Severe pain in Upper right ribcage and under right shoulder blade.


Q: I am a 32 yr old female. I have been having severe pain in my upper right ribcage that wraps around under my right shoulder blade for a little over a month after eating or drinking anything. I thought at first it was just gas... antacids and Beano seemed to ease the pain atleast at first but over the last 2 weeks it has only gotten worse. I have started skipping lunch at work as it is hard to function when in pain, but it has gotten to where even drinking a cup of coffee causes awful pain. I feel kinda warm feeling and very tired when it hurts.. it tends to last anywhere from a half hour to a couple hours at a time. I've gotten scared to eat or drink anything! Feel a little sick to my stomach occasionally as well. I don't know what to do anymore. It even wakes me in the middle of the night, cant get comfortable and have to walk around. Please help. I am seeing a doctor as soon as I can so any questions you can suggest for me to ask would be greatly appreciated.


A:   I do understand your concern regarding the pain abdomen. You have mentioned that you have severe pain located at the right upper ribcage which worsens on eating and drinking, also antacids have not helped to relieve your symptoms. Though there are many causes of pain abdomen, the most likely differential that I would think of in this case are biliary colic due to gall stones, renal stones, pancreatitis and inflammation of the liver (hepatitis).
You may need to consult you doctor for tests that will help to identify the cause. Your doctor may order a complete blood workup along with liver function and kidney function tests, serum amylase, ultrasound abdomen, x-ray abdomen or an IVP to help in the diagnosis. The treatment will depend on the underlying pathology.

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