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Dr. Andrew Rynne

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What causes severe pain under the right rib cage?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1938 Questions

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Posted on Fri, 27 Apr 2018 in Digestion and Bowels
Question: Hi I woke up this morning with severe pain in my right side below rib cage. Npo gall bladder (surgery 2009 removed) I feel like vomiting and have diarrhea. I cannot stand the pain...It is a dull constant pain. Pain level 9
Healthy 63 yr old female, recent physical in November and all was fine. No HBP, diabetes or cholesterol issues

is anyone going to answer me
doctor
Answered by Dr. Ramesh Kumar 17 minutes later
Brief Answer:
Acute enteritis.

Detailed Answer:
Hello Dear,
Thanks for choosing HealthcareMagic for your query,
I am a Gastroenterologist and would be answering your query.
Right sided chest pain in a 63 years old female without any history of major illness with diarrhea as primary symptom can be due to acute enteritis overlapping with mild gastritis.
Cardiac would have been my first differencial if your recent physicals were not fine and loose stools was not a primary symptom.

So most likely its enteritis.It means that there is mild to moderate inflammation in your gut as a result of either food or water contamination(bacterial,protozoal or viral).

I would suggest you to take few over the counter medications asap.
VSL#3 or any good quality over the counter probiotic twice daily.
Tablet zofran 4mg thrice daily(anti emetic)
Tab Tylenol (For pain)
Tab imodium 4mg thrice (to control loose motions).
Along with it drink plenty of water and electrolyte solution(ORS)
200 ml after each diarrhea or vomit.
All are Over the counter.
Few tests to be done are-
Stool test-To rule out bacterial or parasitic infection and to start you on antibiotics accordingly.
Ultra sound abdomen-Rule out liver infection.
E.K.G-To rule out cardiac involvement as pain is involving thorax.

Please feel free to follow up.
Hope i was helpful.
Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 4 hours later
No chest pain. It is all on right side under rib area
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
follow up

Detailed Answer:
That's good.
It seems like a gastric issue. Please follow the earlier suggestion, and let me know how you stay later on!

Thanks!
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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