ERCP Stent creates pain?

[Aileeny]

The GI doc believes that I have SOD type II. Two days ago, I went to California Pacific Medical Center for an ERCP with manometry because Kaiser does not do this procedure.  There were many attempts at cannulation without success because of a cranial diverticulum. What is a cranial diverticulum.  The diverticulum caused the papilla to "sink in"and they could not get at it.  This pouch is blocking the sphincter of oddi. The Dr. said that he's never seen an anatomy like mine. They placed a stent in the pancreatic duct.  I had a lot of pain after eating my first meal of soup yesterday and now I am afraid to eat more.  This is different from the pain I had previously.  Is this from the stent?  Is this pancreatitis?  I have to take dilauded for the pain and I don't want to keep doing that.  I'm a teacher and I had to leave work early yesterday and I am home today in pain.

The report also stated "There was vigorous peristalsis that could not be subdued with glucagon."  What does this mean?

Thanks for your help.

[jsgarden]

I had ERCP done 1 week ago ...my 2nd one
  1.  after bile leak...stents a metaling & plastic stent inside...becauce of COVID 19 they held off on removal 2/11 to 4/29, The last Tues ERCP push up dues to increase in liver enzymes.  I said that I had liver transplant 11/8/19.  This time they replaced stents because of stricture at anatamosis site ..3 plastic encased at site to dilate. I now have abdominal discomfort pain at the rib cage area, just at top of liver & extends across to the left ...I am on narcotics for chronic pain & I still have this pain.  Any answers.  I'm waiting it out as no temp, awaiting  wkly bad work results. air  this is cause of . my enzymes elevation...how long to see decrease.   I appreciate any response.

[Sara_MHModerator]

Wow, you sure have been through it.  How are you?

[CalGal]

The actual narcotic. It may or may not be a problem in your case, but just be careful.

[MissDiva]

p.s.  are you referring to the actual narcotic (hydrocodone et al.) or its side-kick, APAP (acetaminophen) raising the interductal pressure?  

[MissDiva]

CalGal, thanks for the info. This is interesting because I take hydrocodone/APAP for chronic pain and informed my GI doc of my current dosage. He didn't say a thing about it. Thanks again for bringing this to my attention.

[CalGal]

MissDiva, it's going to be very hard for any one to tell you how long the discomfort will last. Some people find the initial pain tamps down in a day or so, but a longer lasting discomfort can remain, especially when a person moves. It's very dependent on what the configuration on your bile duct is. They're not all the same size and shape, unfortuantely. If possible, try to stay away from narcotic-based pain meds as they raise the interductal pressure and can cause more discomfort even with the presence of the stent.

[MissDiva]

Hi all.  I just had ERCP on 3/2/09 where a blockage was cleared from the common bile duct and stent was placed.  I was discharged from the hospital 30 minutes after procedure and found myself nauseous (with some vomiting) and in severe pain throughout the day and into following day. I find that any position other than flat on my back is uncomfortable.  The discomfort is calming down w/ each day.  How long does this last?  Doc's office did not return my call and initially they said I would feel no pain and be 'up and at it' same day.  huh?

[Loripoo]

I had this done, and my doctor said I'd have no pain. He said I didn't need pain medication to just take Tylenol. Ha! Yeah right. I was in alot of pain for two days and was grateful I had leftover Tramadol from an old procedure. If it wasn't for that I would've gone back to his office and demanded pain meds. This is a somewhat painful procedure, So get pain meds people!
Don't let your doctor make you think you won't need it, because you probably will for a couple days. You have a piece of plastic in your body, and a bit of your insides are cut open. That hurts.
It does start to feel better on the second day, mine did.

[Nichole2472]

What did you find out about your pain? What happened?  I just had two stints inserted -one in common bile duct and another in pancreas.  i have been in intense pain for the past two days. Wondering what you found out.

[CalGal]

Overall it means that the configuration of where you main pancreatic duct and the outlet of the bile duct come together is not in the 'general' configuration that docs are used to seeing. But there are millions of people with various configurations....................?

Think of the papilla as a small 'pouchy' outlet with a hole in the middle where the duct would be found. Evidently there was a 'outward' pouch (diverticulum) close to the papilla and when they tried to enter to papilla/duct, the diverticulum somehow interferred.

Stents can cause discomfort - in some it's like a jabbing pain and you need to change position. For others, they just feel a bit 'stuffed' at that point.

The vigorous peristalsis means some portion of your anatomy was 'spasming' a lot. Evidently they couldn't stop the spasms ('milking movements' that would normally move food though the GI tract).

If the pain was severe, you need to contact your doc.