[42F] With acute right-sided abdominal pain and dry cough

Patient Description

A 42-year-old female presents with a sudden onset of deep and sharp pain on the right side just below the rib cage, rated as 7 out of 10 in severity, persisting for 2 days. The area is tender, and the pain worsens with deep breathing. The patient reports occasional shortness of breath and a dry cough but denies nausea, vomiting, fever, chills, or changes in bowel habits or urine color. There have been no recent injuries, changes in diet, or physical activities that might be related to this pain. The patient has a medical history of high blood pressure, a herniated disc, bulging disc, sciatica, and chronic back pain, all diagnosed in 2017. Current medications include Lisinopril 10 mg once daily, Gabapentin 500 mg every 8 hours, Furosemide 20 mg once daily, and Aleve 220 mg, 4 tablets twice daily for pain. The patient has no known drug allergies and no family history of gallbladder disease or respiratory conditions. The patient smoked about five years ago but has no recent travel history to areas with known respiratory illnesses or infections.

Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Pleurisy: This is an inflammation of the tissues that line the lungs and chest cavity. It can cause sharp chest pain that worsens with breathing, which aligns with your symptoms of pain worsening upon deep breathing. Pleurisy can be caused by infections, autoimmune conditions, or other underlying health issues.
- Typical treatment involves addressing the underlying cause, such as antibiotics for an infection, and managing pain with medications.
Gallbladder Issues: Conditions like gallstones or cholecystitis (inflammation of the gallbladder) can cause sharp pain in the right upper abdomen, which may radiate to the back or shoulder. However, these conditions often come with nausea or digestive symptoms, which you haven't reported.
- Treatment may involve dietary changes, medications, or in some cases, surgery.
Musculoskeletal Pain: Given your history of chronic back pain and sciatica, it's possible that the pain could be related to muscle strain or nerve irritation, especially if you've been more physically active or stressed recently.
- Treatment typically includes rest, pain relief medications, and physical therapy.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

Rest and Monitor: Try to rest and avoid activities that exacerbate the pain. Keep track of any changes in your symptoms.
Pain Management: Continue using over-the-counter pain relief like Aleve as directed, but be cautious of the dosage and duration to avoid side effects.
Breathing Exercises: Gentle breathing exercises may help manage discomfort if the pain is related to pleurisy or musculoskeletal issues.
Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider for a more comprehensive assessment.

What you should look out for

Seek medical attention if you experience any of the following:

Severe or worsening pain
Difficulty breathing or shortness of breath
Fever or chills
Any new or concerning symptoms

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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1 mo ago

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[42F] With acute right-sided abdominal pain and dry cough

What might be happening

What you can do

What you should look out for

Experiencing symptoms?