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Pain under rib cage and back

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I have pain under my lower left rib cage and back. I have had these symptoms for nearly a year and have recently had my gallstone removed, but the symptoms persist. The pain seems to peak in the early hours of the morning and wakes me up.

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for asking your query. 

Form your question I understand that you are having a rather troubling pain in the lower left rib cage and back.  

There are many possibilities for this pain but the ones I would like to consider are the following : 

1. Musculoskeletal pain at ribs and intercostal muscles
2. Lung/ Pleural irritation
3. Diaphragmatic irritation
4. A splenic involvement
5. Peptic Ulcer
6. A pancreatic involvement. 
7. A spine problem, with pain radiating

Now there is no need for any alarm. The way we go about finding the cause is a step by step approach and to rule out most common and not to miss causes. For that you will need to get few tests done with the help of your Physician. This will be a Chest XRay, XRay of spine – AP and Later , a Ultrasound of Abdomen, Complete Cholesterol study, S. Amylase, S. Lipase. This will rule out many possibilities and if needed further tests can be done. I  am sure you many options for pain relief. Now I would recommend you to use an anti Ulcer drug (Pantoprazol / Omeprazole ) in consultation with your Physician. This has to be taken just before sleep. If the pain has an ulcer component in it, this will help.

Hope this helps.
Please feel free to ask any follow-up questions. 

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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