What Causes Right Rib Pain Radiating To Right Shoulder And Left Breast?

Posted on Mon, 3 Aug 2015

Question: Hi, for 10 days Now I feel a discomfort under my right ribs, radiating to my right shoulder blade and sometimes on the left under my breast. It also gets uncomfortable when I am laying or sitting in some positions. I went to my GP who did a complete blood analysis of liver enzymes etc, and the Only thing that came back is that I have an iron deficiency. I am Now waiting to get an ultrasound, but I am really scared that they might be something wrong with my liver and that the iron deficiency might be due o some internal bleeding. I am also quite tired and slighlty dizzy the last couple of days. I have IBS and lately have been taking a lot of suplements as preparation for an IVF: dhea, q10, vitamin b, aspirine... Could I have damaged the liver by overdosing on supplement? I am really worried. Thank you for your help.
Kind regards,
XXXX

Answered by Dr. Abhijit Deshmukh (3 hours later)

Brief Answer:
Hi, do not worry

Detailed Answer:
Hi and welcome to HCM,
Thank you for the query.

Looks like there is not much to worry especially if clinical examination and basic blood investigations and liver function tests are normal.
Also the history of pain does not fit into any major problem, internal bleeding, or severe liver problem too.

First thing is to get rid of anxiety.

Possibilities are muscular pain, or pain due to cartilage pain called costo chondritis which is usually self limiting and needs no aggressive treatment.

Do not get worried. Can take some antacid like pantoprazole 40 mg once a day and paracetamol 500 mg thrice a day for 3 to 4 days which is available over the counter and usually good for mild pain.

Also unlikely that your liver is damaged due to medications or supplements as it is unlikely to cause pain. Though I will advise to go slow on them.

Eat on time, sleep adequately.
Do not sleep two hours after meal.
Allay anxiety.
Visit a gastroenterologist if severe pain.
Hope this answers your query.
Best wishes for your speedy recovery.
Happy to help.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Abhijit Deshmukh (34 minutes later)

Hi, thank you for answering. What raised my concern are some lab and imaging results I got in the past that indicated that there could be a problem, but weren't given too much importance at the time. First, on two occasions between 2008 and 2010, my iron levels were slightly higher: 28 and 29umol/L (ref up to 26). Secondly, a scan done in 2013 showed that my "left liver lobe is slightly more voluminous" and that there is a minimal ascite. Showd I worry a lot about it, having in mind my latest symptoms?

Answered by Dr. Abhijit Deshmukh (1 hour later)

Brief Answer:
hi

Detailed Answer:
Thank you for the query
Well these iron reports do not need to be worried about.
Not sure if voluminous left lobe has any meaning in isolation as it is very subjective finding on sonography without much significance
Also ascites is rare to find but can occur during ovarian follicle rupture especially if you are on medication for same.
Well this does not seem to be related to the pain you have so do not worry
Hope this answers your query
Happy to help

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj