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Gastroenterology (Expert Forum)
Problems Post Cholecystectomy
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Problems Post Cholecystectomy
by straub, Jan 03, 2005 12:00AM
I had my gall bladder removed one year ago (surgery was lapascopic). Approximately two months post surgery I developed the following symptoms which have not gone away: 1) abdominal cramps 2) pain to my far right side - upper quadrant - right below the ribs. The pain radiates to my back and prevents me from sleeping on my right side 3) inability to process foods containing fat 4) it feels like my right side is constantly "INFLAMMED" and is by all means most TENDER to the touch. The type of pain I am experiencing is similar to the pain I experienced BEFORE I had my gall bladder removed!
I have had the following tests performed:
A) upper G.I. (otherwise known as E.G.D.) - no abnormality
B) Abdominal Cat Scan - no abornamility
C) Lower Bowel Pass Through Test - no abnormality
D) Liver Enzeme Tests - blood tests were normal
F) IVP - no blockage found
My doctor put me on anti-biotics thinking I might have a bacterial infection but the anti-biotic (namely Amoxicillan) was not helpful.
They have not been able to determine the SOURCE of the pain. Would you recommend I undergo a ERCP Test to look at the bile ducts? & should I also request an ERCP with sphincter of Oddi manometry? or do you recommend some OTHER test?
Sincerly yours,
Bruce
I have had the following tests performed:
A) upper G.I. (otherwise known as E.G.D.) - no abnormality
B) Abdominal Cat Scan - no abornamility
C) Lower Bowel Pass Through Test - no abnormality
D) Liver Enzeme Tests - blood tests were normal
F) IVP - no blockage found
My doctor put me on anti-biotics thinking I might have a bacterial infection but the anti-biotic (namely Amoxicillan) was not helpful.
They have not been able to determine the SOURCE of the pain. Would you recommend I undergo a ERCP Test to look at the bile ducts? & should I also request an ERCP with sphincter of Oddi manometry? or do you recommend some OTHER test?
Sincerly yours,
Bruce
Doctor's Answer
by Kevin Pho, MD, Jan 03, 2005 12:00AM
, Jan 03, 2005 12:00AM
As you have inferred, one possibility would be Sphincter of Oddi dysfunction - which can manifest as gallbladder-type pain in those who have had a cholecystectomy.
You have had a pretty thorough evaluation. One note - the upper GI is not the same as an EGD - the EGD is the more comprehensive test.
If the Sphincter of Oddi is to be considered - the ERCP with Sphincter of Oddi manometry would be the gold standard. Treatment options would include a sphincterotomy or surgery. There are some experimental treatments involving botulinum toxin that you may want to consider.
These options should be discussed with a GI specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
You have had a pretty thorough evaluation. One note - the upper GI is not the same as an EGD - the EGD is the more comprehensive test.
If the Sphincter of Oddi is to be considered - the ERCP with Sphincter of Oddi manometry would be the gold standard. Treatment options would include a sphincterotomy or surgery. There are some experimental treatments involving botulinum toxin that you may want to consider.
These options should be discussed with a GI specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
