Stomach Pain, Bloating, and Rib Pain: When to Seek Help

Stomach pain, bloating, and pain under the rib cage?

Hello Doctor, I have been experiencing stomach discomfort and a lack of appetite for the past two weeks.
Throughout the day, even if I haven't eaten much, I feel bloated.
My weight has decreased by 3 kilograms over these two weeks without any intentional dieting.
Recently, I have noticed an increase in flatulence and a change in my bowel habits (I used to have a bowel movement every two days, but now I feel abdominal pain and the urge to go every morning upon waking, with loose stool).
Additionally, there is a rebound tenderness when I press on the area near my ribs.
I would like to know if it is necessary to visit a major hospital for a consultation.
Thank you for your help.

Xiao Ting, 10~19 year old female. Ask Date: 2021/05/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can go to the hospital for an examination.

Reply Date: 2021/05/05

More Info

When experiencing persistent stomach discomfort, bloating, and rib pain, it is crucial to assess the symptoms carefully and determine whether immediate medical attention is necessary. Based on your description, you have been dealing with gastrointestinal issues for two weeks, including a notable decrease in appetite and weight loss of 3 kilograms without intentional dieting. Additionally, you mentioned an increase in flatulence, changes in bowel habits, and tenderness in the rib area upon pressure, which could indicate underlying health concerns that warrant further investigation.

Firstly, the combination of symptoms you are experiencing—persistent bloating, changes in bowel habits, and weight loss—could be indicative of several gastrointestinal disorders. These may include gastritis, peptic ulcers, irritable bowel syndrome (IBS), or even more serious conditions such as inflammatory bowel disease (IBD) or malignancies. The fact that you are experiencing loose stools and abdominal pain upon pressing the rib area suggests that there may be inflammation or irritation in the gastrointestinal tract.

Given these symptoms, it is advisable to seek medical attention, particularly at a larger hospital or a specialized gastroenterology clinic. A comprehensive evaluation is warranted, which may include:
1. Physical Examination: A healthcare provider will perform a thorough physical examination to assess for tenderness, distension, or any palpable masses in the abdomen.

2. Laboratory Tests: Blood tests can help evaluate liver function, check for signs of infection, and assess overall health. A complete blood count (CBC) may reveal anemia or signs of infection, while liver function tests can indicate any hepatic issues.

3. Imaging Studies: An abdominal ultrasound or CT scan may be necessary to visualize the organs and structures within the abdomen. This can help identify any abnormalities such as gallstones, liver disease, or other structural issues.

4. Endoscopy: If symptoms persist, an upper gastrointestinal endoscopy may be recommended to directly visualize the esophagus, stomach, and duodenum. This procedure can help identify ulcers, inflammation, or other abnormalities.

5. Stool Tests: Given the changes in your bowel habits, stool tests may be conducted to check for infections, parasites, or blood in the stool.

In terms of dietary considerations, while you are experiencing discomfort, it may be beneficial to consume small, frequent meals that are easy to digest. Avoiding spicy, fatty, or highly acidic foods can also help reduce irritation. Staying hydrated is essential, but if you are experiencing nausea, it may be best to sip water slowly.

In conclusion, the combination of your symptoms—persistent stomach discomfort, significant weight loss, changes in bowel habits, and rib pain—indicates that you should seek medical evaluation promptly. Early diagnosis and treatment can significantly improve outcomes and help address any underlying conditions effectively. Do not hesitate to reach out to a healthcare professional for a thorough assessment and appropriate management of your symptoms.

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