What Causes Pain And Tenderness Under The Right Rib Cage?

Posted on Mon, 8 May 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 8 May 2017 Answered on

Thu, 1 Jun 2017 Last reviewed on

Question : about 2 months ago I began experiencing an aching pain on the lower left side of right rib cage .. it is somewhat sensitive to a moderate pressing in the area ... I am generally in very good health .. I exercise 3-4 times a week .. I am about 5'11" / 185 lbs ... I thought at first it could be an injury caused by abdominal exercises .. i have some family history of gall bladder issues .. i am a moderate drinker .. but do to some family- emotional issues i have drank excessively maybe 3-4 times over the past few months ( 6-7 drinks or 6-9 beers ) .. i normally consume 2 drinks a day during the week after excercising and can drink more when going to dinner / socializing with friends on weekends ( 4-6 drinks beers once a weekend ) ... so I've become concerned it could be my liver ... i feel well otherwise .. i take 40 mg of Lipitor daily and 50-100 mg of Zoloft daily and an aspirin ... what would your diagnosis be ? .. what tests would you recommend ?

Answered by Dr. Geeta Sundar (2 hours later)

Brief Answer:
has to be the liver, duodenum, gall bladder or lungs.

Detailed Answer:
Hi welcome to Health care magic,
an aching pain and tenderness in the area you describe has to be the liver, duodenum, gall bladder or lungs. I would rather go for the first---alcoholic fatty liver disease/Lipitor induced liver damage.
But as a differential diagnosis I would like the following tests---

Liver function tests
Abdominal sonography
Routine urine
If above tests are negative--then an x-ray chest.

But it could also be Beer induced gastro-duodenitis--the first part of intestines called duodenum also lies in that area--below rib cage on right side.

So meanwhile take Omeprazole, plus a chewable antacid with Methyl polysiloxane and Silymarin a liver stimulant all twice a day.

And I would like you to stop Lipitor and all alcohol for a while if your liver functions are disturbed.

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Geeta Sundar (11 hours later)

thank you .. if it is liver .. and I am otherwise in good health .. and I stop drinking .. can the liver heal ?

Answered by Dr. Geeta Sundar (6 minutes later)

Brief Answer:
Liver has a great capacity to heal, even if 70% is destroyed.

Detailed Answer:
Sure! Liver has a great capacity to heal, even if 70% is destroyed. All the best!--regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Geeta Sundar (5 hours later)

thanks ! .. are you able to order these tests ?

Answered by Dr. Geeta Sundar (6 hours later)

Brief Answer:
I'm afraid not. I can only advise you-

Detailed Answer:
I'm afraid not. I can only advise you--wish you the best.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Geeta Sundar (44 hours later)

Dr XXXXXXX ... received my test results ... all was in the normal range except the following: GGT 52 (normal 7-50 ) ... eGFR - > 60 (normal or increased ) ... are these anything to be too concerned with ? ... I still have the pain in my side (below right rib cage ) thanks

Answered by Dr. Geeta Sundar (3 hours later)

Brief Answer:
the liver functions are almost fine.

Detailed Answer:
Hi,

The liver functions are almost fine. SGPT will come to normal once you stop drinking. Can your doctor give you a liver supplement like Silymarin to stop the pain?

There is not much cause for concern.
Can you please let me know your lab range of e-GFR? Normally, above 90 is fine, but lab ranges vary.

Regards

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