RUQ Soreness Post-Gallbladder Removal

[smiles57]

Hello.  This is my third post to this forum, so I hope we can narrow down the source of my ongoing issues.

I had my gallbladder removed via "keyhole" surgery in Feb. 2006.  At the time, I was also diagnosed with mild fatty liver.  My gallbladder definitely needed to be removed as it was full of stones and sludge, inflammed and scarred.  Prior to surgery, I was experiencing bouts of morning and afternoon diarrhea (which prompted me to seek medical attention in the first place).  

Up until a few weeks ago, I was pretty much pain-free and only had diarrhea sporadically...only for a day or two then I was normal. If I had some drinks the night before, it would bring it on or if I had something fatty/spicy (like wings, my achilles heel).  Well, after a party I threw where I drank quite a bit, the persistent diarrhea started along with intermittent RUQ pain/soreness.  The first BM of the day is somewhat formed and the remaining ones in the morning and sometimes afternoon are yellow-y and loose to very loose.

I also want to mention that I've been working with a personal trainer for the past 12 weeks in order to help de-fat my liver.  Although I've built muscle, I have not lost a single pound, nor has my body fat percentage decreased (frustrating).

So, I went back to my family doctor.  We started with a blood test for Celiac disease, liver function and pancreatic enzymes.  All came back clean.  I then had an ultrasound.  Nothing out of the ordinary. They paid close attention to the size of the bile ducts and everything appears to be in order.  So, it's off to a GI specialist...but not until Dec 20th!

In the meantime, my trainer had me do ab work Tuesday evening.  It didn't hurt at the time, although I felt a little ill, like I had maybe some bile coming up...felt a little dizzy-ish, too.  I'm really sore, even to touch in the RUQ area.  When my doc examined me, I was tender in that area, but even more tender in the spots where my incisions were.  

I'll be providing a stool sample today, where my doc will be testing for several things (not sure what...I can't read his writing).

After all of this, my questions are as follows:

1)  Could scar tissue or something else from the surgery be causing my pain?
2)  Is it possible that the pain and diarrhea are unrelated?
3)  You would think I'd be losing weight as a result of diarrhea.  Could I be expelling just enough to put me in starvation mode, thus stalling my weight-loss efforts?
4)  I know an ERCP is somewhat invasive.  Should I ask my family doc for an MRCP or some other type of test now instead of waiting until next month for the GI doctor to do it?

Thanks again...here's to hoping we nail this down before 2006 is over!

[Kevin Pho, MD]

To answer your questions:
1) It is possible from post-surgical scar tissue to lead to your pain.

2) It is possible that the pain and diarrhea are unrelated.  Diarrhea is also a side-effect related to gallbladder removal.

3) Difficult to say.  Losing weight by diarrhea is not generally a recommended method of weight loss.  I agree with the testing done thus far, as well as the referral to a GI specialist.

4) An MRCP can evaluate for bile duct stones.  Sphincter of Oddi dysfunction can lead to continues RUQ pain.  An ERCP with subsequent Sphincter of Oddi manometry can be considered to evaluate this possibility.

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.
kevinmd_

[kkratz57]

Hi...additional info on the stool test...they are testing for c. difflex, wbc, o&p and c&s.