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Constipation Complications after Surgery
Our 15 year old daughter 5'2" tall and 100 lbs has been having severe pain after a successful gall bladder removal surgery (09NOV2007). After surgery she could not stomach the pain medicines so she took motrin. At first 2 week checkup she was not having bial movements, and the surgeon (different doctor) suggested that her system needed a jumpstart and suggested a FLEET enyma along with a stool softner should be used. Initially successful, then the movement stopped again. At the next 2 week check up he (the surgeon) prescribed the citric laxative (half bottle- for cleansing) and fiber pills (2 pills a day). Initially cleaned out, but soon after turned back to irregular bial movements. Next 2 week check surgeon was puzzeled and suggested going back to specialist.
The specialist assistant suggested more citric laxitive and miralex (2 times a day) and if persistent diarhea occurs to switch to 1 time a day. We did the 2X treatment for 3 days and switched to one day after severe diarhea (3 to 4 times a day bial movement) and then the stoppage occurred again. Our daughter continued the miralex but stool was spiratic and very little. At next 2 week check up we had several questions for the specialist who was not prepared for the visit (had not reviewed our daughter's case or consulted with his assistant concerning the previous visit). He did not want to have to answer our questions, and finally he stated he was not sure what was going on. He wanted to schedule an ERCP and place her on another laxitive. When asked why, he had no real reason for new laxitive and gave inconsistent responses concerning the purpose of the ERCP. In addition he order blood test with no explanation as to what we were looking for in the test. We had the blood work done, and scheduled the ERCP, but after visiting this site and getting some of or questions answered by reading some of the doctor statements and patient testimonies we decided to get a second opinion and canceled the ERCP because of some of the potential complications that result from this procedure (small percentages - but when we are already not experiencing normal post op sypmtoms we were not willing to take the risk of an ERCP without first getting all questions answered). We contacted our daughter's pediatrician who was puzzeled why a second ultra sound had not been order vice the xrays that the surgeon order after the first 2-week check up. The Pediatrician immediately order an ultra sound, which we were able to have on yesterday. Our appointment with the second specialist is on tomorrow.
Now to the question. We have the blood work back and all we know is that it is normal. Are these test looking at issues with just the liver or does it look at the total GI system components (pancreas, stomach, intestines, colon, kidneys etc...)? We need to understand why the pain after the painful diseased (stones- another thing we could not believe and need to understand why) gall bladder was removed is so strong and constant in the the upper abdomen. Our daughter is not able to sleep through the night due to the pain. Please share some insights.
Settles
The specialist assistant suggested more citric laxitive and miralex (2 times a day) and if persistent diarhea occurs to switch to 1 time a day. We did the 2X treatment for 3 days and switched to one day after severe diarhea (3 to 4 times a day bial movement) and then the stoppage occurred again. Our daughter continued the miralex but stool was spiratic and very little. At next 2 week check up we had several questions for the specialist who was not prepared for the visit (had not reviewed our daughter's case or consulted with his assistant concerning the previous visit). He did not want to have to answer our questions, and finally he stated he was not sure what was going on. He wanted to schedule an ERCP and place her on another laxitive. When asked why, he had no real reason for new laxitive and gave inconsistent responses concerning the purpose of the ERCP. In addition he order blood test with no explanation as to what we were looking for in the test. We had the blood work done, and scheduled the ERCP, but after visiting this site and getting some of or questions answered by reading some of the doctor statements and patient testimonies we decided to get a second opinion and canceled the ERCP because of some of the potential complications that result from this procedure (small percentages - but when we are already not experiencing normal post op sypmtoms we were not willing to take the risk of an ERCP without first getting all questions answered). We contacted our daughter's pediatrician who was puzzeled why a second ultra sound had not been order vice the xrays that the surgeon order after the first 2-week check up. The Pediatrician immediately order an ultra sound, which we were able to have on yesterday. Our appointment with the second specialist is on tomorrow.
Now to the question. We have the blood work back and all we know is that it is normal. Are these test looking at issues with just the liver or does it look at the total GI system components (pancreas, stomach, intestines, colon, kidneys etc...)? We need to understand why the pain after the painful diseased (stones- another thing we could not believe and need to understand why) gall bladder was removed is so strong and constant in the the upper abdomen. Our daughter is not able to sleep through the night due to the pain. Please share some insights.
Settles
Blood work consists of tests which show a little bit of all main functions of...liver, kidneys... This is done to quickly check if something severe (infection...) is happening. From blood work no exact diagnosis can be made, but it can provide good suggestions. With not seeing a total list of tests done, it's not possible to say more.
Stones. If there were stones in gallbladder, this was seen on ultrasound, and written down somewhere. Surgeon, who removed gallbladder has probably checked the gallbladder for stones after removal, this again has to be written. All this can be found in your daughter's medical documentation, which you have the right to check.
Pain after gallbladder removal may origin from a stone remained in hepatobiliary duct (through which a bile flows from the liver into the intestine). This is the reason why doctor wanted to make ERCP.
Pain after gallbladder removal is often, I hope someone will provide some personal experience.
Stones. If there were stones in gallbladder, this was seen on ultrasound, and written down somewhere. Surgeon, who removed gallbladder has probably checked the gallbladder for stones after removal, this again has to be written. All this can be found in your daughter's medical documentation, which you have the right to check.
Pain after gallbladder removal may origin from a stone remained in hepatobiliary duct (through which a bile flows from the liver into the intestine). This is the reason why doctor wanted to make ERCP.
Pain after gallbladder removal is often, I hope someone will provide some personal experience.
Did you find out any more info .. I am so sorry to read your post . My 17yr old just had hers out 10days ago and is highly irregular but no more GB pain. Please tell me what the specialist did for your daughter and if there is a gameplan ...
Cheryl
Cheryl
Don't forget to obtain copies of the lab results as well as the operative report from the initial surgery and the pathology report. Have the doctor review those with you in detail. In my opinion, when there are complications, just having the doctor tell you "everything is normal" isn't an answer. If you need to consult another doctor, he will want copies of those results as well, and it speeds things up to be able to supply them yourself instead of waiting on one or more clinics to fax them in to the new doctor.
I agree with the previous poster who said the ERCP was suggested by your doctor to look for sludge or stones still in the bile duct. What I don't like is the evasive nature of the doctor you're working with. I'd have red flags going up too if it were me in the same situation. Don't ever let your doctor walk out of the exam room if you still have questions. I know that sometimes questions don't occur until after you've left, and a great way to get them answered is to write them down and fax them in. Call the nurse and alert her that you're sending a fax with questions, and would appreciate it if she would make sure the doctor answers them as soon as he can. That way, the doctor can jot down the answers and have his nurse ring you back, which saves everyone time, and you get the answers you need - hopefully!
Another often-overlooked possibility is that your daughter has developed adhesions (scar tissue) on her intestines that blocks the flow of waste. Adhesion development is a normal part of healing, and most people never have symptoms. In ther patients, like myself, the scar tissue takes on a life of its own and just keeps on growing and causes bowel obstruction. Adhesions don't generally show up on tests (ultrasound, x-ray, CT scan, or MRI) so they can be very difficult to get treated. Surgeons are also reluctant to do more surgery to cut them down because that runs the risk of getting into a vicious cycle of surgery, more adhesion development, more surgery, more adhesion development... If the ERCP reveals no sludge or stones, no sphincter of oddi dysfunction or any other problem in the biliary tree, you may want to consult a surgeon about the possibility of adhesions causing the problems.
I agree with the previous poster who said the ERCP was suggested by your doctor to look for sludge or stones still in the bile duct. What I don't like is the evasive nature of the doctor you're working with. I'd have red flags going up too if it were me in the same situation. Don't ever let your doctor walk out of the exam room if you still have questions. I know that sometimes questions don't occur until after you've left, and a great way to get them answered is to write them down and fax them in. Call the nurse and alert her that you're sending a fax with questions, and would appreciate it if she would make sure the doctor answers them as soon as he can. That way, the doctor can jot down the answers and have his nurse ring you back, which saves everyone time, and you get the answers you need - hopefully!
Another often-overlooked possibility is that your daughter has developed adhesions (scar tissue) on her intestines that blocks the flow of waste. Adhesion development is a normal part of healing, and most people never have symptoms. In ther patients, like myself, the scar tissue takes on a life of its own and just keeps on growing and causes bowel obstruction. Adhesions don't generally show up on tests (ultrasound, x-ray, CT scan, or MRI) so they can be very difficult to get treated. Surgeons are also reluctant to do more surgery to cut them down because that runs the risk of getting into a vicious cycle of surgery, more adhesion development, more surgery, more adhesion development... If the ERCP reveals no sludge or stones, no sphincter of oddi dysfunction or any other problem in the biliary tree, you may want to consult a surgeon about the possibility of adhesions causing the problems.
When my son at 12 weeks old had a bowel resection I was told that adhesions could form from the 3rd day post-op until the day he was an elderly man. And, we were told the same thing, that unless they created an obstruction they would not do anything.
C~
C~
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