Pain under ribs. ?

Hi... I'm a 48 year old female... short and overweight. Last year I got sick really bad with being anemic... and severely dehydrated. I then started having problems with not being able to eat without throwing up. During this time... my right side would get really hard and swollen and I would have severe pain under my right rib and towards the front. Then my left side started doing it as well but not as bad as the right. I had lost a lot of weight in a short time. I had x rays done and ultra sound and a CT scan... and all showed up nothing. I eventually got an upper endoscopy done that showed I had a bad case of gastritis. Well... I slowly got better but here recently... my symptoms are returning. Just at my wits end because the doctors have no clue and think I'm over reacting. The thing is... I'm the type of person who hardly ever seeks medical attention unless I'm in severe pain and so frustrated they can't find anything.

1 Answer

  • 8 months ago

    "48 years female" should be the first clue that we maybe dealing with side effects of Menopause.. among common issues with Menopause are reduced bone density and stiff joints.. however, most doctors are not comfortable to simply blame it on Menopause, so we are obliged to investigate further for other medical conditions that are common and far more critical, such as an atypical heart-related chest pain, pleurisy and even breast cancer (you should regularly check for breast cancers around that age with self examination every few months)..

    reduced bone density makes the bones more brittle and more prone to fractures (micro fractures that may not be seen on x rays and on CT scans).. stiff joints is another common problem associated with Menopause as the rib cage is filled with small joints (or else how do you expect our chest to move during breathing)..

    normally. we would expect stiff joints, fractures and pain, over the spine (from neck to buttock), over the hips, and over the forearm, but they can also present elsewhere, such as the chest..

    if the symptoms of Menopause are significant, your doctors may start you on HRT hormone replacement therapy to slow-down the effects of reduced bone density and stiff joints.. but that requires accurate diagnosis and excluding the more sinister causes such as Blood Cancers (leukemias and Lymphomas) lung cancers and breasts cancers..

    another common diagnosis is something called Costochondritis that effects both men and women at different ages.. Costochondritis (costo=rib cage + chondr = a reference to the cartilage over the joints + itis=inflammation) is the inflammation of over the joints of the rib cages..

    Costochondritis is often caused by a trauma from a car accident, but Costochondritis can appear anytime and at any age without any clear cause.. and it may last from few weeks to few years..

    Costochondritis is more centrally located over the chest, but it can radiate or felt over the right or left ribs.. the pain would be made worse with movements and with certain body position - sometimes a cough or a laughter can make the pain worse..


    atypical chest pain due to a heart attack (an angina or an infarction) can present on the right side of the chest - especially among women..

    also a number of abdominal illnesses can produce pain over the chest; for example Gallbladder stones and Cholecystitis that produce "referred pain" that can be felt over tip of the right shoulder and over the shoulder blades at the back; even though the gallbladder is in the abdomen just below the liver..

    referred pain is the sort of pain that is felt elsewhere.. for example, the pain from a heart attack can radiate to the shoulder and to the left arm (this is a typical chest pain caused by a heart attack that often portrayed in movies and on TV with a man holding his left arm in pain) and sometimes, many women can experience a heart attack slightly different with pain felt on the right side of the chest (atypical pain caused by a heart attack) even though the heart is often located on the left side of the chest..


    another clue for your pain, is your weight-loss..

    extreme dieting and extreme weight-loss can have negative effect on bone density and on muscle movements.. if you are currently underweight (below the recommended weight according to your height), such extreme weight loss can make chest pain worse..

    we need fat to cushion the impact or to reduce friction between different body parts.. but with extreme weight-loss and/or high amounts of exercise, they can reduce the amount of fat stored in different parts of the body, and make them more prone to pain and to friction injuries..


    to me the next logical step is to screen your blood for any liver and kidney problems.. changes in the blood electrolytes (mainly Potassium and Calcium) can present with frequent muscle pain and spasm; for example over the chest..

    finding nothing wrong on CT scans and Xrays are clues themselves.. you should not be too eager to change doctors or seek a second opinion elsewhere (even though it is within your rights to request for one).. this is because most doctors have a plan or a line of investigations to try first or to test first before considering more expensive investigations and solutions such as Full Body Scan and the BMD test..

    most doctors investigate for common medical problems before considering the rare unlikely ones.. so be patient, listen to your doctor(s) and hope for the best..

    this may take time, though..

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