Chest Pain & Post Op Gallbladder

[KAREN__0__0]

  I have been suffering from Severe Chest Pain and thin, loose, unformed,
  yellowish stool for the past 8 months.  I have had a variety of test and
  dx's.  I had my Gallbladder removed, because It was found to have
  a cyst attached to the side.  I had chest pain and shaking and the stool
  problems as soon as I stopped the pain medication.  I was sent for a
  ct scan, hydascan, upper endoscopy, colonoscopy, and most recently an
  ercp.  My gastro doctor, prescriped Prilosec and Prozac.  I was found
  to have ulcers on the esophagus and he diagnosed Gerd and IBS.  I have
  just recently started having the chest pain and upper back pain almost
  constantly.  Also I have pain up under my ribs on the right side.  It
  is almost constant and getting to be so painful, that It causes my
  whole body to shake.  I can't sleep at night and I can't eat anything
  without having pain for hours.  I am desperate and only 38 years old
  and can not imagine living with this kind of pain for the rest of
  my life.  My gastro doctor has said to try to stick it out for 3 months
  and come back, but I can not stand it any longer.  Could this pain
  be due to Scaring from the Surgery.  I am told that the Gallbladder
  was diseased and needed to come out, but It did not diminish my Symptoms.
  I was treated with so many antibiodicts that I got a bactarial infection.
  I have taken to regimes of Fladgyl, 250 and 500 mg, and It did not seem to do anything
  for the pain or the diariah.  Could the bactarial infection still be there.
  Should I pursue this lesion thing, I should say that without the Prilosec
  the pain was much more severe, but in the last few weeks, I feel worse
  than I did originally.  Is there someother medical therapy, or Can I
  ask my doctor about surgical procedures for Gerd.
__________________
dear Karen,
Reading your e-mail I am lefyt with the impression that your physicians have done an excellent job of excluding structural abnormalities of your gastrointestinal tract.  Given the failure of the gall bladder surgery to improve your symptoms, i would favor having a diagnosis before considering additional surgeries.  It is not evident from what you write that your physicians are convinced that the majority of symptoms are related to GERD.
I think that you require an esophageal motility study and 24 hour pH probe.  The former test will demonstrate whether esophageal muscle spasm is contributing to your chest pain and the latter study will quantuify the extent of refllux and whether acid in the esophagus is the causative factor for your pain.  In addition to these studies, you should also have a gastric emptying study.  We have seen many patients with nonspecific complaints of abdominal pain, nausea, weight loss who have delayed gastric emptying as the cause for their complaints.  Treatment with a prokinetic agent produces dramatic improvement for many of these patients.
This information is provided for educational purposes only.  always consult your personal physician for specific medical questions.  If you wish we would be happy to see you in the Division of gastroenterology and arrange for the appropriate tests.  Call our Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: chest pain, gastroparesis, gall bladder surgery
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