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Suggest treatment for pressure under lower left rib cage

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Posted on Thu, 21 May 2015
Question: I have pressure under my lower left rib cage .It is worse when sitting.it has been going on for a couple months at first it came and went now it has been constant for a couple weeks
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Answered by Dr. Muhammad Sareer Khalil (1 hour later)
Brief Answer:
Rule out a Cardiac issue before working up other causes

Detailed Answer:
Hello and Welcome

I appreciate your concern

My main concern is first to rule out any cardiac abnormality even if the symptoms don't indicate a cardiac issue. I would order an EKG , ETT and preferably an Echocardiogram in this regard. An Ultrasound of the area i.e left lower rib cage should be done to see for two important things among others. Firstly, size of the spleen and secondly normal diaphragmatic movements. An enlarged spleen and a subsequent splenic infarct can lead to both pressure and pain sensations in the area you described. All these tests can be ordered together by your local doctor / cardiologist. If the pain is not severe enough to affect routine daily activities, please ask your GP for cardiologist referral.

Besides the above mentioned cause, a pleural effusion on the left side can also lead to such pressure symptoms. An X ray chest or the ultrasound can be used to look for it. If no such causes are found then empirically, I would advise PPIs like esomeprazole with pro kinetics like metoclopramide for 2 weeks to see for improvement of the symptoms.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2917 Questions

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Suggest treatment for pressure under lower left rib cage

Brief Answer: Rule out a Cardiac issue before working up other causes Detailed Answer: Hello and Welcome I appreciate your concern My main concern is first to rule out any cardiac abnormality even if the symptoms don't indicate a cardiac issue. I would order an EKG , ETT and preferably an Echocardiogram in this regard. An Ultrasound of the area i.e left lower rib cage should be done to see for two important things among others. Firstly, size of the spleen and secondly normal diaphragmatic movements. An enlarged spleen and a subsequent splenic infarct can lead to both pressure and pain sensations in the area you described. All these tests can be ordered together by your local doctor / cardiologist. If the pain is not severe enough to affect routine daily activities, please ask your GP for cardiologist referral. Besides the above mentioned cause, a pleural effusion on the left side can also lead to such pressure symptoms. An X ray chest or the ultrasound can be used to look for it. If no such causes are found then empirically, I would advise PPIs like esomeprazole with pro kinetics like metoclopramide for 2 weeks to see for improvement of the symptoms. Wishing you best of health Thanks Please consult your doctor before deciding on any further course of action. Dr. M.S. Khalil