Left Rib Pain: When to See a Gastroenterologist or Orthopedist - Family Medicine

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When experiencing persistent pain under the left rib cage, especially after a history of gastrointestinal issues, it is essential to approach the situation methodically. Your symptoms, including difficulty breathing and nausea after eating, combined with the recent manipulation of your spine, warrant a thorough evaluation.
Firstly, the left upper quadrant of the abdomen houses several vital organs, including the stomach, spleen, left kidney, and parts of the colon and pancreas. Pain in this area can arise from various sources, including gastrointestinal problems, musculoskeletal issues, or even referred pain from other areas. Given your history of gastrointestinal discomfort, it is prudent to consider both gastrointestinal and orthopedic evaluations.

The fact that you felt a "bounce" when pressing on the area could indicate a few things. It might be related to the rib cage's normal movement or a sign of a musculoskeletal issue, especially if you recently had spinal manipulation. If the rib cage or surrounding muscles are strained or if there is a rib subluxation (a partial dislocation), this could cause localized pain and discomfort.
On the other hand, your symptoms of nausea and difficulty breathing could suggest an underlying gastrointestinal issue, such as gastritis, peptic ulcer disease, or even a splenic problem. The nausea after eating might indicate that your stomach is not emptying properly or that there is irritation in the gastrointestinal tract.
Considering these factors, here are some recommendations:
1. Consult a Gastroenterologist: Since you have a history of gastrointestinal problems and are currently experiencing nausea and discomfort after eating, it would be wise to revisit a gastroenterologist. They may recommend further diagnostic tests, such as an abdominal ultrasound or a CT scan, to assess the organs in that area and rule out any significant issues like organ displacement or inflammation.

2. Consider an Orthopedic Evaluation: If the pain persists or worsens, especially after the spinal manipulation, it may be beneficial to see an orthopedist. They can evaluate for any rib fractures, muscle strains, or other musculoskeletal issues that could be contributing to your pain. An X-ray or MRI might be necessary to visualize the bones and soft tissues.

3. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any associated factors (like certain foods or activities). This information can be invaluable for your healthcare providers in determining the underlying cause of your discomfort.

4. Avoid Self-Diagnosis: While it’s tempting to search for answers online, self-diagnosing can lead to unnecessary anxiety or mismanagement of your symptoms. Always consult with a healthcare professional for an accurate diagnosis and treatment plan.

5. Lifestyle Modifications: In the meantime, consider dietary adjustments that may alleviate gastrointestinal symptoms. Eating smaller, more frequent meals and avoiding trigger foods can help manage nausea and discomfort. Additionally, practicing relaxation techniques may help with any anxiety related to your symptoms.

In summary, given your symptoms and history, it would be prudent to consult both a gastroenterologist and an orthopedist. This dual approach will help ensure that both potential gastrointestinal and musculoskeletal issues are thoroughly evaluated and addressed. Your health and comfort are paramount, and seeking professional guidance is the best course of action.