<s>[INST] Hi, I have this discomfort feeling such as extreme tenderness, pain and slight puffiness at the top of my upper left abdomen (rib cage), located underneath my left breast. I ve felt this a slight tenderness a couple of weeks ago. Now it s gotten a lot worse. In the past I have had problems in the past with Gastritis. The past few days, I ve currently have a tightness in my chest followed by a nauseating, fullness feeling on top of the tenderness and slight swelling on my upper abdomen. Does anything come to mind with these symptoms? [/INST] Hi. This is most probably a case of Costo-Chon Chat Doctor.  I would advise you to get an MRI of the painful area, telling the Radiologist to be specifically see for the painful-tender area. This will confirm the diagnosis. I would suggest the following treatment.-Rest to the area by means of strapping with the Adhesive tapes during the deep Expiration phase. This will limit the movement, reduce the pain and give rest for healing to occur.-Anti-inflammatory medicines in full dose as per the weight.-Steroids if required for its strong anti-inflammatory role.-Las ix to reduce the edema. This sort of treatment helps all my patients. And should help you too. Surely get confirmed the diagnosis by an examination done by a Surgeon. </s>