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Severe pain below ribs, stabbing sensation. Ultrasound normal. Cure for pain?

I have a pain that keeps coming and going just between the bottom of my ribs where they come together at the top of my tummy. At times it gets so bad I it seems like a knife being put in and twisted. I have been to emergency before and had an ultrasound with out any luck but as I sit here now with the pain I wonder if they have missed some thing
Asked On : Thu, 6 Dec 2012
Answers:  1 Views:  18
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General & Family Physician 's  Response
Hello. I'm Dr. Christensen.
I'm sorry you're uncomfortable. It's difficult to diagnose your problem without an evaluation, but it sounds like you already had an ultrasound to look at your gallbladder. Usually, when gallbladder ultrasounds are performed the technician also tries to get a look at your kidneys and pancreas, so I presume there was nothing abnormal going on in those organs, either.
Unfortunately, a gallbladder ultrasound is sometimes normal in a patient who has gallbladder disease. If a person's symptoms are suggestive of gallbladder disease and his or her ultrasound is normal, another test called cholescintigraphy (also known as a HIDA scan) may reveal abnormal gallbladder function. This is something you should discuss with your doctor.
Having said all that, the location of your pain isn't classic for gallbladder disease. Most people with gallbladder problems have pain in the upper right side of their abdomen, just beneath the right ribs. Gallbladder pain can also radiate to the right mid-back or even the right shoulder. Your pain seems to be more centrally located in your upper abdomen -- in the epigastrium, or "pit of the stomach." Pain in this area is more commonly associated with ulcers or gastritis (inflammation of the stomach lining). If you haven't already done so, a trial of antacids (liquid Maalox or Mylanta) might be worthwhile. Just take a couple of tablespoons the next time your pain occurs. If the antacid seems to help with your discomfort, the possibility of an ulcer needs to be pursued. This might entail a test to rule out Helicobacter pylori infection (H. pylori is the most common cause of ulcers in developed countries) or even upper endoscopy. At the very least, several weeks of acid-reducing medications (omeprazole, lansoprazole, pantoprazole, cimetidine, ranitidine, etc.) would be indicated.
In any event, if you're still having pain your workup is not yet complete. You should contact your physician to discuss the next step in your evaluation.
I hope that helps, and I hope you feel better soon!
Answered: Thu, 6 Dec 2012
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