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Q. I get pain in my lower ribs while coughing and taking deep breath with history of AS. Please help.

Answered by
Dr. Divya Agarwal
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 03, 2020

Hello doctor,

I have been having pain around my lower ribs towards the back side (left side) since the past eight days. The pain gets worse while lying down and trying to change sides in the night. It also hurts while sneezing or coughing (feels better if I cough or sneeze by holding the area with my hand). It hurts a little sometimes while deep breathing. While sitting or standing straight, the pain is almost not there and also it does not hurt while bending forward or backward. But it hurts a little while bending sideways.

I did a course of Hifenac Max for 5 days and the pain did come down slightly. However, it again got bad last night.

I was diagnosed with ankylosing spondylitis in 2009. Since then I have had two episodes of severe pain in my lower back right side (sacroiliac joint). But it has never pain in the area of ribs like what is happening now. I have also had multiple episodes of uveitis over the past eight to nine years. I am HLA-B27 positive.

I do not have any other symptoms. My appetite is fine and I do not feel any other discomfort. My motion is regular. Also, I am not on any regular medication. My BP is normal (measured using an electronic commercial machine at home) and my vitals were mostly normal (apart from slightly high cholesterol) when I did my health check up 3 years back.

Dr. Divya Agarwal

Rheumatology
#

Hi,

Welcome to icliniq.com.

In the light of the fact that you are HLA B27 positive, the pain that you are experiencing is due to the same problem. This is called enthesitis, and it occurs due to inflammation at the attachment of muscles to bones. So the treatment also remains similar to that of AS. You need to take a full dose of NSAID (non-steroidal anti-inflammatory drugs) whichever suits you best.

For the present, you could take Voveran sr 75 twice daily with an antacid like Pantocid. If things still bad, Sulfasalazine may be added. Calcium and Vitamin D must be continued. Regular physical exercise is a must to control this disease. Please make sure you follow this.

I hope this helps.


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Thank you doctor,

Could you please tell me for how many days should I take the Voveran SR before I take a call whether or not to add Sulfasalazine? Also, I had taken Hifenac Max for five days last week.

Dr. Divya Agarwal

Rheumatology
#

Hello,

Welcome back to icliniq.com.

I think depending on how well you feel with Voveran take it twice a day for at least one week, then you can probably reduce it to once a day for another one week, by then we can take a call.


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