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Severe abdominal pain worse after eating
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Severe abdominal pain worse after eating

I am a female 44 years old have had constant abdominal pain for about 4 months.Pain is more severe after eating solid food which in the last month pain even with liquids.My primary Dr.has ran all types of tests including blood work,CT.MRI,and X-ray he sees a partial blockage.Gastro Dr.has done endoscope,colonoscopy and MRCP,all test are normal and he does not see blockage.I have had hystorectomy for endometreosis and gallbladder removed.Gastro Dr. treated me for constipation with amitiza which has not helped the pain at all.My pain has gotten more severe within the last week.Pain is constant and I cannot eat anything and not sleeping due to pain.My Primary Dr.suggests ERCP test to check for stones in bile duct of which Gastro DR. says MRCP shows the same as ERCP tests.Can you please help me with suggestions I am having weight loss,not sleeping and can just barely function enough to hold down my job.
Thank You for your help
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You have had a comprehensive look at your GI system, with many of the major disorders already ruled out with the testing you have received.

The MRCP is almost as good as the ERCP, but the ERCP is the more sensitive test.  Furthermore, an ERCP can be coupled with a Sphincter of Oddi manometry - which can evaluate for Sphincter of Oddi dysfunction.  With the gallbladder removed, this disorder becomes a bit more common, and can lead to the symptoms you are describing.  

If this approach is non-revealing, you can consider more specialized testing.  This can include a gastric emptying scan to look for gastroparesis, or a 24-hr pH study looking for GERD.  An esophageal motility test can also be considered to look for motility disorders.

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_
3 Comments
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I almost hate to post a comment, but feel I must. I met a 37 yr old female 4 yrs ago on the American Crohn's and Colitis Assocn website (now defunct for legal reasons) when I posted some questions about my Crohn's disease  - of some 35 yrs then. She also had Crohn's but went on to get a pancreatic tumour, and I got breast cancer, so we had a lot in common, although I am much older. Heather went through interminable tests, and chemo at UCSF,and died Jan 2007 at 39 yrs old, leaving two young children. I miss her terribly, because we both found a soul sister, with whom we could talk about the taboo subject of IBD, and then our very different lives. although some 6,000 miles apart. We had intended to meet up this year in Cornwall, England, where I live,
but sadly, this was not to be.
I don't think for one minute that you have a pancreas problem, but barring all other conclusions, you may want to ask your Gastro about this possibility.

Heather and I both had/have daily diarrohea and constant lower abdomen pain and struggled with maintaning our weight. Your symptoms don't quite dovetail with ours, but I do think you have an abdominal problem that needs further investigation.

Wish I have more intuition and information, Pattie - you can e-mail me direct on : ***@****, if you need further informtation.
Take care, and please pursue your problem with your medics.
Love. Liz.
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I hate to add to it, but I am a 27y/o female.  I do have pancreas problems.  I got a severe case of acute necrotizing pancreatitis when i was 34 weeks pregnant with my daughter.  She did wonderfully, thankfully, but I did not.  I have had problems ever since.  It has been 3 years.  I now have chronic pancreaitits, which causes me considerable pain daily.  Eating anything aggravates it.  I get horrible pain and nausea.  My pain is mostly concentrated in my Upper left quadrant of my abdomen and it radiates to the left side of my back.  I also get pains in my left shoulder, sometimes in my right.  It is a horrible illness, I just wanted you to be aware of some of the more common symptoms so you can talk with your doc about it!
Good Luck!
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I too am a 27y/o female with suspected pancreatic problems.  Almost constant pain since 07/05/06, extreme fatigue, nausea, no appetite.  Many tests done, including 3 CTs(1 without and 2 with contrast)  All show an enlarged pancreatic tail.  Unfortunately the doctors here have taken then approach that I am 'TOO YOUNG' for it to be anything serious.  My concern is that this has shown in each scan, and if a doctor would be concerned with those reports if I was 50(dr actually told me that) what makes them less concerned just bc I am half that age??  My aunt died when she was 27 of colon cancer bc no one would take her seriously either.

psychnurse21 I would love to know more of your story and talk with you if you don't mind.  If you are able please email me at ***@****


Thanks and best of luck to you all.


Beth
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