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Cause for pain in side, back and dry, sore mouth.

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Hi, I have these symptoms:

1.Dull achey pain on my sides around my ribs going into my back. Sore to the touch. Pain starts under my armpit.
2.When I get up from sleep in the morning my sides are fine with no pain for about 5 minutes or so and then once I start to walk around a bit they become sore
3.I have very little runny nose
4.My mouth and lips are dry at times
5.My lymph nodes in my neck are swollan and tender but moveable
6.On occasion I feel my shoulders are heavy
7.I have shortness of breath at times.
8.If I take Advil my aches do get better
9.I get sores in my mouth and my tung feels swollan
10.I had pain in my chest a few weeks ago for about a week but since then it has gotten better. Felt like heartburn.
11.No weight loss, I'm at a constant 180lbs.
12.No fever
13.No loss of appetite
14.I feel a pop in my groin area (where my pubic area meets my leg) on my left side when I cough hard. I had an intense sharp pain a few weeks ago in this area after coming back from a walk but it go better when I passed gas and had a bowel movement.
15.No visible blood in my stool or urine.
16.Very slight funny feeling in my throat, not sure if it's a sore throat or not.
17.No pukiness but I have felt slightly dizzy once or twice.

Sorry for the long list but I wanted to provide as much detail as possible.

What condition might I have? Please let me know if you need any additional information.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 30 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I undertand your concern.
You have a lot of symptoms, isolated, and they do not really reflect one particular condition per se. So let's take them one by one.
- The pain around the ribs, radiating also under the armpits, which also reduces on taking Advil, shows constochondritis pain, where there is an inflammtion around the ribs area. Some patients are prone to develop this condition, just like some people are prone to migraine, and Advil is the appropriate treatment.
- Little runny nose, and swollen but movable cervical lymph nodes, with a funny feeling in the throat. These symptoms indicate an respiratory tract infection, mostly URTI and for this a course of antibiotics is required, which i will mention below.
- Shortness of breath and chest pain can be attributed to heartburn. However it is better you get an ECG done just to be on the safer side.
- Can you describe the pop around the groin? Are you referring to some kind of swelling that appears, or a pain around the joint?
I will advise the following medications for you :
1) Tab. Levofloxacin 500 mg twice daily for 5 days, for the URTI.
2) Cap. Omeprazole 20 mg once daily before breakfast for 14 days. This entire duration course will reduce the heartburn and also prevent future episodes.
3) Tab. Advil ( SOS ) for the constochondritis pain.
4) Tab. Neurobion Forte once daily at bed time- mouth sores, indicate vitamin deficiency. Hence this medicine can be continued with good diet comprising of more fruits and vegetables.
Hope this was helpful,
Regards.


Patient replied :

Hi,
Thanks for the reply.
The pop I feel in that area is not a bone popping but some type of soft tissue problem I think. It's in one specific area and it feels like something is moving or something in there. But when I say something is moving I don't mean I can feel it moving when I touch it but I get a sensation that I feel when I'm coughing. I'm not sure how to explain it. Maybe not popping but pulling. I've had it for about 4-5 months now and it seems to be swollan a bit. If I run my hand down across it I don't really feel anything with my hand like a lump or anything but I do feel some type of sensation in the area itself. It's not painfull at all. The only time it got very painfull was when I went for a walk and some type of gas had built up in the area and to relieve the pain I started to flatulate and went for a bowel movement. It lasted for maybe another hour and then it went away. But now that I think about it a bit it feels like a minor ache but almost not noticeable at times but definitely there. Could this be a hernia of some type? If not what could it be? Thanks


Hello,
Thank you for additional information.
From your history, it is quite possible that it is an initial period of a developing hernia. As you know, in hernia, through weakness in the muscular wall, intestinal contents protrude out and it takes time to develop. It mostly has vague pain, and the swelling can take months to develop. Moreover anything that raises the intra abdominal pressure, like coughing or straining during pooping, will increase the vague pain, and something moving down sensation. It can't be anything else in that area.
I will advise you to get yourself evaluated by a general surgeon, who can do some clinical tests like 3 finger test to find out if it actually is hernia, and guide you accordingly. Please do not go for any investigations like ultrasound even if they ask you becaude hernia can't be detected in an ultrasound. It completely depends on the physical examination by the doctor.
Hope this was helpful,
Regards.


Patient replied :

Thanks, I'll look into the hernia thing. I did want to add that it's uncomfortable to wear elestic shorts or pants around my waist. I don't know if this helps narrow a possible cause or confirm that it is a hernia?
I'm not sure if I mentioned in my symptoms that I also have back pain on a daily basis and at times it's lower and then middle and upper pain. It a dull type of pain that seems to come on more if I'm bending and doing stuff at work. I try to be carefull not to pickup heavy things. Advil also seems to help. Could this be related to the rib pain I'm having? I do on occasion get sharp pain if I move suddenly or pickup something a bit heavy. A few months ago I was having lower leg pains and I concluded that my shoes were not exactly work for me so I invested in a fairly expensive pair of runners and "poof" the pain was gone. Could my back also be related to this in some way? Over the last few months I did a lot of heavy work around my yard lifting rolls of sod and interlocking and pea gravel by the wheel barrel and at the time I didn't really feel any pains but could it be that my body hasn't recovered from the heavy work? I'm just throwing some ideas out there.
I really appreciate your patients and help with all the information and questions. I'm only 43 and I feel like I'm breaking down a bit more everyday and it's frustrating.
Thanks


Hello,
Please don't break down.
You have conditions that can be treated.
Yes the back pain could be due to all the heavy work that you were subjected too. If the hernia is ruled out, even the pain in the groin area can be attributed to that. The good thing is if Advil is helping, it rules out any serious issue.
So try to avoid lifting up heavy weights and doing heavy work which will subject your muscles to more stress.
Once you get the hernia evaluation done, let me know.
Wish you a great health!
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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