Gastrointestinal Issues: When to Seek Medical Help - Gastroenterology and Hepatology

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Gastrointestinal issues..?


Hello, Doctor: I would like to ask about the swelling under my left rib cage that has been present for quite some time.
I have seen a doctor in the past, but they said that one side of the ribs is naturally more swollen and dismissed my concerns.
Is that really the case? When I lightly press on it, I feel some pain and a bit of nausea (I’m not sure if the nausea is related to pressing on my stomach).
Additionally, my bowel movements have been irregular in both timing and shape (sometimes I have diarrhea two or three times a day, but other times I only have a bowel movement once every one or two days).
Recently, I have been experiencing severe dizziness when I lie down to sleep (it feels like the world is spinning).
I also feel dizzy when bending over to tie my shoes, although it’s not as severe as when I’m lying down.
My entire abdomen has looked like I am three months pregnant for a long time.
I want to see a doctor, but I’m afraid of being dismissed again, with the doctor thinking I’m just overly anxious.
I sincerely seek your advice.
If I do need to see a doctor, which specialty should I consult? Can I request specific tests? I’m very worried that the doctor might think there’s nothing wrong and not allow me to undergo tests, as I am genuinely concerned and want a thorough examination to confirm my health status.

bb, 30~39 year old female. Ask Date: 2005/01/31

Dr. Chen Zhiping reply Gastroenterology and Hepatology


Hello, the area below the left rib may involve parts of the stomach and intestines.
If you are experiencing persistent discomfort along with gastrointestinal symptoms such as bloating, it is advisable to consult a gastroenterologist for an evaluation of your gastrointestinal tract, which may include procedures like an upper endoscopy, colonoscopy, or abdominal ultrasound.
Additionally, if dizziness occurs during changes in posture, it may be due to vestibular imbalance caused by postural changes.
It would be prudent to have an examination by an otolaryngologist (ENT specialist).
Sincerely, Dr.
Chen Zhi-Ping, Internal Medicine.

Reply Date: 2005/01/31

More Info


When it comes to gastrointestinal issues, understanding when to seek medical help is crucial for your health and well-being. Based on your symptoms, it is clear that you are experiencing a range of concerning signs that warrant further investigation.

Firstly, the swelling under your left rib cage, along with tenderness upon light pressure, is a symptom that should not be ignored. While some doctors may dismiss it as a normal anatomical variation, persistent swelling accompanied by pain could indicate an underlying issue, such as inflammation, organ enlargement, or even a mass. It is essential to have this evaluated by a healthcare professional who can perform a thorough examination and possibly imaging studies, such as an ultrasound or CT scan, to determine the cause of the swelling.

Additionally, your irregular bowel habits, characterized by alternating diarrhea and constipation, can be indicative of several gastrointestinal disorders, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even infections. The fact that your bowel movements are inconsistent and sometimes accompanied by discomfort is a sign that your digestive system may not be functioning optimally. It is advisable to discuss these symptoms with a gastroenterologist, who specializes in digestive health.

The sensation of dizziness and vertigo, especially when lying down or bending over, adds another layer of complexity to your situation. Dizziness can be caused by various factors, including dehydration, inner ear issues, or even gastrointestinal problems that affect nutrient absorption. Given that you also mentioned a feeling of fullness in your abdomen, which resembles a distended belly, it is crucial to address these symptoms collectively. They may be interconnected, and a comprehensive evaluation is necessary to rule out any serious conditions.

When seeking medical help, it is important to be proactive. You should consider scheduling an appointment with a gastroenterologist, as they specialize in diagnosing and treating gastrointestinal disorders. During your visit, be prepared to discuss all your symptoms in detail, including the duration, frequency, and any associated factors such as diet or stress. This information will help the physician understand your condition better.

You may also want to request specific tests that can provide insights into your gastrointestinal health. These could include blood tests to check for anemia or infection, stool tests to evaluate for pathogens or malabsorption, and imaging studies to visualize your abdominal organs. If necessary, the doctor may recommend an endoscopy or colonoscopy to directly examine your digestive tract and obtain biopsies if needed.

In summary, your symptoms of abdominal swelling, irregular bowel movements, and dizziness are significant and warrant further investigation. Do not hesitate to seek a second opinion if you feel your concerns are not being taken seriously. It is your right as a patient to advocate for your health and request the appropriate tests to ensure a thorough evaluation. Remember, early detection and intervention can lead to better outcomes in managing gastrointestinal issues.

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