<s>[INST] I am having and extreme and sharp pain under my ribs under my right breast, that wraps around to my spine. I have had this feeling before, but it was prior to my galbladder being removed due to excessive galstones. I cannot find any relief, and this has been for 4+ hours now, and it has only gotten worse. What could this be? [/INST] Hi.thanks for posting query at Chat Doctor. Possibilities:1. Stone remnants in common bile duct which maybe ruled out by having an abdominal ultrasound examination 2. Liver inflammation (hepatitis) which maybe ruled out by having blood tests. If liver enzymes ARW high, cause should be properly investigated.3. If all tests are negative, then it may be functional pain.4. Bile secretion is constant in patients whom gall bladder is removed. It may cause gastritis, so patients are prescribed a proton pump inhibitor(omeprazole, pantoprazole) for the rest of their life to avoid gastritis and associated symptoms. Hope to answer your concern. Wish you good n around health. Regards Chat Doctor.  </s>