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Forum Name: Gastroenterology Topics

Question: Hard to breathe b/c of sharp pain behind lower right ribs


 Law Student - Mon Dec 12, 2005 1:59 am

For about one week, I have had a pain behind my lower right ribs. It especially hurts when I take a deep breath. It is also hard to sleep with any weight on it.

I am a 25 male, and am slightly overweight (6'3", 230 lbs). I've never smoked and drink only occasionally. I was diagnosed with IBS two years ago. It became especially bad this past summer/fall, but 10 mg of Elavil daily seemed to take away all of that pain. I was actually down to around 200 a few months ago, but have added a great deal of weight as a result of feeling better. Any chance the pain behind the ribs is related to the IBS?

I am going through finals right now at law school, so if I can put off going to the doctor for a week, that would be great. However, if this seems more urgent, I will make time.

Thank you!
 Dr. Safaa Mahmoud - Sat Jul 15, 2006 1:16 pm

User avatar Dear Law Student,

The chest contains many organs, like the heart, lungs with its pleural covering, esophagus, muscles, ribs, tendons, and nerves. They all can be the source of the pain felt in the chest.

- According to your complaint, Pleurisy is more likely to be the cause, pleurisy is an inflammation of the pleura, which is a double-layered membrane covers the lungs separating it from the rib cage. Viral infections like flu, are the most common cause of pleurisy. The pain is felt as sharp pain which get worse by coughing, sneezing, moving and deep breathing. Auscultation of the chest shows a characteristic sound known as pleural rub.

- Overexertion of the chest wall muscles or their inflammation as a part of viral infection like flu or cold results also in chest pain, the pain is usually aggravated with certain moves and is usually associated with tenderness over the affected muscles.

- Pain due to rib or chest wall bone disease is also another cause of chest pain. They are also tenderness over the affected areas. In all of these conditions the chest pain is usually aggravated by taking deep breath and cough.

- Sometimes chest pain is not originating from the chest itself; instead it is due to problems in the digestive tract. These problems include IBS, gastritis and gastric ulcer, gall bladder disease, GER.

- Pain due to gastritis increase either after fasting or after meals, while pain due to gall bladder disorder is felt on the right side of the upper abdomen and is associated with fatty meals.

- If all causes are excluded anxiety can cause many somatic symptoms including abdominal pain and breathing difficulty.

You need to be examined by your doctor, since the pain you described can be any of these causes. Only by complete history and physical examination your doctor can reach the right diagnosis and provide you the proper management.

Best regards,

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