Pancreatitis post ercp

I am a 24 year old female, otherwise healthy, normal weight, who has been through hell. I had my gallbladder removed 8 weeks ago, it was a dysfunctional one. Since then I have had severe RUQ pain, resulting in an ERCP, and my doctor cut my sphincter during this procedure, I was then admitted to the hospital for pancreatitis after the surgery. I spent 4 days in the hospital and was discharged. I am starting to have pain again. Is this normal. Did it happen to anyone else?

[michell221]

Sphincter of Oddi dysfunction can appear after gallbladder removal.   The symptoms can be RUQ pain and nausea.  ERCP with manommetry  is done to determine if you have this disease. There is a risk of pancreatitis after surgery and most doctors will insert a stent into the duct to lower this risk. The stent should pass on its own in 2 weeks but you need to have an xray to be sure.  If it does not pass they can remove it   Did the dr measure your pressure in the ducts during ercp?  If it is high they usually cut it.  This procedure helps some with sphincter of oddi and others it does not.  It is a hard disease to manage.  Some people end up getting the sphincter cut many times since it tends to scar over and back up again.  If they continue to have issues they may opt for a sphincteroplasty which is a more serious operation.  

Another option that works for some is management with drugs such as levisin, nitro or amitryptiline.  

I would talk with your dr and try some meds first to see if they help and if not then you may need to visit a dr who specializes in SOD.  There are not many in the us.  I have visited  Dr Peter Cotton at MUSC .  There is also Dr Sherman or Lehman at Univ of Indiana.

[felicia723]

Thanks michell. I have spoke to Dr. Cotton in emails, I think in the long run I am going to end up in one of his trials. I spoke to my doctor today it is not the Pancreatitis he thinks the ERCP was not helpful so we are going to try meds again. I do not know if the pressure was measured, I am sure it was I have an excellent doctors, I went to many doctors before choosing him. I did have the sphincter cut, and I did feel better today is a week, and I feel pain again. This is a terrible disease, and I truly do not think anyone will ever understand it unless they go through it.

Thanks so much for responding to me.

Felicia

[akteech]

Several years back I aquired pancreatitis from a Crohn's med I was taking.  I went right into the hopspital when I had pain and was dehydrated,but after 3 days the enzyme levels showed it to be pancreatitis.  I spent another 4or 5 days in the hospital with no food, just IV nutrition and pain meds.  
I asked for an ERCP to find out what caused it and after the procedure I again spent another week in the hospital.  You are right it is a horrible experience, and over the years I have had that pain time and time again.  Sometimes I used to have them check enzyme levels to make sure it was not pancreatitis (which it was not).  
I have been lucky and have not had the bad pain for some time now.
I wish you the very best in your quest to find some answers!!!

Anne

[michell221]

Sounds like you are on the right track.  I have heard some people are really sore for a few weeks after ercp so I am hoping that it will get better and it did help. Did he stent you?  The stent may be aggravating you.  What meds are you going to try?  Let me know how it works out.  

I had bad attacks after my GB surgery for about 5 months or so everyday.  They gradually eased off in about 8-9 months.  I went to dr cotton about 3 months after my surgery because I was scared and getting high liver levels during attacks.  I chose not to get ercp and to wait a few more months to see if I improved.  Thankfully I did  but will get it if I get to a point where it is not tolerable.  I have about 3-4 attacks a month.  It starts off as a knawing feeling in my URQ and then it hits full force in a couple minutes and feels like someone is kicking my in the stomach,  I cant breathe, I sweat and have pain radiating in my URQ and back.  I then vomit a few times and the pain goes away.  Sometimes if I catch it early and drink anything carbonated it stops the spasms before it gets bad.  I just hate this disease.  I can be shopping at target and all of a sudden I am doubled over trying to find the nearest restroom because I know I am going to get sick and feel like I am going to pass out from pain.

[felicia723]

He did not stent me. He sent me for a ct scan today which was negative I see him tomorrow to discuss where to go from here. I have tried levisin, and bentyl. Neither one did anything, the Bentyl worked a little before the ercp but barely enough to keep taking. I wish I never had the ERCP but I thought the benefits would outweigh the risks. However it has been a week and I am back in pain, so I am one of the unlucky ones who the procedure must not have worked for. I will let you know what he says my options are tomorrow. Did you ever have an ERCP?

[michell221]

No I chose not to have the ercp .  He told me that is fine and come back if I need to.  I waited since I just had my surgery 3 months before I saw dr cotton  and mine settled down to 3-4 10 min attacks a month after about 7 months or so. It took quite a while after my gb surgery for it to settle down. I think the GB surgery will cause it to flare for a bit.  

  I was scared the ercp would possibly make me worse and cause the ducts to shrink even smaller from scar tissue buildup after they cut it.  I was also afraid of pancreatitis.  I will only get it if I cannot live with the pain and it happens everyday for hours.  You could have pain also from them not stenting you.  They should have stented you.  Dr cotton and lehman etc will always stent a patient since it usually causes pancreatitis when you do not.  I would get in to see Dr cotton to get his opinion.   Amitryptiline is another drug option that may help.