Right Rib Pain: Causes and Concerns in Gastroenterology

Pain upon palpation in the right upper quadrant?

Hello doctor, I recently noticed some discomfort in the area just below my right rib (approximately one centimeter below the lowest rib) and slightly above my navel on the right side.
It usually doesn't hurt, but occasionally I experience a dull pain.
When I press on the lowest rib, I feel mild pain, and the most painful spot is about one centimeter below the rib, but it's not severe enough to hinder my movement.
I have a concern that the painful area I press on had shingles about six months ago; could this be nerve pain? Or could it be an issue with my liver, gallbladder, or gastrointestinal tract? This pain has persisted for some time, and I initially thought it was residual nerve pain from the shingles.
Additionally, I have a sedentary lifestyle, I'm somewhat overweight, and my abdomen is a bit large (my waist circumference is about 90 cm).
Is it possible that the pain is due to pressure from sitting?

Niming, 20~29 year old female. Ask Date: 2018/04/15

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It is possible; you can check with an ultrasound for confirmation.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/04/15

More Info

Understanding right rib pain, especially in the context of gastroenterology, involves considering a variety of potential causes and underlying conditions. Your description of pain localized to the area beneath the right rib cage, particularly after pressing on that area, raises several possibilities that merit further exploration.

Firstly, the pain you are experiencing could indeed be related to your previous episode of shingles (herpes zoster). Postherpetic neuralgia, a common complication following shingles, can lead to persistent nerve pain in the area where the rash occurred. This type of pain can be sharp, burning, or aching and may be exacerbated by pressure or movement. If the pain is consistent with the distribution of the nerves affected during your shingles episode, it is plausible that this is a contributing factor.

However, it is also essential to consider other gastrointestinal issues that could be causing your symptoms. The right upper quadrant of the abdomen houses several vital organs, including the liver, gallbladder, and parts of the intestines. Conditions such as gallbladder disease (including cholecystitis or gallstones), liver issues (such as hepatitis or fatty liver disease), or even gastrointestinal disorders (like gastritis or peptic ulcers) could manifest as pain in this area. Given that your pain is intermittent and not severe enough to impede your daily activities, it may suggest a less acute issue, but it should not be dismissed.

Additionally, your mention of prolonged sitting and being overweight could contribute to musculoskeletal pain. Poor posture and excess weight can lead to strain on the muscles and ligaments in the abdominal and back regions, potentially causing discomfort that mimics visceral pain. This type of pain can often be alleviated with changes in posture, physical activity, and weight management.

Given the complexity of your symptoms, it is advisable to seek a comprehensive evaluation from a healthcare professional. A thorough history, physical examination, and possibly imaging studies (like an abdominal ultrasound or CT scan) may be warranted to rule out any significant underlying conditions. Blood tests to assess liver function and check for signs of inflammation or infection could also provide valuable insights.

In summary, while your pain could be related to postherpetic neuralgia, it is crucial to consider other gastrointestinal and musculoskeletal causes. A multidisciplinary approach, including gastroenterology and possibly pain management, may be beneficial in addressing your symptoms effectively. If your pain persists or worsens, or if you develop additional symptoms such as nausea, vomiting, or changes in bowel habits, do not hesitate to seek medical attention promptly.

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