What causes epigastric discomfort or pain below the ribs?

Question

Hello doctor,

I have been experiencing pain in my upper stomach under my ribs, which is mostly mild, coming and going almost every day since last year. There was a gallbladder stone of 15 mm, and the doctor told me to remove it, so I went to many surgeons who said it was not necessary for the gallbladder, as the pain was not from the right side, and no issue with the kidney.

What could it be?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I can understand that you must be very concerned about this annoying chronic pain.

Well, it is always advised to be guided by proper testing before jumping on the diagnosis in the first place, rather than based on assumptions. I think since you have a stone in the gallbladder, and the pain is severe, episodically lasts for one hour to six hours, and accompanied by vomiting, likely seems to be due to gallbladder, the treatment of which is surgical removal and not medicines. So I may need some more information about your pain. Is it severe enough to let you out of your work, or when there is pain, you can not do anything else? Does this pain last for one to six hours? The other close possibility is stomach-related pain or reflux-associated pain. The pain in the stomach generally goes away with the medications you are taking already. So I would need a little more information, about whether your pain completely settled down with the medications you take. If there is no relief in the symptoms of the pain, then it is unlikely to be stomach or reflux-related.

You see the problem with diagnosing abdominal pain is, that there are more than ten organs in the tummy, and when someone complains of pain in the abdomen, it can arise from anywhere, a good and relevant information, and improvement or no improvement with medications, help guide us to diagnose the case before even going for endoscopy and surgery. So I want you to provide me with the information, secondly, upload the ultrasound reports, and any other blood testing to help me further. Lastly, endoscopy is helpful in diagnosing stomach and reflux disease, it is generally safe and hardly takes five minutes or so, and it is always helpful to guide and help in reaching the correct diagnosis, particularly in your situation, where an ultrasound abdomen showed gallstones.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

This likely seems due to gas, and stomach related. I understand your weight is a little higher than your height. Weight generally slows the stomach movements and bowel movements, and it is not uncommon to see gas and stomach motility issues tend to occur more often among overweight individuals than individuals with normal weight. I am suggesting you some medicines, take them for two weeks, plus avoid foods that produce lots of gas, or burps, or which you think bring up the pain or discomfort. Here is the prescription for you to use, and see if it benefits you.

Take tablet Rifaximin 200 mg thrice daily before meals.
Take tablet Domperidone 10 mg twice daily before meals.
Take a capsule of Dexlansoprazole 60 mg once daily all for two weeks.

Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

I hope you will do better with these medications.

Thank you.