intestinal upset

  Hello
  Eight days ago I started getting what I defined as high gas,extreme pressure in chest,tingling in extremities,nausea,headach.  Progressivley got worse. Th Dr. sent me to Cardio to rule out heart.  Heart is in good shape. I'm 47 yr old female,menopausal.  twenty yrs ago at age 23 I had my gallbladder taken out,terrible attacks.  The funny thing is these symtoms (symptoms) are incredibly similar.  Meaning they would always start about the same time every day and last the same time.  Is there any possibility the duct if not removed ,could cause same upset? I've never suffered from heartburn,belching excessivley,eating or not eating has no baring on syptoms (symptoms). I've tryed,tums,alka seltzer,tagamet,pepcid,and even soda.  My Dr.is stumped,all I know is that I'm miserable and know my body well enough to know something is up.  Any suggestions would be great.  Maybe something I could pass on to my Dr.  Thanks so much for the time.          Diane Nelson

[HFHSM.D.-rf]

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Dear Diane Nelson,
The sudden onset of chest pressure mandates that a cardiac cause be excluded, which appears to have been done by your physician.  It is intriguing to me that your current symptoms are similar to those that you experienced 23 years ago prior to having your gall bladder removed.  It is possible that you have developed stones in the common bile duct, although the presentation of duct stones is different from the symptoms that you describe.  Patients with common bile duct stones will complain of intense pains in the region between the ribs.  They may have jaundice (yellow eyes0 fever and chills.  Physical examination will show tenderness to palpation in the epigastrium (region between the ribs) and over the liver. Other possibilities to consider as the explanation for your symptoms are hepatitis, viral infection and bowel disease.
If your doctor has not yet ordered liver tests as well as pancreatic tests (amylase, lipase), this should be done.  An ultrasound of your liver, bile duct and pancreas is also necessary.  Depending on the results from these studies, you may need an ERCP.  This test allows for dye to be injected into your bile duct and pancreatic duct.  X rays are taken and studied looking for anatomical abnormalities. You may also need a barium study of your colon and small intestine.
Best of luck
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by a physician.
W would be happy to meet you personally in order to better characterize the cause of your symptoms and to provide reassurance. If you wish to be seen by a gastroenterologist of the Henry Ford Health System, please call [phone] and request consultation with Dr Ben Menachem, one of our experts in the treatment of abdominal pain.
HFHSM.D.-rf
*keywords: abdominal pain, pancreatitis, common bile duct stone, liver, cholangitis
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