Conversation: The conversation between human and AI assistant.
[|Human|] I have a sharp pain two inches below left rib cage. This will be accompanied with intermittent vomiting throughout the day producing no more than clear sticky liguid, unless I have up digested food. This pain is also acompanied by a large lump on my bottom left rib, which disapears whe the nausea and pain subside. I can suffer with this daily, or maybe every three weeks
[|AI|]  Hi, Dear thanks for the query to Chat Doctor virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer fromChronic Pyloric Partial obstruction, as projectile vomiting is not there in your case. The frequency of 3 weeks suggests more in favor of Partial obstruction. Causes for Partial Pyloric Obstruction/Stenosis need to be investigated for the proper treatment of your case. Chronic Duodenal Ulcer with obstruction/Ca Pyloric Stomach/ Congenital Pyloric Stenosis needs to be ruled out by proper investigation in your case. Disappearance of large lump with pain below left rib once nausea and pain subsides is very characteristic presentation, to indicate the hypermobile hypertrophic Gastric Body causing lump in your case under left rib. Surgeon with Gastroenterologist would be the better combination for evaluating your case. Possibility of other such causes- as Colonic mass under the left rib and IBS and others needs to be ruled out. Treatment-Treatment General-Fluid Diet mainly/Avoidance of solid, fried spicy food/Frequent small liquid meals/It B12 500 mg sublingual before surgery/High protein low-carb diet in purée form with plenty of watery base would be needed to prepare the case before planning surgery,to withstand the imbalances and stress of surgery. Investigation -Get OGD copy(Oesophago-Gastro-Duodenoscopy) done and carry out Biopsy of the obstructing pathology CT Contrast study of Stomach and Colon would fix the cause of the lump under left rib in your case. Surgical Excision with Bypass procedures would be planned as per the need of your case, by your GI Surgeon in tune with the investigated outcome. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. Chat Doctor. N.M.S. Genl-CVTS -Senior Surgical Consultant