Reoccurant pain 'gall pain' years after gall bladder removal

I am a 42 year old female nonsmoker, nondrinker  Except for the "gallbladder" problem, I have no other health problems except polycystic ovarian disease. My pain started in 2001 after my gall bladder surgery.I have had this reoccurant "gall" type pain in the area under my right breast bone piercing into my back "like a knife". This has continued for a few years since my gall bladder removal. I have months with no pain and then it flares up again. When it is "flared up" the pain is especially bad at night and travels down my right side and into my back often preventing me from sleeping.(At times it hurts so much (during the day)that I can not tolerate any pressure and cannot even wear a bra during the day). However it still feels better when I'm sitting or standing upright. I am allergic to codeine, but even 2 motrin, or 2 extra strength tylenol (or sometimes both spaced by a couple hours)will not take the pain away. The only thing that made me somewhat better was buscopan, however after several weeks I became itchy all over and had to stop it. Sometimes a hot water bottle makes things better. I can only sleep on my right side, when I move at night (as we all do) I often wake up if I'm not on that side. (I have also tried diet changes, and zantac to no avail.)I have had a normal: liver enzyme blood levels,CT scan, HIDA scan, & many Ultrasounds. Nothing has been seen except for a small adrenal cyst on the right kidney. I would like the pain to stop. I need relief and would like to live a "normal" life! I meet with my specialist on Friday to review our "next steps" and my MRI results which I've been told by my family doctor is "normal". I am not allowed a second opinion without waiting for another year for an appointment (the wait is long here) and my next specialist appointment with the same specialist could take another 9months to come. So any ideas of what I can do to relieve the pain besides having continual pain killers and or sleeping pills would be helpful.  Ideas of what it might be would also be helpful as I will suggest it to my GI specialist at my Friday appointment. Thank you ever so much for any "pearls of wisdom".

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation.

Continued causes for the pain can include bile duct stones or Sphincter of Oddi dysfunction.  The latter disease may be more prevalent in those without a gallbladder and can cause similar symptoms.  

Tests to consider would be an MRCP to evaluate the biliary ducts.

Sphincter of Oddi dysfunction can be evaluated with Sphincter of Oddi manometry (usually done during an ERCP).

You can also evaluate the upper digestive tract, via an upper GI series or upper endoscopy, looking for inflammation, ulcers, or GERD.

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_b

[jlbritton41]

Hi, I'm 41 I had gallbladder removed also 4 months ago. Iv'e been getting the same pain that everyone else has been getting.
The only thing with mine, I didn't have my whole gallbladder taken out my gallbladder was attach to my liver so they only took half of my gallbladder there is still a part of it in there yet. But when I breathe thats when I have alot of pain, thats when I can feel it the most. So I can still end up with gall stones. I have had a bunch of test done also and they too came back normal and blood work also came back ok. I have a follow up visit with personnel doctor. I am getting tired of having this pain, just like everyone else is having. Please tell me what I can do to ease my pain?

[Jennica]

We are desperate for some real help.  My husband has suffered from this RUQ pain for many years.  About 15 yrs ago they removed his gallbladder but told him after the surgery it was healthy and probably not the cause of his pain.  The pain has gotten much worse recently and he is becoming depressed and feeling hopeless that it will ever be resolved.  He has hepatitis C but his Dr. said all his liver tests are fine and his viral count is way down.  My husband has no idea when or how he got this disease and we have been told it isn't related to his pain.  He has had the abd CT, sonogram, gastroscopy and all are negative.  He just went to his gastroenterologist and the best he was offered was a referral to a pain clinic.  Has anyone tried this route?  If so what was the outcome.  I can not tell you how this has knocked him down.  He is 77 but until last summer played tennis and golf and went on hikes in the national forest.  Now he can't do anything and is in great pain.  Is there any hope?  Is he just being shuffled off because of his age?  The doctor said he doesn't want to "put him through all the tests"  Does that just mean he doesn't matter?  I noted with interest the post mentioning the sphincter of oddi dysfunction test and the test for bile duct stones.  I will definately bring this to the doctors attention.  
Thank You
Jennica

[mjam]

Had my gall bladder removed 5 years ago, never had stones, just "flu-like" symptoms, tests showed it was not working.  Since then I suffered from "the dumping syndrom (syndrome)" and take Cholysteramine to control that, but the flu like symptoms continue, lots of rumbling in my intestine, nausea like feeling but lower than stomach, had lots of tests, nothing showed up.  Anyone else had this problem, and what can I do to eliminate this.  It is not affected by what I eat.

[treetopshot]

I was sick for over 2 years with a burning stomached, nausea, URQ heart-attack-like pain and a repeating prescription for Pantaloc. I had a CAT scan and scope and everything was normal.  I finally a HIDA scan which showed my gallbladder was not functioning normally.  Out came my gall bladder and I felt better for 2 weeks.  Then the URQ pain started again only worse.  It always feels swollen in that area and I still have an upset stomached and Diarrhoea.  I was given Cholestermine which helped with the constant diarrhoea.  All blood and urine tests always come back normal which doesn't help.   A few weeks ago I got a stomached virus and ended up in the hospital.  They gave me buscopan and pantaloc(again) which helped a lot.  Since I have gone on the pantaloc I no longer have diarrhoea.  I can't see a specialist until Nov/06 (we have long waits here) and my doc said there is nothing more he can do for me other than pain management.  I would recommend the pantaloc though to stop the diarrhoea.  Reading about Sphincter of Oddi, it sounds exactly what I have, unfortunately, it sounds like I might be a type 3 which you can't do much about.  Hang in there and most importantly, watch how much fat is in the food you eat!  Maintaining a low fat diet really does seem to help plus getting exercise.  I will keep you posted...