Severe Rib Pain After Meals: Possible Causes and When to Seek Help

Bloating and pain in the left or right rib area after meals?

Hello, doctor.
Recently, after dinner for more than an hour on two consecutive days, I experienced sudden bloating and severe pain in the upper abdomen, specifically around the left and right rib areas.
The pain was very intense, and I suspected it was due to overeating.
I consulted a doctor who believed it was caused by binge eating and prescribed medication for relief.
However, a week later, the same symptoms reappeared even though I did not overeat, and it was more than two hours after dinner.
I would like to know if there could be other underlying conditions.

P.S.
I have had gallstones for over a decade but rarely experience symptoms.
In June of this year, I underwent an endoscopy during a health check-up, which revealed a mild gastric ulcer.
Should I seek medical attention during these episodes? Which specialty should I consult? Thank you for your response!

Zhao, 50~59 year old female. Ask Date: 2022/12/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is advisable to confirm whether gallstones are causing obstructive abdominal pain using ultrasound.
You can schedule an appointment with a gastroenterologist, and if necessary, visit the emergency department.

Reply Date: 2022/12/24

More Info

Severe rib pain after meals can be concerning, especially when it occurs repeatedly and is accompanied by a history of gallstones and a recent diagnosis of a mild gastric ulcer. Given your symptoms and medical history, it is important to consider several potential causes for your rib pain.

1. Gallbladder Issues: Since you have a history of gallstones, one of the most likely causes of your rib pain could be related to your gallbladder. Gallstones can lead to cholecystitis (inflammation of the gallbladder) or biliary colic, especially after eating fatty meals. Even if you are not experiencing typical gallbladder attacks, the presence of gallstones can still cause discomfort and pain in the upper abdomen and rib area.

2. Gastric Ulcer: You mentioned having a mild gastric ulcer. Ulcers can cause pain that may be exacerbated by eating, especially if the food irritates the stomach lining. The pain from an ulcer can sometimes radiate to the back or sides, mimicking rib pain. If the ulcer is aggravated, it could lead to more severe pain after meals.

3. Gastroesophageal Reflux Disease (GERD): Another possibility is GERD, where stomach acid flows back into the esophagus, causing pain and discomfort. This can sometimes be felt as rib pain, especially after eating.

4. Musculoskeletal Issues: Sometimes, rib pain can be due to muscle strain or injury, especially if there has been any recent physical activity or strain in that area. However, given your symptoms' timing with meals, this seems less likely.

5. Other Gastrointestinal Disorders: Conditions such as pancreatitis or even functional gastrointestinal disorders could also lead to pain after eating. Pancreatitis, in particular, can cause severe pain in the upper abdomen that may radiate to the back and sides.

Given that your symptoms have persisted despite medication and dietary changes, it is advisable to seek further medical evaluation. You should consider visiting a gastroenterologist, as they specialize in digestive system disorders and can provide a more comprehensive assessment of your symptoms. They may recommend further diagnostic tests, such as an ultrasound of the gallbladder to check for gallstones or inflammation, or an endoscopy to evaluate the state of your gastric ulcer.

When to Seek Help
You should seek immediate medical attention if you experience any of the following:
- Severe, persistent abdominal pain that does not improve with over-the-counter medications.

- Pain accompanied by fever, chills, or jaundice (yellowing of the skin or eyes).

- Nausea or vomiting, especially if it is severe or contains blood.

- Changes in bowel habits, such as diarrhea or constipation, especially if accompanied by pain.

In summary, while your rib pain may be related to overeating or gallbladder issues, the persistence of your symptoms warrants further investigation. Consulting with a gastroenterologist will help determine the underlying cause and appropriate treatment for your condition.

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