Chronic Stomach Pain

I am a 42 year old female. I have had chronic upper stomach pain on the right side below my rib cage since Dec 06. It started with stomach pain, vomiting and diarrhea which lasted four days and went away. Then the pain came back and I had diarrhea on and off for 4 months. Then the diarrhea stopped. Since then I just have chronic pain everyday. It only goes away when I sleep and will not return until I am up a couple of hours. The pain as i said is on the right but can radiate to my back on both sides.

I have been to the ER twice, 2 gastro doctors, an orthopeidic Dr, a hemotologist and a neurolgist. I have had the following tests

Endoscopy,
Colonoscopy
Upper GI Barium
2 stomach and pelvic CT scans with contrast
MRI of the spine
Ultrasound of the Liver, pancreas and gallbladder
HIDA scan
Full bloods on 6 occassions

All tests came back negative except fat in my liver, high homocysteine and positive for Prophyria Cunte Tarde and some tears in two of my discs.

My amalayse and Lipase are always on the low side of normal. My doctors told me to go to the Mayo Clinic. My question is could this be gallbladder or pancreas and it is not showing up. Can you have pancreas problems and not have elevated amalyse or lipase levels. I do not know what to do. I do not have time to go to the Mayo Clinic. I am concerned it is either the gallbladder or pancreas. My doctors have said no.
Any help would be appreciated.
Fairy1

[Kevin Pho, MD]

You have had a comprehensive evaluation, including multiple specialist referrals.  It would be unlikely that I can come up with something over the internet without examining you.  

Negative CT scans, ultrasounds, and HIDA scans would make gallbladder or pancreatic disease less likely.  You can consider Sphincter of Oddi dysfunction, which can be evaluated with an ERCP and Sphincter of Oddi manometry.  

If there is elevation in the liver tests, a liver biopsy can be considered.  

Otherwise, I agree with the suggestion to go to the Mayo Clinic, as it is one of the best medical institutions in the world.
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_