Obstructed bowel symptoms but no obstruction!

I was diagnosed with diabetes last year. I had my gallbladder removed in mid-June this year.  3 weeks later I was back in the hospital with abdominal pain just above the navel and vomiting.  Was told it was a bowel obstruction, so in went an NG tube and 3 days later I was feeling better.  Almost a month ago, I got the same pain again and went right back in the hospital.  I was not vomiting this time, still passing gas and stool.  Just the same pain.  Initally the ER doc said it was an obstruction (my doc saw the X-ray and said that actually ALL my small and large intestine were slightly dialated), but my doctor came in and looked at my X-rays plus barium Upper GI with lower GI follow through and stated that all was fine.  No mechanical obstruction, no dialated bowel.  I was released, but the pain has persisted, and now , 3 weeks later, even feels as if it has spread upwards (towards sternum).  The pain is a sort of dull aching just beneath the muscle wall, like as if the intestine was bloated and rubbing against it.  The doc checked for hernia but found none.  Combine this with the usual nausea from a slow emptying stomach and you can probably guess how miserable I've been.   I have an appointment with a gastrointerologist, but that's not 'til November 9 (about 3 weeks from now) and I was hoping for something to help me possibly understand what may be going on.  Any insight is appreciated.

[Kevin Pho, MD]

Hello - sorry for the delay in replying and thanks for your patience.

Couple of ideas.  The first would be any type of gastroparesis, which can cause the symptoms.  Being a diabetic would increase the risk for this.  The gastric emptying scan would be the appropriate test for evaluation.

Any type of dyspepsia - either caused by an ulcer, inflammation of the upper GI tract, or GERD - can lead to the symptoms.  An upper endoscopy would be appropriate to evaluate this, and would be a better test than the barium tests.  I would also consider a blood test for H Pylori - a bacteria associated with ulcers and inflammation.

Lastly, you may want to consider Sphincter of Oddi dysfunction.  This can cause gallbladder-like symptoms in those who had their gallbladder removed.  An ERCP with manometry is the most comprehensive test to evaluate this.

These options should 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.
Medical Weblog:
kevinmd_b

[NorCalBrat]

I had gastric bypass in April 2004, had a bowel obstruction in May 2004, Cholecystectomy in July 2004. I have been dealing with the same symptoms as you explain. My common bile duct is distended to 8 mm. CT abdomen/pelvis with contrast show no signs of another obstruction, but I have symptoms like I did when I had the obstruction in May. Only have BM maybe 2-3 times/week. I continue to have abdominal pain, like what I experienced prior to the cholecystectomy. Seen the gastro, put me on robinul forte, and prevacid to no avail. May be considering colonoscopy and scoping. Have made several visits to ER, urgent care, and PCP. I can honestly say that I understand the frustration and distress you must be experiencing, all we can do is be persistent and take a proactive approach to our health care. Good Luck to you ........

[lordghaleon]

Thanks for the advice NorCalBrat!  Appreciate it!  Just wish I could get some more advice rather than just lame SPAM trying to rip me off here.

[renee1952]

Hi, Dr. Pho, who moderates this board will answer your question. His is the opinion you are paying for. Hopefully he will also remove all the spam. I have been reading on this board for a long time and this is the first time I've ever seen spam here.

[lordghaleon]

Yeah, I figure he will answer in due time.  I just got disappointed that a lot of space was taken up by this spamming idiot.  Hopefully he will do something about this garbage.

[lordghaleon]

Thanks for answering doc!  I have already had the stomach-emptying test done and it did show that it does not empty well at all.  Gastroparesis is something I have been suspecting for a while.  I also had the endoscopy with biopsies and is showed I had very mild gastritis.  I did not know that gastroparesis could produce obstruction-like sensations.  Do you know why that is?

All of this is stuff I am going to discuss with my gastrointerologist, but like I said, that would be for another 3 weeks or so.

[Urbanette]

I am new to this site and area but I am NOT new to the physical problems I have been dealing with since July.  Saw a new Gastro doc out of town yesterday and he thinks I have problems with the Vegus nerve.  Every AM I wake up with extreme nuasea, often vomitting, faintness, weakness, heart palpitations, sweating, chills and usually a bowel movement, or several but NOT diarrhea, and then after a few hours, I will be ok the rest of the day.  I have had blood loss and had to be in ICU and have 2 pints of blood 2 different times in the hospital.  I have visited ER more than I can count and now am staying out only because of a Chemo therapy drug for nausea and vomiting called ZoFran but it costs for 30 pills over $973.00 I SWEAR THIS IS TRUE, but able to get it thru maker for only $10.  Had negative Colonoscopy twice and negative endoscopy once.  Doctor upped my Zelnorm from two per day to three and explained it MUST be taken on an empty stomoach or it looses 50% of it's effectiveness.  Can anyone shed any light on my problem.  I am sick and tired of being sick and tired every day.