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Pain caused by?? scar tissue? liver or Pancreatis(pancreatitis)?
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Pain caused by?? scar tissue? liver or Pancreatis(pancreatitis)?

I am a post R-Y (open) proceedure pt of 11/2003. My gallbladder was romoved with liver biopsy too.  The digestive portion seems fine; I weigh <190.   However, I am repeatedly having pain on my rightside 3-4" below my scapula and to the right side of the spine.  Tonight, I stretched and my husband touching inbetween the ribs cause me pain of 7 on 1-10 scale.  It doesn't feel like muscles. It feels inflammed but deep.  I have searched everywhere on the net:  What is located in that region?  I rarely drink but do take NSAIDs maybe 1-2 times a week. Post Surgery - My Diabetes was resolve to A1C monitoring which runs between 5 & 6.  My only daily meds are synthryoid & Birth Control Patch. As for suppliments.  Multi-Vit & fe.

The biopsy showed mild fatty liver and the report on the gallblader (gallbladder) was cholecystitis and no stones.   I haven't found anything that specifically triggers this pain.  I just move on my side in bed and WOW OUCH!.  It's a quick stabbing pain.

Please give me aid.  
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A pulmonary cause can be evaluated for, as well as a musculoskeletal cause.  A reasonable initial test to evaluate for the symptoms would be a chest CT scan - which can evaluate the lungs as well as any bony abnormality that can lead to the pain.

If negative, GI causes can be pursued.  This can include ulcers, biliary duct stones, or Sphincter of Oddi dysfunction.  Tests to consider would be a upper endoscopy (to evaluate the upper digestive tract) or an MRCP to evaluate the biliary tree.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
21 Comments
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Avatar_n_tn
I have had a few cases of severe acute pancreatitis, and now have chronic pancreatitis.  In my experience, I had severe pains that came and went every minute or so on the LEFT side of my upper abdomen and it radiated around to my LEFT flank area.  The pain that I continue to have is also in the Left upper quadrant of my abdomen.  It can at times seem to start in the middle of my upper abdomen, but has never been on the right before.  I've also had pains that radiated to my left shoulder and between my shoulder blades in my back.  From all that I've read this is the normal area for pain from pancreatic issues.  Of course I'm sure that doesn't mean pain could never be on the right though.  
Could you possibly be having pain from adhesions or scar tissue caused by your surgery? That's a possibility... I'd check with your doctor just to be safe!!
Hope you feel better soon!
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Avatar_m_tn
Fatty liver ca be controlled through good liver friendly diet and good nutrition and exercise. Also you shouldn't drink if you have fatty liver. I agree with the above poster, you should see the doctor, maybe it is adhesion pain but it could be something else that needs treatment.
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I had my GallBladder surgically removed 2 years ago.  I did not have stones, but had a comet tailed shadowing (Adenomyometosis).  I have recently started having a tingling like crawling feeling under my right rib above the fatty part of my stomach.  Now it is hurting when I bend to the right.  Very sore to the touch.  My doctor says it is a pulled muscle, 6 months ago.  If anyone has any ideas, please help me.  It is agrivating and it almost feels like a babys foot moving.  (have had pregnacy test and yearly checkup.  No BABY  Thank you
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Avatar_f_tn
HI,

I think I have pacreatitis. A couple of years ago I had the same pain, went to the doc. she thought I had panceatitis and sent me to a surgeon.  He said blood test results were not conclusive enough and didn't agree with doc. The pain is in the same area as yours and I have no gallbladder or uterus which could cause this.  What do you do for it?
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Avatar_n_tn
Have the docs done anything else besides a blood test to determine if you have pancreatitis? Like maybe a CT scan or MRCP, or ERCP? Do you remember your amylase and lipase levels? Also remember that the amylase and lipase levels only stay elevated for a certain amount of time after the onset of the pancreatitis attack (I think only a few days).  Also if you have chronic pancreatitis, the emzymes may not even elevate anymore due to the pre existing damage to the pancreas.  I have chronic pancreatitis, and I can definately tell the docs when I am having an attack, and my enzymes are not raised.  There isn't a whole lot they can do for me.. I try to stay at home during the attacks now.  It's just pain control, and trying to stay hydrated.  Unless I get very dehydrated from the vomiting during an attack, I stay out of the hospital now.  Other than that, they have me on pancreatic enzymes.  I have to take a few pills everytime I eat, even a snack.  That helps me digest what I eat.  Before I had a major problem with malabsorption due to my pancreas not making the proper amount of digestive enzymes.  The docs can test this by doing a 24-72 hour fecal fat test.  The enzymes help some of the pain, and definately keep you out of the bathroom!! lol
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Avatar_f_tn
I have had the same pain (I think same cause) for about 2 years now on and off.  It is in my left side of abdomen and radiates to my back.  It is sometimes really painful and then will subside.  I have Gastroparesis and the Gastroenterologist thinks it may be caused by something else.  So, I don't know if there is a correlation between the two.  I have read that Pancreatitis can be casued by gallstones, but my gallblader (gallbladder) has been removed.  I have had 2 colonoscopies and gastroscopies and abdominal CTSCAN.  Don't know if these show anything in pancreas.  Are there any particular foods or beverages that you stay away from?  Thank you for your reply.
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Avatar_n_tn
I have had pain in both the left and right upper rib area that radiates into my spine for about six months. In January I went to the ER they did a CT scan, that looked normal with the exception of an enlarged biliary duct (Dr. says that's ok and would not cause this much discomfort), and an endoscope that looks into your stomach,  blood work came back with elevated lipase 350 and amylase 150 so I was told I had pancreatitis. My numbers went up and down a few more times over the next few months. I just had more blood work last week and they are on the high side of the "normal" range. The pain wakes me up during the night, and I also cannot lay on either side some of the time. I have had the CT scan, ultra sound and MRI and all comes back normal with a few cysts here and there, they are not large and the Dr. says this is very common, 40 percent of the population has these on some of their organs. I have been on a lowfat diet since January because of the pancreatitis and have lost weight and do not want to lose more as I'm already to thin. I should mention that I did have my gallbladder out two and a half years ago and ended up need a blood transfusion as I was bleeding internaly.

Nursgirlie23 you mentioned malabsorption, (I have just now started to read about this because no one can seem to figure out whats wrong so I'm always trying to figure it out on my own) Did your fingernails change at all when you had malabsorption? Since this all started I have these deep ridges that start at the cutical and slowly grow out. The rides go across the nail not length wise. Do you know if this can be caused from malabsorption? Has anyone else lost weight while going through this? I cannot beleive this many of us suffer from the same symptoms and nobody can seem to make a diagnosis.
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Avatar_n_tn
Sorry It took me so long to respond.. have been away from the puter for a few days... having a flare up with ole Mr Pancreas...
There are foods that I have to stay away from... and am always learning of new ones.. I think it is probably different for each individual, but the rule (as I've been told) is to stay away from really fatty or fried foods, and also meats can cause extra pain.  For me, I can't eat ANY fast food, red meat causes pain, and for some reason any regular sodas (i think this may be because my pancreatitis was caused by hypertriglyceridemia, and sodas have a lot of sugar.. ) When I am having a flare-up, even salads cause me pain, also anything i eat while having a flare-up goes straight through.. literally!!
I have also been diagnosed with gastroparesis, and this was after the pancreatitis, so maybe the two are related.  
I do have ridges on my fingernails, they are very brittle and split very easily.  My docs have told me that this can be from the malabsorption, and also could be from high calcium levels in the blood.  I've been having problems with my calcium being high ever since I had my first attack.  They are questioning if maybe that could have contributed to the pancreatitis, and also if I could have hyperparathyroidism... Which could be another cause of pancreas problems.. when it rains it pours!! lol
I would be happy to answer any other questions you might have.. it always helps to talk to someone who truly understands!!
I'm on AOL, as psychnurse21, so you can email me anytime...
not sure if I'm allowed to post that.. but we'll see :)
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Thanks for the info nursgirlie23. I stay clear of fast foods, fried foods and salads. Luckily my nails don't split and break I just get deep ridges in them that go from side to side not from the cutical to the tip. There has to be a solution to all of this, or do we live like this for the next fifty years? How did your Dr. diagnose you with malabsorption?

Someday's I wish I would have never had my gallbladder out, I'm only 39 years old and should not feel like **** all of the time. I used to be a very energetic and spontanious person, now I'm to nervous to do a lot because you never know when the discomfort is going to come. Has anyone ever heard of someone getting better after having these symptoms for such a long period of time?  Some times when I'm having a lot of discomfort my teeth even hurts. Has anyone else ever experienced this? It's very odd. My Dr.'s are going to keep trying to figure this out but in the mean time I'm getting a little angry and emotional on and off because it is just so frustrating.
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Avatar_n_tn
I had my Gallbladder taken out in Nov 2003, I also had a pacreatic psuedocyst  discovered during my pregancy, my daughter was born in OCT 2003. A doctor (quack, unknown to me) started to drain the cyst that was the size of a softball on my pancreas,  during the third stent replacement and draining by ERCP the Dr. broke the stent in my pancreas and left it in there after shoving it way into a duct. A few months later I had my first bout of pancreatis (pancreatitis). The quack sent me to my hero who had to open me up from my belly button to my sternum, and three hoses for draining from my liver area. During this procedure the hero split open my pancreas like a carrot in half. I now have pain under my rib cage and in my stomach like I am dying from the inside out. more of my pacreas is now damaged than not and my amalasyse lipase, and liver function is all out of whack. The Drs don't do anything except put me in the hosptial with mophine and phenagren with a IV drip. I can handle it at home for a while but if I start vomiting and get dehydrated it back to the hosptial with me. I am so sick now going on a month I am condsidering calling my doc for a quick admit. where painkillers await me.
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Avatar_n_tn
Djonsey,
They diagnosed the malabsorption problem with a 24 hour fecal fat test.  They can also do a 72 hour one.  My results were sky high.  The doc said there should be very minimal fat if any in your feces.  The digestive enzymes really help with the number of stools per day, and seems to help some of the pain.  But when I am having a "flare up" like right now, they don't do much... Everything goes straight through.  I just can't seem to keep anything down right now, and the pain is pretty intense.
I guess I might be right there with you scarmama with a quick admit.. lol.. although that's the last thing I want to do right now...
I know what you mean about how awful it is to be so young and being so sick and in so much pain.. I just turned 27 saturday... and I've already been dealing with this for a little over 2 years.  
I also had numerous pancreatic psuedocysts that they attempted to drain via ultrasound guided aspiration... but they just kept getting bigger, they eventually had to open me up to take them out surgically.. i've now been opened up 7 times from just below breast to just above pelvic area.. I told them last time to just install a zipper... lol..
hope everyone is getting some pain relief today...
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Avatar_n_tn
My CP and malabsorption was diagnosed by a 24 hour fecal fat test... they can also do a 72 hour one.. The doc said that mine was very very high and that there should be minimal fat if any in your feces.  The digestive enzymes help but when I'm having a "flare up" like right now, everything goes straight through.  I'm having a lot of pain and nausea/vomiting right now.. I have a call out to my doctor, so I may be right with you scarmama on the quick admit to control the nausea/vomiting... And trust me that is the last place I want to be right now.. I've been in the hospital too much!
I know what you guys mean about it being awful being so young and so sick.. I just turned 27 on saturday and I've already been dealing with this for over 2 years.  It can be so depressing at times!
I had to have numerous psuedocysts removed surgically, they tried to drain them by ultrasound guided aspiration, but they just kept getting bigger... Now, I've had 7 major abdominal surgeries where they've opened me up from just below the breast to just above the pelvic area.  I told them last time to just install a zipper!!! lol
I already tried to post this message once and it didn't work.. so if this ends up being on here twice, I'll apologize in advance...
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Avatar_n_tn
I am havin a pain...constant,, it really hurt in my lower right side, more so to move it ( as in to turn my shoulders left to right)  and take steps in a certian way. First time feelin this cant massage it out or crack it out like I usually do ...that makes it worse, only reason it concerns me is that nothing I do makes it go away and  have had a certain type of fever for a couple of days and nausea, chills really suck, and my stomach seems bigger than normal, no appetite either, kinda hit me all at once kinda scary, hope its nothin though.
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Avatar_n_tn
If you are having those symptoms.. You should contact a MD ASAP!
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Avatar_n_tn
i have had alot of stomach problems all my adult life but what can make the color of your stool green have pains in left and right side into back and have the dumping problem
thankyou
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Hi ,I had my Gallbladder out in 2000 ,the surgeon was sure i would be able to have it done Laprascopic way since i never had any stomach surgerys before  ,but my famly dr wanted me to have it done the old way so i had 13 staples ,anyway for years i always had a elevated Bilirubin ,but i guess the other enzymes were okay after my gallbladder was removed i thought it would go back to normal ,it is higher now and my dr thinks maybe it's scar tissue ,i was wondering if anyone has had an elevated bilirubin ,i don't  drink alcohol ,i do take a beta blocker [atenonol] for b pressure for many years i read it causes elevated bilirubin and i take xanax for anxiety ,my last bloodwork it was 2.00 my dr sent me for a pipida scan in 2004 but i guess that test was okay i'm just confused this bilirubin did anyone ever have a problem with theirs thank you:}
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Avatar_n_tn
Hello,
I am new to the site.  My name is Kim, and I have had chronic pain in my left upper back for about 3-4 yrs now.  I have recently, (finally) had an MRI done, and the results came back "normal", but they say I have scar tissue around my ribs.

The pain is unbearable, and I am at this time taking pain meds.

The pain seems to start in my neck, beside the spine and pushes into the spine.
Then it radiates down my left back, behind my shoulder blade and pushes into my spine in that area, and also down my outer left side.  This effects my shoulders also.  I have a lot of swelling throughout the whole upper left area, including the shoulder.  When I look in the mirror, my stature is off, and one shoulder sits higher than the other.

Is there anyone with this sort of symptom?  I've heard they can remove scar tissue, but I can't seem to find any information on it.  
Hopefully none of you have this terrible affliction, but if you do, can I hear from you?
Thank you
Kim
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Avatar_n_tn
What, exactly, does pain caused by chronic pancreatitis feel like?  I have been having occasional mild-to-moderate pain in my abdomen, as well as a tightness in my chest and throat that sometimes renders breathing somewhat labored.  I've also had a fever on a couple of occasions the past few days.  However, at no point has any pain been severe and it has never radiated into my back.

I only ask because I don't have any insurance and I only want to go to the doctor if it is absolutely necessary.  I am otherwise healthy, though I do drink alcohol.  Can anyone give me any hint as to what it might be like to experience a pancreatitis attack?  Thanks a lot.
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Avatar_n_tn
Trust me, if you were having an attack of acute pancreatitis you would know it! Although my first attack was a very severe one.  The symptoms started with vague pain in the left upper quadrant of my abdomen and also epigastric area, and radiated to my back.  It gradually got worse, it almost felt like labor pains, coming and going every few minutes.  Then all of a sudden it got unbearable, and I began to have intense nausea and vomiting.  After that I don't remember much until I woke up in ICU a few days later.. but from what I was told I had fever, my blood pressure dropped and my pulse shot up to 140 at rest.. my respirations were very fast.. but do remember mine was a very severe case.. the docs at the hospital said it was the worst case they had seen in over 20 years..
If you are worried that it could be pancreatitis, have some blood work done, where they check your amylase/lipase.  Although it is possible that they would not be raised in chronic pancreatitis, usually with acute pancreatitis they raise, and stay elevated for a few days...  
hope that helps..
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I had my gall bladder out a year ago. Three days after the surgery I felt like someone had thrown a baseball at my stomach. Since then I have continued to have occasional pain in my stomach right behind the scar where my surgery was. The pain radiates into my back and up between my shoulder blades. It normally happens when my stomach is empty. When I get hungry, I have about three minutes to get something to eat. Otherwise the pain gets so bad that I am unable to eat at all. Sometimes I wake up at night with it, and I have to walk around for a while waiting for it to subside. Once it finally goes away, I feel exhausted. There are really no other symptoms. I have had several blood tests, an ultrasound, cat scan, and everything comes back normal. I am currently waiting for results of an MRI. Has anyone had this problem, and what was the outcome?
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I just got out of the hospital Friday.  I had tremendous back
spasms in my right lower back that radiated to my right side.  They took a cat scan and found that I did not have kidney stones but did have gallstones.  I was dehydrated and also had a urinary tract infection. She said that my liver showed no signs of being out of whack and blood work seemed fine.  I am out of the hospital now but have to have an ultra sound done on my gallbladder.  I still am in alot of pain on the right side and am still having trouble with pain and spasms when I lay down.  My doctor thinks that my back spasms are due to my bad back and not from my gallbladder and has me now doing therapy on my back to ease the spasms.  I feel like my pain is from my gallstones.  I would like to have my gallstones taken care of as I am the fourth one in my family to have them and I know the pain each one of my family members has gone through before they had theirs out.  Does anyone know what this pain can be caused from?
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A related discussion, Unexplained pain - possible pancritis was started.
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