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Digestive Disorders

Knife like burning pain under right rib

03/18/2002

Question:

I have a dull-burning-knife-like pain under my right rib. I have a lot of belching. My hepatic profile came back all in normal range, but my last two LDH levels were slightly elevated, 249,than 259. I do take Naproxen Sodium. My doctor gave me Nexium, as whenI had this last year, (about the same time)the pain, finally went away. I`ve had my gallbladder taken out several years ago. Could this be scar tissue. The pain moves from under my right rib, to my back(about the same area, only in the back.) Belching does relieve the pain, but it`s a lot of belching! Can ulcers cause your LDH to elevate slightly? When they remove your gallbladder, do they remove the duct? Any ideas? For two days, I was pain free and today it`s back. I am going to have the blood work repeated soon. Thanks!

Answer:

This Website is not intended to be used as a forum to provide diagnoses. The pain that you describe sounds like pain caused by gallstones, but of course you have had your gallbladder removed in the past. In some cases similar pain can arise from spasm of the sphincter muscle that controls the flow of bile from the bile ducts (the bile ducts are not removed with the gallbladder). However, a more likely cause of your symptoms is a peptic ulcer. This is because you have been taking naproxen (known risk factor for ulcers), the pain is burning and sharp in nature, and the previous episode responded to Nexium, the latter a medication that eliminates stomach acid and heals ulcers. You might be better further evaluated with tests for ulcers, such as an endoscopy, rather than hepatic profiles and LDH.

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Response by:

John D Long, MD
Assistant Professor of Clinical Medicine
College of Medicine
University of Cincinnati