Dear Ask The Doctor: I've had a pain on and off for many months on my right side under my rib cage. In the beginning it hurt when I was sitting and would sneeze. Pushing on it eased the pain. Now, it has gotten worse and hurts more often, mostly when I am sitting because the area is constricted, but now when I am standing too and has started radiating to the back. Pushing on a specific area hard helps a little bit. Stretching, with my arms up and over my head helps. I never drink any alcohol, eat a very healthy diet and am not overweight. What can the problem be?
Dear Patient: The pain seems to be due to liver enlargement, and its pressure on the surrounding organs. The condition is known as non alcoholic steatohepatitis (NASH), that causes inflammation and accumulation of fat and fibrous tissue in the liver. Although a similar condition can occur in people who abuse alcohol, NASH occurs in those who do drink little to no alcohol. It may be associated with diabetes, insulin resistance, overweight, high fat or a high cholesterol diet. You may want to consult your doctor for tests including liver function tests, ultrasound or CT scan for the diagnosis of the condition.