It can be quite unsettling to experience pain around your rib cage, whether it’s on the right or left side. It’s even more disconcerting when your GP rules out other medical conditions, leaving you searching for answers about why you still feel discomfort. Could there be a connection to your IBS symptoms?

Pain under your left rib pain may feel painful and very sharp. It may occur after an obvious injury ranging from pulled muscles to a rib fracture or may suddenly occur without any known medical reason.

However if your Doctor has ruled out any medical conditions such as broken ribs or injuries and you are still experiencing pain under your left rib then what else could the cause be?

Read on to learn about the possible causes of rib pain that may be linked to symptoms of Irritable bowel syndrome such as bloating and gas.

You will learn about tests, dietary changes, and supplements including enzymes that may help relieve some of the gas and pain underneath your ribs.

Consulting a healthcare professional for proper evaluation and diagnosis is essential if you’re experiencing pain beneath your left or right rib cage. They can assess your symptoms, conduct necessary tests, and identify the underlying cause of your discomfort.

Can IBS cause pain under your left rib?

Though abdominal pain is a common indication of irritable bowel syndrome (IBS), pain localized under the left or right rib cage isn’t typically associated with this condition.

Typically, IBS discomfort is felt in the lower abdomen and may come with symptoms like bloating, gas, diarrhea, or constipation.

Rib pain isn’t a standard part of IBS according to the Rome IV criteria. Source Pubmed

However there is a condition called SIBO, small intestinal bacterial overgrowth that may cause pain under your ribs.

Can SIBO cause pain under ribs due to gas and bloating?

If the main cause of your rib pain is not linked to any medical conditions and is simply due to gas and bloating then Small intestinal bacterial overgrowth (SIBO) may be linked to some of your symptoms.

We have spoken about SIBO may times before, but as a reminder SIBO is a condition that is caused by an overgrowth of bacteria in your small intestine. Source Pubmed

This overgrowth of bacteria is associated with symptoms including bloating, gas, and abdominal discomfort, this discomfort could extend to the area beneath the left rib cage.

This may be due to increased gas production or intestinal distension caused by bacterial overgrowth.

Some studies found that up to 78%, of people with irritable bowel syndrome (IBS), might have small intestinal bacterial overgrowth which could be causing their symptoms of bloating, gas and wind.

When these people were treated with antibiotics, their symptoms improved temporarily, and the amount of gas they produced decreased.

If you suspect you have SIBO, you can easily test for SIBO and you can also try and avoid certain carbohydrates and gas forming foods to see if they alleviate any symptoms. If you do test positive for SIBO, you may also need to take antibiotics or herbal anti-bacterials to reduce the overgrowth.

Foods to avoid if you have gas and bloating under your ribs

Did you know that avoiding gassy foods and cutting out complex carbohydrates can reduce how often someone passes gas by as much as 50%.

If you suffer from gas it is best to avoid beans, chickpeas, lentils pulses and broccoli, cabbage and cauliflower.

Sometimes, it’s possible to change the way you prepare food to make it produce less gas. For example, soaking beans for 12 hours and then cooking them for 30 minutes can break down certain hard-to-digest carbohydrates, like raffinose and stachyose, which can help reduce gas production.

Foods That Promote Significant Gas Production

Dairy Products such as milk and high-lactose products

Vegetables including cabbage, cauliflower Brussels sprouts

Onions, Celery,

Fruits such as apples and pears

Dried fruits such as raisins and figs

Complex Carbohydrates– brown dark bread such as Rye bread

Legumes such as baked beans, chickpeas, lentils

Some patients find that all avoiding high Fodmap foods is great benefit. Source Pubmed

The low FODMAP diet is a temporary elimination diet that can be beneficial for individuals with gas and wind. FODMAPs are a group of carbohydrates that are poorly absorbed in the small intestine and can trigger symptoms in some people.

Following a low FODMAP diet can be very overwhelming, so we always recommend booking a consultation with an IBS specialist to help identify which FODMAPs you may be sensitive to.

Do carbs cause pain and make you bloat ?

You might be experiencing pain, bloating and gas after eating carbohydrates such as bread, and pasta. But why is that?

When your body struggles to digest and absorb carbs (like sugars and fibre), instead of being absorbed, these carbs end up in your colon where bacteria break them down, releasing gas and lactic acid.

Many types of beans and legumes, like stachyose and raffinose, can’t be digested at all and contribute to gas production.

Try digestive Enzymes for pain and gas

Carb intolerance can happen for a few reasons, such as not having enough enzymes in your intestines. In this case you may want to consider taking some enzymes that contain amylase to help you break down your foods. Book a consultation with a Gut Health Nutritonist to help you.

Small intestinal Bacterial overgrowth may also contribute to difficulty breaking down carbohydrates due to the bacterial overgrowth.

Test for Lactose Intolerance

The most common carb intolerance is lactose intolerance, where your body doesn’t make enough of the enzyme needed to break down lactose (found in milk). It may be worth conducting a lactose intolerance test.

If you are lactose intolerant, you will find that consuming milk products containing lactose may cause gas. You should consider taking an enzyme to break down lactose called lactase. This is also called β-galactosidase, and it can reduce the amount of hydrogen gas and symptoms like gas in people with lactose intolerance.

Another enzyme called α-galactosidase, which comes from a bacteria called Aspergillus niger and is found in products like Beano, can decrease flatulence in people who eat foods like legunes and chili.

Activated Charcoal for Gas and Bloating

Studies have shown that activated charcoal may also help to reduced gas and bloating after having a carbohydrate rich meal.

If you also experience an unpleasant odor, you may benefit from a combination of charcoal, Yucca schidigera, and zinc acetate, in fact one study revealed that this combination reduced smelly flatulence by 86%. Source Pubmed

Another study indicated that Bismuth may help with smelly wind and reduce hydrogen sulfide due to small intestinal bacterial overgrowth.Source Pubmed

How to Take Activated Charcoal for Gas and Bloating

If you do decide to take activated charcoal, make sure you take it on an empty stomach with with a large glass of water.

It is important to know that activated charcoal may cause some possible side effects, including:

Constipation
Tongue discoloration
Black stools

It is always best to seek professional advice from an IBS specialist.

Avoid Fructose

For some people sugars like fructose (found in fruits and sweet drinks) and sorbitol (found in fruits and artificial sweeteners), can also cause issues if your body can’t absorb them properly.

You can consider running a fructose malabsorption test. It may be necessary to avoid all foods with fructose,

Can Probiotics cause gas and farting?

Probiotics have several health benefits, including strengthening the gut lining, reducing acidity in the gut, preventing harmful bacteria from sticking to the gut walls, and releasing chemicals that affect nerve signals, such as nitric oxide.

However probiotics can also cause wind and flatulence. This happens because probiotics contain live bacteria that interact with the bacteria already present in your gut. These interactions can sometimes produce gas as a byproduct, leading to increased flatulence for some people.

You may want to experiment as ot everyone experiences this side effect, and it may vary depending on the specific probiotic strain being consumed.

Studies on a probiotic called VSL#3, Source Pubmed which contains friendly bacteria, showed that it could reduce gas and bloating in people with irritable bowel syndrome (IBS), although it didn’t necessarily help with pain or changes in bowel habits.

Other studies on Bifidobacterium infantis found that it could decrease pain, discomfort, bloating, and difficulty with bowel movements in people with IBS. This seems to be linked to changes in the immune system in the gut.

Stop Chewing Gum

Stopping chewing gum and smoking can decrease the amount of air swallowed, which can help reduce excessive belching and gas.

What are the causes of Rib pain unrelated to IBS?

In addition to gas and bloating, Pain beneath the left rib cage may also stem from various conditions, including:

Musculoskeletal Issues: Strained muscles or rib injuries on the left side can cause localized pain.
Organ Problems: Discomfort under the left rib cage may be linked to issues with organs in that area, such as the spleen, stomach, or left kidney. Conditions like splenic enlargement, gastritis, or kidney stones could be responsible.
Costochondritis: Inflammation of the rib cartilage might cause sharp pain beneath the left rib cage.
Gastroesophageal Reflux Disease (GERD): Heartburn or acid reflux could trigger a burning sensation under the left rib cage, potentially mistaken for IBS pain.

Summary

Pain under your rib cage needs to assessed by a Doctor and any medical conditions should be ruled out.

If medical conditions have been rule out symptoms of IBS including gas and wind and bloating could be the cause of the pain.

Consider testing for Small Intestinal Bacterial Overgrowth to see if the bacterial overgrowth is causing the pain.

Try avoiding Gas forming foods such as beans and pulses and cabbage and cauliflower

Consider trialling the the low Fodmap diet

Consider taking enzymes, activated charcoal, probiotics, anti-bacterials such as oregano

Consider testing for Lactose Intolerance and fructose malabsorption

Booking an appointment

If you need help with digestive symptoms please read more about our ibs clinic and we would be pleased to book you in for a consultation.

Working with a gut health nutritionist may help you with address underlying gut imbalances such as SIBO and receive professional guidance such as digestive supplements and testing.

Can IBS Cause Pain under Left ribs?

IBS Specialists as featured in the Guardian