Crohn's patient in remission that had gallbladder removed

I had my gall bladder removed on March 25, 2004.  Since then I have had severe upper abdominal pain that shoots into my back and left side.  I've told this to the doctor and surgeon.  Since then I have had multiple blood test, ct scans, sonograms, and a mrcp scan.  They have not been able to find anything, but yet I'm still in severe pain.  The pain is generally in the morning when i first awaken or sometimes when I'm driving.  Also I can no longer lay on my left side without the pain starting in my stomach, causing me to vomit.  When the pain hits the only wat to supress the pain is to vomit.  I have also had and EGD and colonoscopy done also.  Please advice me what I should do next.

[Kevin Pho, MD]

One consideration would be Sphincter of Oddi dysfunction.  This is a disorder where people have biliary-type pain without clear causes.  It tends to be magnified in patients who have undergone a cholecystectomy for reasons that aren't well understood.  

A test to evaluate for this would be fatty meal ultrasound.  If positive, then one can consider an ERCP with Sphincter of Oddi manometry (which would be the definitive test).  Treatment for this can involve surgery or can be done endoscopically in the right situation.

Another test to consider would be a gastric emptying scan to evaluate for gastroparesis, which can cause some of your symptoms.  

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.
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