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

### input:
My wife has a burning pain at the base of her rig cage that goes around the left side to her back. She has had stomach issues for 16months now. We have been to specialist that have done a Botox injection into her spinketer valve and this helped some. They feel her stomach is tense and will not relax. They put her on Busprione and this helped for awhile. She is in a lot of pain right now and nothing seems to help. I have given her a norco and 1mg ativan still the pain does not let up. We have been in the Er 3 times since the 1st and all they do is give her ativan by iv and send her home. One person we talked to thinks she has an inflammation in the area of that valve but the anti-inflamatory meds we have do not help much.

### output:

As per your explanation I realize she has extreme pain in stomach and towards lower rib cage. Now if there is pain that means there is something wrong. Here you have also told you have done ultrasound abdomen and have tried with various things but still she has no relief. I suggest taking new ultrasound scan of her abdomen. And check report what it says. If there is any new diagnosis then take treatment as per that. But if there is normal report then I will suggest my patient to do lifestyle changes first. That is food habits like have break fast well, lunch average and dinner minimum maximum by 8:pm or before that. Do not have anything after that. Maintain same time for daily break fast, lunch and dinner. Apart from this I suggest having different fruits and vegetables. Take fiber rich diet. Have enough amount (3-4liter)of water in a day. Sleep well, do regular exercise like walking for at least 15 -20 minutes. Above all are basic advice given for digestive system problem. Now to answer your question: here you have asked what could be the cause for lower rib cage pain? Let me explain you here we can just assume, it can be weakness of lower ribs, it can be due to gall bladder stone, it can also be due to acidity, as well can be due to gastric ulcer. Here what ever will be the cause first we need to diagnose with ultrasound newly perform one. And them. Take appropriate needed treatment. Apart from this the basic changes in lifestyle and food habits are must. I am sure this must be useful for you. Try it and take care.