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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Abdominal Pain?

I sometimes get a severe pain/cramp in my upper left abdomen, below my ribs. The pain, like a charlie horse, usually occurs when bending or sitting in an awkward position. Standing up helps the pain decrease, but if i sit or bend again the pain will return. The cramp can last from seconds to minutes. The area will remain sore and tender to the touch for hours or days. I do not note any protrusion. I am morbidly obese, have had various abdominal surgeries. Could this be a hernia?
Wed, 12 Nov 2014
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General Surgeon,  's  Response
Hi.
Thanks for your query.
Read your history carefully and understood your problem.

The commonest reason for the typical pain you have explained can be due to costo-chondritis. In this condition the lower ribs get inflamed, remain dormant till the site is instigated - which in your case is due to bending .
Once the pressure on it released the tenderness will go down.

Noticing protrusion is very difficult in morbidly obese people.
So we have to get help of ultrasonography or CT scan or an MRI- MRI will be the best as it will help diagnose the costochondritis and / or hernia.

The possibility of hernia is less as there may not be any scar in the area you have pain and that is not the usual site for any hernia at all.

The investigations along with physical examination by a Surgeon will help clear the diagnosis , you to get appropriate treatment and get well soon.


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What Causes Severe Abdominal Pain?

Hi. Thanks for your query. Read your history carefully and understood your problem. The commonest reason for the typical pain you have explained can be due to costo-chondritis. In this condition the lower ribs get inflamed, remain dormant till the site is instigated - which in your case is due to bending . Once the pressure on it released the tenderness will go down. Noticing protrusion is very difficult in morbidly obese people. So we have to get help of ultrasonography or CT scan or an MRI- MRI will be the best as it will help diagnose the costochondritis and / or hernia. The possibility of hernia is less as there may not be any scar in the area you have pain and that is not the usual site for any hernia at all. The investigations along with physical examination by a Surgeon will help clear the diagnosis , you to get appropriate treatment and get well soon.