Celiac plexus gastroenterologist pain question..

3 yrs ago I had facet joint arthritis pain lower back severe and went to spinal anaesthsiologist for radio frequency ablation..results great ...but here is joist of my question..
I had been having severe painful bouts of severe painin left quadrant of pancrease area for 5yrs..pancrease enzymes ok, 5yr previous upper lower colonoscopy,etc showed nothing..took opiate when pain hit and a day and it would be gone for awhile...
I was seeing spinal doctor as painful episode occurred again and he injected xylocaine into lumbar one nerve at spine..Bam!  it numbed pain immediately and he ablated( cut) nerve a few days later and I had no pain til recently..1 yr++ since..
I take opiates for neuropathy pain NOW..that did not respond to nortriptyline,cymbalta.
...for years only used opiates for breakthru pain...and last year was finally put on time release opiates, taken off nortriptyline, diagnosed with familial thyroiditis so now have to deal with hypothyroid wt gain,constipation...etc..

Now pain is bad and back in area that prompted my having ablation of lumbar one nerve...anyone know about celiac plexus gastroenterology diagnosis and complications?

[S. Kaul, MD]

Hi there!

The coeliac plexus is a complex plexus consisting of smaller ganglia including the gastric, superior and inferior mesentric, abdominal aortic and spleno-hepatic-pancreatic plexus (lineal plexus) and is related to the lower plexuses such as the renal-supra-renal, pelvic plexus and testicular/ ovarian plexus; joined by the splanchnic nerves. Though pain from the thoracic/ lumbar regions could be referred to the middle/ LUQ, it is always the more likely possibilities that would need to be considered in the situation such as GI related causes, chest wall inflammation, pain referred from other regions etc. I would suggest considering a detailed evaluation by an internist, preferably at a university/ teaching hospital and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist care may be sought.
Hope this is helpful.

Take care!

[Icannot]

As a retired med professional, I understand and thank you so very much. The internist I have now referred me to a gastroenterologist who did ultrasound of pancreas and gall bladder and his nurse called and said things looked fine..
I had presented to him with nausea and lack of appetite neither of which he even asked me about during visit but I asked nurse to at least ask him for blood or breath test for h.pylori and it has been a week with no answer..
I wrote about lumbar1 ablation and mentioned to nurse I wanted to rule out pain on left or right side of abdomen being related to celiac plexus..so no answer. I live in Phoenix and will ask pain dr to suggest a research team at a hospital.
It just seems I get no assistance from non pain community..
I worked with dr's who would have loved to have used me as a research subject but that was 25 years ago..I can't do anything without seeing primary care first...I want to get off opiates as I am 63 and a few yrs of lower opiates or anything would really help me.
Thank you again