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What causes sharp pain and pressure in rib cage?

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Posted on Tue, 24 Nov 2015
Question: I have pain under my right rib cage that randomly pops up once a week. it almost feels like its tied to gas but it is not. its under my diaphragm and when triggered it will last about 5 min at a time. It is a sharp pain in the upper right of my stomach, I will then get flush in face and will start a facial sweat. It will then start going away slowly after the 5 min til its gone.
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Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Clinical evaluation and investigations accordingly.

Detailed Answer:
Hi.
Thank for your query.
Read and understood your history and concerns.

To recapitulate: Male/35 - pain under right rib cage/diaphragm - when triggered will last for 5 minutes - sharp - then you get flush and sweating in the face - goes away slowly after 5 minutes - fells like tied to a gas but it is not - not seen by a Doctor - no medication history as you thought to be just indigestion or something - were told recently by someone that the pain is too low to be indigestion.

My thoughts and explanations and further course of actions:
- This may be due to costochondritis as per the description you have given.
- Cardiac and the problems under the diaphragm must be ruled out by investigations.
- Other causes can be due to inflammation of the liver and/or gall bladder

I would advise you the following:
- Routine tests of blood including liver function tests, urine and stool.
- Ultrasonography of the abdomen to start with and confirmatory CT scan of the lower thorax and upper abdomen.
- EKG and cardiac check up must be done.
- Further tests as per the clinical evaluation under the guidance of a Doctor, preferably a General Surgeon or Gastroenterologist. Like upper GI endoscopy
- Examination and investigation for any mass in the neck or chest that can irritate the diaphragm and cause the pain.

The flush and sweating in the face is mostly due to a reflex response of the branch of the vagus nerve connected to the facial nerve or arterial distribution.

I hope this answer helps you to get an early and proper diagnosis and treatment, please feel free to discuss further and keep no gap of communication.

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

General Surgeon

Practicing since :1984

Answered : 18117 Questions

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What causes sharp pain and pressure in rib cage?

Brief Answer: Clinical evaluation and investigations accordingly. Detailed Answer: Hi. Thank for your query. Read and understood your history and concerns. To recapitulate: Male/35 - pain under right rib cage/diaphragm - when triggered will last for 5 minutes - sharp - then you get flush and sweating in the face - goes away slowly after 5 minutes - fells like tied to a gas but it is not - not seen by a Doctor - no medication history as you thought to be just indigestion or something - were told recently by someone that the pain is too low to be indigestion. My thoughts and explanations and further course of actions: - This may be due to costochondritis as per the description you have given. - Cardiac and the problems under the diaphragm must be ruled out by investigations. - Other causes can be due to inflammation of the liver and/or gall bladder I would advise you the following: - Routine tests of blood including liver function tests, urine and stool. - Ultrasonography of the abdomen to start with and confirmatory CT scan of the lower thorax and upper abdomen. - EKG and cardiac check up must be done. - Further tests as per the clinical evaluation under the guidance of a Doctor, preferably a General Surgeon or Gastroenterologist. Like upper GI endoscopy - Examination and investigation for any mass in the neck or chest that can irritate the diaphragm and cause the pain. The flush and sweating in the face is mostly due to a reflex response of the branch of the vagus nerve connected to the facial nerve or arterial distribution. I hope this answer helps you to get an early and proper diagnosis and treatment, please feel free to discuss further and keep no gap of communication.