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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What could be the reason for pain in left side of rib and vomiting ?

I woke up this morning and I was perfectly fine. I haven t done anything out of the ordinary, but my side is in extreme pain. When I breath in it hurts worse, when I touch it right at the end of my ribs, it s very sensitive. It s cause the side of my back to hurt as well. ;\ I m not sure if this has anything to do with this issue, but the past couple of days I ve been throwing up. I haven t been able to keep anything down, but once I vomit, I feel better. This has never happened to me before, so whether this could be related i m not sure. If you have any ideas or thoughts, please leave them, it s appreciated, thanks!
Thu, 19 Jan 2012
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Internal Medicine Specialist 's  Response
Hello Kassey,

Thanks for your query. Three possibilities are coming to my mind from your symptoms. I will try explaining the three one by one.

1)     The first possibility is of kidney or renal stones in the left kidney. Kidneys are in close approximation with the abdomen and any stone in the kidney can cause pain in the abdomen which can radiate to the back. Changes in body position do not relieve this pain. This is a cramping sort of pain and may be accompanied by nausea and vomitings.

2)     The second possibility is of pleuritis which is inflammation of the pleura, a lining covering the lungs. This pleuritis may be due to pneumonia and causes chest pain (usually sharp) when you take a breath or cough.

3)     The third possibility is of any muscular pain related to the musculoskeelatal system and radiating to the back as well.
Now to rule out these possibilities you need to consult a physician and get certain investigations done. these include a complete urine examination, x-ray KUB( kidney urinary bladder) or ultrasound abdomen and a x-ray or CT chest. Till that time, apply warm compresses and take some anti inflammatory pain killer after consulting your doctor.

Hope this information helps you. If you have additional questions regarding these recommendations, you should not hesitate to contact Doctor at HealthcareMagic, who is in contact with me. Wishing you good health.






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Hi,
I have attched the conversation i had with a doctor below...can you please go through it and give your opinion.


senthil.psgct: Hi, I'm 27 and not able to ejaculate whenever i masturbate, but i'm having wet sleep
Doctor: Hi
Doctor: I am Dr. Jagdish
senthil.psgct: Hi Doctor
Doctor: Are yo married?
senthil.psgct: no
Doctor: Do you used to ejaculate normally before?
senthil.psgct: i never tried to masturbate
Doctor: Are you masturbating now/
senthil.psgct: yeah, when i try now im not able to ejaculate
Doctor: How many times you masturabated ?
senthil.psgct: probably 9 or 10 different times over last 2 years
Doctor: so any time did u have ejaculation
senthil.psgct: never
senthil.psgct: i was having a very small drop sometimes
Doctor: usually the normal quantity of ejaculated fluid ismax 1 teas sponn 5ml
senthil.psgct: no not that much
Doctor: but u r wetting the cloths in sleep
senthil.psgct: i might be getting that quantity in sleep
Doctor: is that right?
senthil.psgct: yeah
Doctor: plz hold
senthil.psgct: ok
Doctor: The first thing you should due if you are concerned is to have a semen analysis performed.
Doctor: f at that time the volume is determined to be low, than you must first determined that the specimen was obtained properly(48-72hrs abstinence) and retrograde ejaculation has been ruled out.
Doctor: *if
senthil.psgct: what is that...how and where to do that?
Doctor: I will tell u
Doctor: Low volume may represent a rare decreased in androgen levels.
Doctor: If you go to lab ask for semen analysis
Doctor: they will give a kit and ask you to collect semen in th bottle ok
Doctor: Do u follow me?
senthil.psgct: oh...k...how do i get the semen?
Doctor: Any amount is ok
Doctor: one drop is also fine
senthil.psgct: see im not able to ejaculate when i masturbate and thats my problem
Doctor: ok
Doctor: Low volume may represent a rare decreased in androgen levels.
Doctor: So please get the serum testosterone levels
senthil.psgct: through semen analysis?
Doctor: No
Doctor: it is a blood test
senthil.psgct: ok
Doctor: If the harmone is low , the semen is not prodcueed
senthil.psgct: if thats the case, then it shud not be produced in sleep also rite?
Doctor: There are other causes no ejaculation
Doctor: ok
senthil.psgct: u there?
Doctor: obstruction of the ejaculatory ducts, Vas Deferens, or epididymus cause no ejaculate
Doctor: For that u need ultrasound of prostate,Vasography
senthil.psgct: but doctor im ejaculating in sleep so obstuction of duct is ruled ou
senthil.psgct: u there?
Doctor: Plz be patient
Doctor: if the chat is not complete Iwill call u
senthil.psgct: ok..hope u have my number
Doctor: 0000&
senthil.psgct: no...its 0000..last digit has typo err
Doctor: the point is u r ejaculating in sleep and not ejaculating in masturbation
Doctor: ok
senthil.psgct: yes
Doctor: So but the investigations are same
Doctor: Why are you not ejaculating
Doctor: Defintely u r prodicuing semen
senthil.psgct: yes
Doctor: The semen is produced in prostate and mixed with sperms from testicles
Doctor: It comes from deep in prostate thru urethra
senthil.psgct: i see
Doctor: in between uyerthra and testiclea there are tubes which carry semen'
senthil.psgct: oh..
Doctor: When there is an obstruction of the ducts it will go back to bladder
Doctor: or it may n ot come forward]
senthil.psgct: i see
senthil.psgct: why is this obstruction not happening in sleep
Doctor: So u need Ultrasound of the proistate to see whether there is obstrctuion of the ducts going thru the prostate and to see if there is swelling of the prostate which might be blocking'
Doctor: I dont know
Doctor: There is no explanation for all
Doctor: Vasography is they inject dye thru the penis and look whether the floe is normal or obstructed
senthil.psgct: i see...
senthil.psgct: may i know whats ur qualification?
Doctor: MBBS with 2 yr family medicine in USA
Doctor: I recommend you consult the urologist . He will do the ultrasound of the Prostate and assist in vasography
senthil.psgct: ok..
Doctor: May I ask u few Q
Doctor: Do you have any medical problems ?
senthil.psgct: yes
senthil.psgct: no
Doctor: Do you take any medicines ?
senthil.psgct: im perfectly fit...don take any medicines
Doctor: ok
Doctor: DO you have any stress ?
senthil.psgct: no
Doctor: Ok
Doctor: So I do not see any other causes of no ejaculation from history
Doctor: Do you have any diifuclty urination
senthil.psgct: nope
Doctor: So probably there is back flow of semen or might be obstruction

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