RUQ PAIN FOR TWO MONTHS NOW

two months ago i started to have ruq pain with nausea i went to the ER and they did the usual blood test and CT scan they told me i had pancreatitis to go on a pure liquid diet and the pain will go away in a few days.  about a week later i ended back in the ER  for the same problem they also did the CT scan and found that i did not have pancreatitis if i did i would be laying in a hospital room.  the CT scan showed nothing they wanted me to follow up with the general surgeon to see what was going on.  i went see him the first thing he did was ask me if i was checked for gallbladder problems.  i said no and he pushed on my stomach near my right rib and it was tender.  he then sent me straight to the ultrasound dept. two days later the i was scheduled for a hida scan.  upon that scan the second injection that was given if i did have gallstones would be painful, but it wasn't.  when the results were back for that my injection fraction was 91%.  so the general surgeon wanted to set up an EGD but wanted to put me completely under for this 15 min. job.  i talked to my primary care doctor and he and i agree that being put under completely for a 15 min. job is too dangerious especially for some one with a heart condition.  well i ended back into th ER a few weeks later they did the blood work and CT scan the doctor came back and said that i was the healthiest person he had seen all day that the only thing they found were either enlarged or inflamed lymph nodes in my stomach area.  that was about three weeks ago.  i don't know what's going on and it seems like no one else does either but i need to find out before something is too late.  my symptoms are ruq pain with right flank pain that runs into my back up to my shoulder blade area, nausea, and sometimes headaches,  thats pretty much it

[Banned1]

I'm so sorry you are suffering.  I'm not a doctor and I know nothing about medicine except what I've learned through my illness.  If the EGD is an upper endoscopy, perhaps you could ask to have that done under conscious sedation?  If you were diagnosed with Pancreatitis in the ER, doesn't it make sense that you had Pancreatitis in the ER?  If there is any way to get copies of your test results, they could be very illuminating.  I've learned that you can learn more through test results and reports than you ever imagined.  Doctors tend to compress information and sometimes they leave things out entirely.  There are MANY types of Pancreatitis.  Forgive the length of this post but I want to help.  If I had an eighth of this information when I first got sick, it would have made a world of difference for me.  Also, I'm NOT sharing my story here.  This is just good information that might help.

Your symptoms could be SO many things including sludge/stones in the common bile duct, gallbladder/gallstone problems, Sphincter of Oddi Dysfunction, Small Bowel Bacterial Overgrowth, acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, minimal change chronic pancreatitis, etc., etc., etc.  Here are a couple of links to abdominal pain charts:
*http://www.ahealthyme.com/topic/abpainchart
*http://www.healthorchid.com/Content/Consumer/AbdominalPain_Chart.asp?id=14
*http://www.itzarion.com/pain-symptoms-chart.html
*http://www.mayoclinic.com/health/abdominal-pain/MY00390/DSECTION=causes

There are some other minimally-invasive tests such as the Endoscopic Ultrasound (EUS) and MRCP-S (Secretin) which can image the pancreas and ductal system.  The EUS is the gold standard test for diagnoses, it does require twilight sedation and is similar to an upper endoscopy, it just shows more.  Less helpful but also VERY worthwhile, especially for you, is an MRI-S, which is essentially an MRI with the drug Secretin administered.   Discuss your concerns about complete sedation with your GI and with the anesthetist.

You're probably going to wonder why I'm talking about stool next but regulation of bowel movements is a huge help when you have abdominal pain and nausea.  Metamucil or a similar daily fibre product is a great help for MANY people with abdominal pain.   It does not make you go, it makes you regular by adding fibre to the watery stools, making them firm.   Senokot is also a great product that acts like a glue to bind everything together.  Even with pain that is RUQ (right upper quadrant) and not RLQ, it could still be bowel-related.

Many people have great success with digestive enzymes and pancreatic enzymes.  This is something you can talk to your primary Doc about.  I'm told that they won't do any harm so really - unless you are contraindicated or have side effects - there isn't a downside to trying them.  Your Doc might even have samples.  This is something you can do now and it reduces the amount of work the pancreas has to do, which will also reduce any damage to the pancreas.  You can buy these at the health food store, too, but make sure they only have protease, amlyase and lipase.

A low-fat, fibre-rich diet can make a BIG difference.  If you eliminate fried foods from your diet and start with bland foods only, you may get to a point where you have no pain.  Then you can add new items to see how you feel.  Less than 30 grams of fat per day is a great starting point.   Some argue that high-fibre diets can be harmful but they never seem to have any evidence to support that.  Either way, potential changes to your diet require personal research and a chat with your Doctor before you actual undertake them.

Keep a log of everything that enters and leaves your body.  It can help identify patterns in your foods, symptoms, medications, bowel habits and pain level.   This is one of the best ideas here.  If you do nothing else, please try this.  Hindsight is 20/20 and it can honestly lead you to certain foods or medications that might be contributing to your symptoms.  I have a three strikes rule.  When a food bothers me, I stop eating it for a few weeks and try it again.  If it hurts me again the second time but I love it, I'll avoid it for a couple of months before trying it again.  Three strikes and it's out.

You are not alone!  Try to stay positive and reach out for support when you need it.  Talk to your Doctor, family, friends, co-workers, church or social service volunteers or anyone you feel safe with.   Don't let your illness take over your life.

One of the best sites for information is:  http://www.top5plus5.com/.  Their group is also incredible.  Search yahoo! groups for "Sphincter", you will find quite a few groups.  Both Michele's and Maddi's are worth joining.  There is a lot of great information there that might help you. Here are a couple of links but find groups that you like:
http://health.groups.yahoo.com/group/Sphincterofoddi_pancreatitis/messages?o=1
http://health.groups.yahoo.com/group/Pancreatitis_sphincterofoddi/messages?o=1
http://health.groups.yahoo.com/group/ThePancreatitisPlace/messages
http://health.groups.yahoo.com/group/pancreatitis/

I hope I haven't overwhelmed you with information.  I just believe that knowledge is power and you are your own best advocate.  I've been undiagnosed for three years now but I'm getting closer to answers and I want better for you!  At least now my pain is fairly well managed and I'm seeing specialists in the appropriate field.  Take care of yourself.  Good luck and Godspeed.  Please post or email if you want to vent or ask any questions.  All the best,

Sam