Q: My wife is 44 years old. She is complaining of pain on the right side of the abdomen below the rib cage from the past one year. I have consulted so many doctors who say that it is a gastric problem. Many tests like ultrasound, endoscopy and scanning have been done and all were normal. But the medicine prescribed for gastric problem is not helping. The pain is not continuous and lasts for 10-12 hours, after which it subsides. She also feels severe burning in the same area sometimes, which she cannot tolerate. My observation is that she is not having her periods regularly from the past 5-6 years. But when checked everything was normal. In the past three years, her periods started having a gap of 3-4 months. Doctor said that it is due to menopause. But, when she had the last episode of pain and burning sensation for three months, she had a period and the pain and burning had almost subsided. She again started having pain and burning but she had her period last month, after which it subsided. Now the same thing has started again. Now the doctor says that it is not due to her period problem. She is taking all sorts of gastric medicines. What are the tests required and which specialist should I consult for this?

A:Your wife may be going through her menopause but a pain under the ribs on the right side of the abdomen is unusual for a period pain. Pain from biliary colic (gallstones) can be in this area and is very severe; it comes on and off very suddenly. It may last a few hours and then a dull ache may remain for a short while. It usually has no pattern and can come on at any time. However the episodes are usually very circumscribed and it would be unusual for it to come and go for 12 hours as in your wife's case. A burning pain can originate from anywhere but is often related to reflux/acid into the gullet. I see that she has a urinary calculus - but again the pain is a bit high up for this to be the cause. I think you should be reassured that if all her tests are negative (you haven't told us what they are) and if she is not losing weight, then the pain cannot be due to a serious cause. Hopefully it will settle in time.