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Right upper quadrant pain after giving birth
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Right upper quadrant pain after giving birth

So, this is why it is filed under general...I had my gall bladder removed 2 years ago - I did not have cholelithiasis but my gall bladder was apparently all full of adhesions. Since giving birth to me daughter late last year I have had intermittent right upper quadrant pain primarily under my ribs - pretty much what could be considered classic gall bladder type pain. Any ideas? Other GI symptoms I have with this are intermittent generalized abdominal cramping with an urgency to move my bowels - loose stools (not diarrhea), I have watched to see if this is exacerbated by fatty foods and it really doesn't seem to be. I did wonder if maybe this is a (for want of a better word) sub-acute pancreatitis....

I feel pretty stupid going to my PCP and saying "Hi Dr. Jones, remember how they removed my gall bladder 2 years ago....well it's hurting again..."

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You could possibly have sphincter of oddi dysfunction or pancreatitis .  It also could be something completely different but more testing is needed to find out.  

  SOD is typically pain on the right side and back and pancreatitis can be on the right or left and back.  You can google john hopkins sphincter of oddi for more info or chronic pancreatitis to see if this matches your symptoms and start from there.

I have SOD and it was hard getting diagnosed.  My GI dismissed me as well said ibs.  I finally went to er one night with a bad attack of pain they gave me dilaudid and it made it worse. They again sent me home and I went right back because I kept throwing up. They tested my liver levels and it was 10X normal.   MY GI then had to admit something was wrong and he referred me out to DR Cotton at MUSC in SC.

Has your  liver levels ever been checked during an attack of pain? Do narcotics make the pain worse?  Narcotics typically invoke the pain of these attacks in most with SOD because they raise pressure in the sphincter.   There are 3 types of sphincter of oddi .  There is Type 1 dialted bile duct and elevated liver levels and pain, Type 2 elevated liver levels or dilated bile duct and pain  or Type 3 Pain only.  So if  you do not have elevated liver enzymes during attacks it does not mean you not have it.  Type 3 is just pain only.  Unfortunately this is the most difficult to treat.

Mine typically bothers me when my stomach is empty but others it bothers after they eat.  I suggest talking to your dr about this . and possibly getting a referral to a Dr that specializes in SOD and pancreas issues. They know what to look for and are the best.  Most GIs will not venture into diagnosing or helping these type of patients.  Most tend to say IBS or you are making it up.  This is maybe because this syndrome is not something most GIS deal with and most GIS are not comfortable with ERCP since it is dangerous.

  The best Drs are  at MUSC in SC Dr Peter Cotton, Univ of MN Dr Freeman, and Univ of Indiana Dr Sherman.     You can even try to make an appointment directly with them.

The test to check for SOD  is MRCP to look at your ducts and ERCP with manometry to measure the pressure in your sphincter.  The ERCP is risky and can cause severe pancreatits which could land you in the hospital months.  That is why it is critical you only get this done at a center that specializes in this procedure such as those I mentioned.  If your pressure is high then they can make a cut in your sphincter to relieve the pressure.  This helps some.  In others it has to keep being repeated.  There is no real cure that works 100%.  Some people find relief from nitroglycerin, or levisin to help with the spasms .  Some even find a little relief with amitryptiline.  These drugs can help a small percentage of people so you could try it first.  Sphincter of oddi also sometimes goes along with chronic pancreatitis so they can check out this possibility as well with an EUS procedure.  Chronic pancreatitis or SOD do not always show elevated enzyme levels so more procedures are usually done to get a clearer picture of the problem.

If you have any more questions just ask :)
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