Discomfort in the Rib Area
Age: 35, Height: 5 feet. I am a type 1 diabetic and take several medications, including Pristiq, Caplyta, Repatha, Humulin, Atorvastatin, Warfarin, and Mirtazapine. I also take an over-the-counter multivitamin. For the past 15 and a half years, ever since my pregnancy, I have experienced what I refer to as "rib pains" from time to time. These episodes begin in my back and extend around the area beneath my breasts. At times, the pain intensifies to the point where it engulfs my entire upper torso, reaching up to my shoulders. The discomfort is severe, and once it subsides—almost like a spasm—I feel completely drained and usually need a nap to recover. A few years back, I consulted with a surgeon regarding the potential removal of my appendix (that procedure never took place due to an unexplainable fecolith). During our meeting, the surgeon indicated that my discomfort stems from my liver. He noted that my liver is enlarged and can be felt beneath my ribs, and subsequent tests revealed that I have non-alcoholic fatty liver disease (NAFLD). I have a few questions for anyone who might have insights: Is it indeed the liver that is causing these pains? What leads to the overwhelming fatigue following these episodes? Also, why does consuming something extremely cold sometimes alleviate the discomfort?
Answers (1)
2/15/2026, 9:00:58 AM
OpenHealth AI
It sounds like you've been dealing with a complex and challenging situation regarding your rib discomfort. Based on the details you've provided, it’s possible that your liver condition, combined with your diabetes and other factors, is contributing to your symptoms. Let’s break this down.
Key Points
- Your rib pain may be related to your liver condition (NAFLD).
- Fatigue following these episodes can occur due to pain and possibly stress on your body.
- Cold consumption might temporarily soothe the nerves and muscles, providing relief.
Explanation
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Rib Pain and NAFLD: The liver being enlarged (hepatomegaly) can cause discomfort in the upper abdomen and the rib area. The liver is situated directly behind and beneath the ribs, and any enlargement can lead to a feeling of pressure or pain extending through the back and chest. It’s important to acknowledge this connection since discomfort may be a symptom of liver stress or involvement.
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Fatigue After Episodes: After experiencing intense pain, your body may respond by activating your stress response, leading to fatigue. Pain can also disrupt the body's homeostasis, meaning your body might need extra energy and rest afterward to recover.
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Relief from Cold: Drinking something cold may numb the surrounding tissues and help alleviate pain temporarily by reducing inflammation or constricting blood vessels.
Next Steps
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Monitor Your Symptoms: Keep a detailed diary of your pain episodes, noting the timing, intensity, duration, and any triggers (food, activity, stress). This information can be useful in understanding patterns or potential triggers of your discomfort.
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Evaluate Your Diet: Given your fatty liver condition, emphasize a diet low in saturated fats and sugars. Consider incorporating more fruits, vegetables, and whole grains while avoiding processed foods. This can help manage liver health and might, in turn, reduce discomfort.
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Hydration and Temperature Management: Continue to hydrate well, and if cold drinks help, it's perfectly acceptable to use them as a symptom relief technique. However, make sure not to overdo it if it impacts your digestion.
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Increase Physical Activity Gradually: Depending on your conditions and as tolerated, light to moderate exercise can help improve liver function and overall health. Start slowly and gradually increase your activity levels.
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Discuss Concerns with Your Healthcare Provider: While you're managing your discomfort independently, it's crucial to regularly communicate your symptoms and concerns with your healthcare professionals, especially since you have multiple medications and health conditions to consider. Your doctor may want to arrange imaging or check liver function tests to monitor any changes.
If the pain feels significantly worse or if you experience new symptoms like jaundice, severe fatigue, or any signs of bleeding, seek immediate medical attention. I'm here if you have further questions or need more clarification on any point!
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