Possible ulcer or surgery side effects?

I am a 28 yr old female experiencing periodic epigastric pain attacks. I had a laparoscopy about two months ago for ovarian cysts and endometriosis. After the surgery I experienced a bowel ileus and an infected abdominal hematoma (bacteriodes fragilis). When I began flagyl treatment for the infection I began to have severe upper abdominal pains and bloating and I thought it was a side effect of the antibiotic. I finished the antibiotic (500mg every 6 hours for 2 weeks).

At this point I have painful attacks about once a week that last from 1-4 hours. There does not appear to be any food relationship. All attacks have occurred between 12pm and 8pm. The attacks consist of what feels like sharp muscle spasms directly below the breatbone. They are bad enough to make me feel I should go to the emergency room but I know they will subside. Sometimes it feels left or right sided and it has radiated to the back on a couple of occasions.  The painful bloating comes and goes. I have had a normal gallbladder ultrasound and a HIDA scan that appeared normal this morning. I have been taking protonix for about 3 weeks and have felt no decrease in symptoms. Lipase and amylase tests were high normal one day after an attack.

Could this be an ulcer or just inflammation from the side effects of surgery?

Thanks for any help,
Darla

[Kevin Pho, MD]

Ulcer is possible.  I would also consider GERD as well as inflammation of the upper digestive tract.

The normal gallbladder ultrasound and HIDA scan would make liver and gallbladder disease less likely.  

I would consider an upper endoscopy or upper GI series at this point to image/visualize the upper digestive tract.  If negative, more specialized testing such as a 24-hr pH study or gastric emptying scan can be considered.

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_

[hugdarla]

I forgot to mention my appendix was also removed during the surgery and the pathology came back as acute inflammation.