Left Rib Pressure: Causes and When to Seek Help

There is a swelling sensation under the left rib cage?

Since the end of last year, I have been experiencing a bloated pressure sensation under my left rib cage, which has recently worsened and become quite uncomfortable.
I previously visited a doctor who mentioned it was due to irregular bowel movements and issues with my colon.
When my left abdomen was palpated, it felt like there was air inside, accompanied by a dull pain.
After taking medication for three days, my bowel movements improved slightly, but a few weeks after my menstrual period, the symptoms returned.
Now, I have bowel movements every two to three days without any bleeding.
After a bowel movement, the pressure in my abdomen slightly alleviates, but the bloating sensation returns immediately.
Additionally, I have noticed that I start to feel pressure after eating, which lasts for a long time.
The sensation eases when I sit up straight.
What could be causing this? Should I get any tests done? Thank you for your response!

Yu, 10~19 year old female. Ask Date: 2015/06/23

Dr. Ke Fangxu reply Surgery

Young women often experience stubborn constipation issues.
It is recommended to increase water intake and supplement with dietary fiber; however, some patients may not see improvement in their symptoms.
If the symptoms are severe, it is necessary to consult a physician for medication.
If one wishes to avoid long-term reliance on medication, it circles back to the basics.
It is advisable to develop good lifestyle and dietary habits, increase fluid intake, and maintain a regular exercise routine.
For a 17-year-old, invasive examinations are generally not recommended, and it is better to start with improvements in daily routines.

Reply Date: 2015/06/23

More Info

Understanding left rib pressure can be quite complex, especially when accompanied by symptoms such as discomfort, pressure, and changes in bowel habits. Based on your description, it seems that you have been experiencing a persistent pressure sensation under your left rib cage, which has worsened over time. You mentioned that a previous doctor attributed some of your symptoms to bowel issues, particularly related to constipation, and that you felt some relief after taking medication for a few days. However, the symptoms have returned, especially after your menstrual cycle, and you have noticed a correlation between eating and the pressure sensation.

There are several potential causes for the pressure and discomfort you are experiencing under your left rib cage:
1. Gastrointestinal Issues: Given your history of constipation and the relief you experienced after medication, it is possible that your symptoms are related to gastrointestinal problems. Conditions such as irritable bowel syndrome (IBS), gas buildup, or even food intolerances can lead to sensations of pressure and discomfort in the abdominal area. The fact that you feel better when sitting upright suggests that your symptoms may be exacerbated by certain positions or postures that compress the abdomen.

2. Musculoskeletal Factors: Sometimes, discomfort in the rib area can stem from musculoskeletal issues, such as muscle strain or inflammation of the rib cage. Poor posture, especially if you spend long periods sitting or slouching, can lead to muscle tension and discomfort in the ribs and surrounding areas.

3. Reproductive Health: Since you mentioned that your symptoms seem to worsen around your menstrual cycle, it is worth considering that hormonal changes or conditions such as endometriosis could be contributing to your discomfort. Endometriosis can cause pain and pressure in the abdominal area, particularly during menstruation.

4. Organ-Related Issues: Although less common, it is essential to rule out any potential issues with the organs located in that area, such as the spleen, stomach, or even the left kidney. Conditions like splenomegaly (enlarged spleen) or gastritis could lead to sensations of pressure or discomfort.

Given the complexity of your symptoms and their persistence, it is advisable to seek further medical evaluation. Here are some steps you can take:
- Consult a Gastroenterologist: Since your symptoms are primarily gastrointestinal, a gastroenterologist can perform more specialized tests, such as imaging studies (like an abdominal ultrasound or CT scan) or endoscopy, to assess for any underlying conditions.

- Keep a Symptom Diary: Documenting your symptoms, including when they occur, their intensity, and any associated factors (like diet or activity level), can provide valuable information for your healthcare provider.

- Consider Dietary Changes: If you suspect that certain foods may be contributing to your symptoms, consider working with a dietitian to identify potential triggers and develop a suitable dietary plan.

- Evaluate Posture and Activity: Pay attention to your posture, especially when sitting for extended periods. Incorporating regular breaks to stand and stretch may help alleviate some discomfort.

- Follow Up on Reproductive Health: If your symptoms correlate with your menstrual cycle, discussing this with a gynecologist may provide insights into whether hormonal factors are at play.

In summary, while your symptoms may initially seem related to gastrointestinal issues, the persistence and nature of the discomfort warrant a comprehensive evaluation to rule out other potential causes. Seeking medical attention will help ensure that you receive an accurate diagnosis and appropriate treatment.

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