as well as the area of pain can help the doctor determine which tests to run. These tests will help your doctor determine your diagnosis.

If the pain started after an injury, the doctor may order an imaging scan such as an X-ray. An X-ray can show evidence of fractures as well as abnormalities in the bones. If there are any abnormalities on your X-ray, such as an abnormal growth, the doctor will order an in-depth imaging scan like an MRI. An MRI (magnetic resonance imaging) scan gives the doctor a detailed view of the rib cage and surrounding structures such as muscles, organs, and tissue.

Having said all about conditions involving the rib cage, please do let me know if you think the pain is NOT from the rib cage so that I can discuss other possibilities in the abdomen that might be causing your pains.


I hope this helps,
Any further queries are welcome.
Dr. A Rao Kavoor