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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Rib Pain, Diarrhea And Constipation?

I Since Sept 15 I have been experiencing pain in my right rib cage, just below my rib cage and radiating out my back. I have also had diareaha then constipation and am constantly naeseous. I have a LONG history chronic pancreatitis that developed immmediately after having my gall bladder remove in 2003 and up until 2 days ago, the pain was almost identical to that of pancreatitis. I went to my local ER on 9/17 and a cat scan said that I had gas in my biliary tree. I have been dealing with the same symptoms every day since then but on Wed night I felt somthing like a pop just under my sternum. I immediately got very nauseous and dizzy. Later when I tried to eat, I had a very strong pain in that area as soon as the food w swallowed. I went to another ER on Thurs and they didnt see anything abnormal I. Cat scan. Well, I was awakened early this morning with a very strong pain below my rib cage that I have never felt before. It would hit in waves, also like LA nor pain (definitely not pregnant, had hysterectomy 14 yes ago). And now, I have had a fever that varies from 99-102 , an off/on headache plus I have very strong body aches and not only does it hurt to move but it hurts just as much to even touch my arm or leg.
Mon, 7 Mar 2016
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General Surgeon 's  Response
Hi.
Thanks for your query.
Noted your history of pain in right rib cage area in Sept 2015, just below rib cage, radiating to the back, diarrhea then constipation, constant nausea, long history of chronic pancreatitis, that developed after gall bladder removal in 2003. Went to ER on 9/17, had CT, shows gas in biliary tree, felt pop under sternum, nausea, dizziness and severe pain on eating . Now on waking up severe pain below rib cage, hitting in waves. Had hysterectomy 14 years ago. Running fever, headache and body aches.
All these symptom in chronology are suggestive of biliary tree infection, pancreatitis and most probably gastritis or gastric ulcer.
I would suggest you the following in such a case:
X-ray of the abdomen in standing position to see for gas under diaphragm to see whether there is any perforation of the stomach ulcer.
Upper GI Endoscopy to see for Gastric problem
If there is perforation you need urgent surgery.
If no perforation you need admission to the hospital for intravenous antibiotic and sympotmatic therapy to maintain hydration and electrolyte balance.
This looks to be an emergency hence should go to ER and admit in the hospital for further investigations and treatment.
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What Causes Rib Pain, Diarrhea And Constipation?

Hi. Thanks for your query. Noted your history of pain in right rib cage area in Sept 2015, just below rib cage, radiating to the back, diarrhea then constipation, constant nausea, long history of chronic pancreatitis, that developed after gall bladder removal in 2003. Went to ER on 9/17, had CT, shows gas in biliary tree, felt pop under sternum, nausea, dizziness and severe pain on eating . Now on waking up severe pain below rib cage, hitting in waves. Had hysterectomy 14 years ago. Running fever, headache and body aches. All these symptom in chronology are suggestive of biliary tree infection, pancreatitis and most probably gastritis or gastric ulcer. I would suggest you the following in such a case: X-ray of the abdomen in standing position to see for gas under diaphragm to see whether there is any perforation of the stomach ulcer. Upper GI Endoscopy to see for Gastric problem If there is perforation you need urgent surgery. If no perforation you need admission to the hospital for intravenous antibiotic and sympotmatic therapy to maintain hydration and electrolyte balance. This looks to be an emergency hence should go to ER and admit in the hospital for further investigations and treatment.