Pain below the ribs is a common complaint stemming from various sources within the upper abdomen and lower chest. This discomfort can arise from organs, muscles, bones, or nerves, making self-diagnosis challenging due to overlapping symptoms. This article explores common causes of pain below the ribs.
Digestive System Issues
Digestive tract problems frequently cause pain below the ribs. Acid reflux, or gastroesophageal reflux disease (GERD), occurs when stomach acid flows back into the esophagus, causing a burning sensation. Gastritis involves inflammation of the stomach lining, leading to a gnawing or burning pain in the upper middle abdomen that may worsen or improve after eating. Peptic ulcers, open sores in the stomach or the first part of the small intestine (duodenum), can also cause similar burning pain.
Issues with the gallbladder, such as gallstones, can cause pain felt on the right side below the ribs. This discomfort arises after consuming fatty meals, as the gallbladder contracts to release bile for digestion. Pancreatitis, an inflammation of the pancreas located behind the stomach, results in severe upper abdominal pain that can radiate to the back. Conditions like Irritable Bowel Syndrome (IBS) or severe constipation can cause abdominal discomfort, cramping, and bloating that may manifest as pain below the ribs.
Muscles, Bones, and Connective Tissue
Pain below the ribs can also originate from the musculoskeletal system. Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone, causing sharp pain that can be localized and tender to touch. Muscle strain in the intercostal muscles (between the ribs) or abdominal muscles can result from overexertion, sudden movements, or forceful coughing. This type of pain worsens with movement, breathing, or direct pressure.
Direct trauma to the rib cage, such as from a fall or impact, can lead to bruised or fractured ribs. These injuries cause pain in the chest area, especially when breathing deeply, coughing, or moving. Nerve impingement, specifically intercostal neuralgia, involves irritation or damage to the nerves that run between the ribs. This condition can produce sharp, aching, burning, or stabbing pain that follows a band-like pattern around the chest or abdomen, worsening with physical activity like coughing or sneezing.
Other Organ-Related Conditions
Beyond the digestive and musculoskeletal systems, other internal organs can contribute to pain below the ribs. Kidney issues, such as kidney stones or infections, cause pain in the flank (side of the back, just below the ribs) that can radiate to the front, lower abdomen, or groin. Kidney stone pain is described as colicky, coming in waves, while infections may present with fever, chills, and painful urination.
Problems with the spleen, located on the upper left side beneath the rib cage, can cause pain. An enlarged spleen or a ruptured spleen can lead to pain in the upper left abdomen that may radiate to the left shoulder. Lung and pleural issues, such as pneumonia (lung infection) or pleurisy (inflammation of the lung lining), causes pain that intensifies with deep breaths or coughing. Shingles, caused by the reactivation of the chickenpox virus, can produce a painful, blistering rash that appears as a stripe on one side of the body.
Understanding When to Seek Medical Help
While many causes of pain below the ribs are not severe, certain symptoms warrant prompt medical attention. Seek immediate emergency care if the pain is sudden and severe, or accompanied by symptoms including difficulty breathing, chest pressure, pain radiating to the arm or jaw, fainting, high fever with severe pain, vomiting blood, or black, tarry stools. These indicate serious conditions requiring urgent intervention.
Consult a healthcare provider within a few days if the pain is persistent and does not improve, or if it is accompanied by unexplained weight loss, changes in bowel habits, or interferes with daily activities. Pain that develops after an injury should also be evaluated. This information serves as general guidance and is not a substitute for professional medical advice; always consult a healthcare provider for an accurate diagnosis and appropriate treatment plan.