Pain following choleocystectomy/pancreatitis

Hi,

I wonder if you could offer any advice at all?  I am reluctant to go to my GP, as I am currently being treated and investigated for so many other issues (diabetes and Cushing's to name just two!) and I'm sure he's going to think I'm a moaning hypochondriac if I go to him with yet another issue....

I had my gallbladder removed 18 months ago, following NO symptoms of gallstones (despite being full of stones apparently), BUT following an attack of acute pancreatitis.  I wasn't really given much say in the matter, as the pancreatitis was a nasty attack and I was strongly advised to get my gallbladder out asap after it.  It was a straightforward procedure, with no after effects.  I can't really say I felt better, because apart from the pancreatitis incident, I never had any problems beforehand!  I do suffer from time to time with what I believe to be known as "dumping syndrome" which, whilst unpleasant, doesn't worry me too much as I believe it's normal.

However, over the last couple of weeks, I have had a recurring pain which is reminiscent of the pain I suffered with the pancreatitis - although a lot milder in its form.  It's a sort of crampy, central pain which feels like it's more in my chest than anywhere (sort of around and behind my boobs is the best, but crude, explanation!).  It feels as if it's radiating down into my shoulders sometimes too. This is exactly where the pain of the pancreatitis was.  It can sometimes seem to be slightly worse after eating, but the type of food I've eaten doesn't seem to matter.  It's intermittent, but the last week I have had it on and off most days. It can also be worse when I'm lying down, but more so if I lie on my left side.  Each time I get it, I get paranoid I'm going to get an attack of pancreatitis again, which I know is irrational!  I don't get any acid indigestion type symptoms with this pain.

Do you have any idea what this may be?  I can live with it, but I'd love to know what it is.

Many thanks

[Kevin Pho, MD]

Difficult to say without evaluation, but you may want to consider a recurrence of the pancreatitis.  

Obtaining the requisite pancreatic enzymes can be considered, and if the symptoms continue, an abdominal CT scan can be done.

Other possibilities include a biliary duct stone, as well as various upper GI disorders.  If those are suspected, an MRCP to look at the biliary tree, as well as an upper endoscopy, can be considered.

These options can be discussed with your GI physician.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[jvol]

A related discussion, Post Choleocystectomy Syndrome was started.