<s>[INST] I have a history of bile duct stenosis with elevated LFTs and pain as is typical with gallstones. I do not have gallstones. Over the past four weeks, I have become very lightheaded, dizzy and nauseous at times, with tender swollen lymph glands and increased tiredness. The vice-like pain around my ribs is constant - unaffected by eating - and causes me to have a cough when lying flat. I now also have shoulder tip pain and a dull ache over my left kidney region. Any advice? [/INST] Hola. Liver pathology , gallbladder pathology and kidney pathology are the diagnoses to consider. The sensitive test to detect pathologies of these three organs is the ultrasound. As you also feel tired and have pain, is necessary to be examined and make the ultrasound as soon as possible to establish diagnosis and right treatment. I wish you good health.(In case the answer would have been useful please indicate this) </s>