Question

My mother has a sharp pain in her right side just under the rib cage that's tender to the touch. It's not as bad when standing or lying down, but worse when sitting. She's had it about 5 days. No fever, eating well, but constipated. What's the likely cause?

Answer

Pain in the right side of the abdomen, especially near the rib cage, suggests a disorder of the liver or gallbladder. These organs lie just under the rib cage and, when they become inflamed, the pain is felt at that region. Diseases such as hepatitis and gallstones can present in this manner. However, other disorders can also cause pain in this region. The fact that the pain is worse with sitting (when this region is somewhat compressed), and that it is sharp, points to a muscular or bone process. Inflammation of the rib cage (costochondritis) or even a fracture could cause such pain. Often such pain will be worse with taking a deep breath.

Her constipation may also be a factor with the pain you describe. Severe constipation can cause abdominal pain or cramps. This may be felt anywhere in the abdomen, but very commonly in the lower left side. The constipation may have occurred secondarily due to the inflammatory process affecting the right side of the abdomen. Alternatively, the pain felt may be a consequence of the constipation. Finally, whatever process is leading to the constipation (such as a blockage in the colon), my also be causing the pain in the right side of the abdomen.

There is no way to diagnose the cause of such pain without a thorough physical examination. An experienced physician will be able to differentiate between the possible causes, and plan the proper diagnostic tests to make the diagnosis. If your mother has not yet seen her physician (or a gastroenterologist) then she should make an appointment as soon as possible.