### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am having horrible pain that is mostly on the right side under my rib cage.My stomach cant get any bigger or harder.Pressure like someone is pushing my ribs up,and pain from time to time radiates all around my rib cage.....Lately noticed I am a full blown narcoleptic....Please help.......Milena B.

### output:

Hi Milena ! Good evening. I am Chat Doctor answering your query. Even though it needs clinical assessment for a diagnosis, from your history, it seems that you have inflammation/calculi in your gall bladder/biliary system giving rise to such intermittent severe pain. If I were your doctor, I would advise you to avoid fatty/oily food which would precipitate the pain more due to contraction of the gall bladder to empty bile into the intestines.  I would advise you a bland diet, some routine investigations like a CBC, a blood sugar, liver function test, a serum amylase and lipase to rule out associated pancreatitis, and an ultrasound abdomen to see the status of the biliary tree including the gall bladder to exclude a stone causing cholecystitis and also to know the status of the pancreas. Further management would depend on the result of clinical examination and reports of the related investigations. Till then, you could go for an anti-spasmodic along with a proton pump inhibitor for a symptomatic relief. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.