Hi Dear !! Thanks for your query to HCM .
Read and reviewed your query and health concerns.
IN the given situation, You seems to suffer from-
Cholecystitis with Gall stone with accompanied Hepatitis?obstructive.
This is because standing,you feel fine and eased with pain.This is because of the inflamed
liver relieveing diaphragmatic discomfort in standing.
Gas is from
ileus from hepatitis and from Gall stone irritation,increasing sphincteric tone in intestines.Pain is troublesome at night, due to inflammed liver irritating diaphragmatic
peritoneum and back more while in lying down position.Pain is more on left and in stomach,as it is accompanied by irritating and inflammed left liver,from partially-obstructing gall stone in CBD.
CT abdomen with Hida scan would fix this diagnosis of partial obstruction due to gall stone in CBD.(Common bile duct)
Review and ruling out other causes by MRA(MR
Angiography) is needed by Consults with GI-Surgeon.
This would resolve causes of pain under right ribs in your case.
Hope this would help you to plan further of this complex illness of yours.
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Good Day!!
Wishing Good Healthy Life in time to come!!
Dr.Savaskar M.N.
Senior Surgical Specialist
M.S.Genl-CVTS