Post ERCP problems

[sk8flo]

Sometimes I wish I had never mentioned to the new doctor 3 months of epigastric pain and fatigue.  Prevacid she gave me caused severe colic, flank & back pain.  GB removed 16 years before. Tests showed all intra and extrahepatic ducts dilated.  No sign of pancreatic disease.  Had urgent ERCP and spincterotomy, very mild pancreatitis next day so was in hospital for total 3 days.  Week later colic pain returned, no pancreatitis/perf, gastroenteritis errupted, used pedilyte for 48 hours.  24 days out, had my usual am coffee, started to eat bagle and had epigastric pain.  Within hours, pain was severe, localized to above waist 8" total across, epigastric area, occ gas, no diarrhea/constipation, no fever, normal stool/urine, etc. But it took donnatal and 4 Advil every 4 hrs. to get through the work day, although the pain relief lasted only 2-1/2 hrs.  Don't need pills today but continue to have discomfort and am able to eat some.  I don't have IBS or other GI motility problems.  All the pain is RUQ, flank, but mainly above my waist.  Have booked a colonoscopy in 2 weeks.

With all the duct dilitation, how long will it take to truly get back to normal?  Could this be a result of the Cipro in the hospital?

Thanks for your imput.

[georgie439]

Sorry my bad, I see the Dr. did answer you but like yeah didn't he read the part where you had your GB out.  A very important piece of the puzzle!!
Very interesting, about the micro stones, cause I have literally been going crazy, loosing sleep, basically a nervous wreck!!  You are the First person (and believe me I have been on many websites that has this problem)  I hope mine is like yours, I did have 2 cat scans one in Dec, and one last week, no tumors or masses seen, I also had mrcp, regular endoscopy and an Endoscopic ultrasound, this also saw no tumors so I'am praying for the best.
The reason I wanted you to email me was, I had some personal questions that I didn't want to ask on a public forum!
I use hotmail which isn't a direct link, again
   ***@****
Please write to me, I know I sound desperate and your right I'am.  Maybe one day I can do you a good turn.
You never know.............Denise in NY   georgie

[sk8flo]

I guess the doctor did not read my post thoroughly - it happens.  I had my gallbladder out 16 years before this event.  During the ERCP, obviously everything was checked from throat to duodenum and was totally normal except for a small hiatal hernia, no gastritis/ulcers/esophagitis, etc.

Also I am 59 yr. old and have never had bowel issues.  My main concern is the acute onset of moderately severe pain lasting 24 hours, continued RUQ cramping.  I have had only one week out of the past 4 that I felt back to normal.  I guess I will just have to wait and see what the colonoscopy shows although I doubt is will be anything significant.

Just to help others, the theory about the duct dilitation is that micro stones can cause chronic inflammation at the sphincter and eventual narrowing to the point that the bile just backs up into all the ducts.  The sphincterotomy is basically a big cut into the sphincter to allow the bile to flow out into the duodenum normally.  (And MD did say a big gush of bile came out.)

My LFTs were always normal, no jaundice or other signs of pancreatic or liver abnormalities.  The urgent ERCP was to avoid cholangitis and infection.

[Kevin Pho, MD]

Difficult to say without evaluation.

Repeating the ultrasound to exclude gallbladder or live disease can be considered.  I would also evaluate the upper GI system for inflammation or ulcers.  This can be done with an upper endoscopy or upper GI series.  

If these tests continue to be non-revealing, a HIDA scan with CCK stimulation can be considered to look at the gallbladder ejection fraction.  If low, removing the gallbladder can be considered.

I am not aware of Cipro leading to these symptoms.

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_

[Nursgirlie23]

Hi! I just wanted to reply to you.  At 34 weeks of pregnancy, my triglycerides went sky high.  It resulted in Acute necrotizing pancreatitis.  My daughter was ok, but spent a week in NICU.  I however  have been sick ever since (2.5 years now).  I have spent a total of 8 months in the hospital in those 2.5 years.  
If you would like to talk email me
***@****
Tina

[georgie439]

Hi again, I hope you do decide to write, I think we have alot in common.  As for the Dr. responding you have to post on the other Gastro board on this website, this one is just for patients.  To the other correspondent, I will email you tommorow.
Thanks..........georgie

[sk8flo]

Just some additional info - my workup included an abdominal ultrasound which showed the dilated ducts and they recommended in the report an ERCP and/or CT scan.  A CT scan was done with contrast of the upper abdomen which ruled out any pancreatic involvement (tumor) but did show the severely dilated ducts.

When I had the pain one week later, a stat CT scan with contrast of the abdomen and pelvis was done and it ruled out pancreatitis or a perforation which are the biggest worries re having an ERCP.  

The doctor does not believe in putting in a stent for this particular issue - more recent literature is making it controversial.

Hope this helps others.  As for me, eh, I'll just wait it out.

[lizziecee]

Hi - until the dr replies, just an observation from someone who has had Crohn's for 35 yrs. My gastro recently put me on a regime of Cipro - 5 days on, 10 days off. I was fine when on Cipro, but the urgent diarrhea, blood and mucous came back within 24 hrs. I have now been on daily Cipro 250mg for some 3 months and am doing absolutely fine. No pain, normal bowel movements and have started to put on some much needed weight. I feel the best I have done for some 3 yrs since I got breast cancer. Seems as if the Cipro is having a beneficial effect on the inflammation in my intestines and I intend to stay on it as long as my gastro agrees. I have monthly blood tests, and they are fine. I also do a weekly injection of 25 mg of methotrexate, but this did not keep the diarrhea and weight loss under control.
I know all drugs don't work for everyone (I was violently allergic to azathioprine) but Cipro is my wonder drug.
Take care, Liz.

[georgie439]

Wow, finally someone with my problem!!   I also have the intra and extra dilated ducts, have had 2 ct scans, mrcp, and EUS up at a university hospital. I had my gb out about 18 mths before the pain started. PLEASE PLEASE PLEASE email me

                  ***@****

I really hope to here from you, Did they mention sod?  If so what type??  ARe you female, I'am 44, and ironically had baby at 41 which may have elevated my tryglecerides??  Whatever that means??  Please write or respond. You are the first thread I have read like this. Did you have ct scan??
  
                        Sincerely,
                        Denise