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Severe Constant Pain in upper Abdomen (centre only)
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Severe Constant Pain in upper Abdomen (centre only)

Hi,

For the past six months I have been suffering from severe pain in my upper abdomen. The pain is always very central and radiates to my back in the same area relative to the pain at the front. This pain always seems central immediately below the chest/breast area. This pain starts as a dull bloaty/achy feeling which gradually builds over the course of many hours before reaching the point at which the pain becomes unbearable resulting in me writhing on the floor in pain. The pain is always constant and never comes in waves, it simply increases steadily over time.
I had two 'attacks' six months ago one week apart both of which required hospitalization. When the hospital did blood tests they found abnormalities in my blood and also gallstones. I was given Morphine for the pain and within 48/72 hours was fully recovered and sent home. I did not have another attack again until last week were the same pattern occured however this time there was nothing wrong with my blood tests (including the one were they check your pancreas by taking blood from the wrist), there was also nothing wrong in my x-rays and an ultrasound although re-affirmend gallstones present there was no inflammation of the gallbladder (my gallstones were described as quite small). I was told by doctors that my gallstones were not the cause of the problem even though they wanted to take my gallbladder out after the 1st two attacks! Anyway I am now on the list for an endoscopy.
Another twist in this was after the last hopital visit I had another attack (two days ago) so I went to my GP before the pain had reached unbearable levels. The doctor did not think it was an ulcer (which is what the hospital want to check for with the endoscopy and what I feel it must be). The GP gave me morphine in tablet form and also told me to keep taking my Buscopan & Omeprazole given in hospital. The pain eased over the next 24 hours (without ever reaching the unbearable levels previously) and so far since I feel ok.
Now that I have given my history on this my question is what do you think is the most likely cause of this pain because to be honest I am concerned that the hospital thought it was gallstones and wanted to take my gallbladder out but do no longer think it is (at least this time) and seem unable to get to the bottom of this. My GP thinks it is some sort of stomach spasm (I think that is what she said) because as she put it I would have other symptoms if it was an ulcer.
I just want this sorted as its making my life hell.
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8 Comments Post a Comment
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82861_tn?1333457511
Sounds like classic gallbadder attacks to me.  If the stones are very small, they may be getting stuck in the bile duct which causes the same symptoms as a hot gallbladder.
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Avatar_m_tn
Hi JayBay,

Thanks for your reply, this is what the Docs thought to begin with but an ultrasound in my last visit showed that the stones are not in my bile duct and the gallbladder was not inflammed in any way. Blood tests also confimed no infection so they ruled my gallbladder out. Very frustrating that they don't know what is wrong. I have just been back to the GP today to do a breath test using Orange Juice. They are checking for the bacteria H. Pylori which could mean I have an ulcer. GP not convinced but doing the test anyway.
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82861_tn?1333457511
I had the same experience with my testing.  Every last thing showed up normal.  I had to beg a surgeon to at least take a peek inside with the laparascope and that's when they found the gallbladder infected and scar tissue all over my small intestines.  Taught me that tests are not always the last answer.  A year after the gallbladder I had the same experience when my appendix got infected.  All tests normal; begged the surgeon to peek again, and out came the appendix.  Both my gastro doc and surgeon know me well enough by now that when I tell them something is wrong, there IS something wrong.  LOL!

You're in a tough spot right now and I pray something can be done for you very soon.
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Avatar_m_tn
Hi JayBay,

Thx again for your reply. I have had the H.Pylori test (waiting for results). I have looked into my condition more and more online and I suspect at this stage that it is an ulcer in my duodenum. Every symptom I have had is mentioned in relation to this problem (especially the severe pain below the breastbone in a central position) so I am sort of hoping that this H.Pylori test comes back positive as the treatment (called Triple therapy) is quick and simple. If it comes back negative I am left with the endoscopy (which can check the Duodenum as well as the gut). If this also shows no problems then I guess your probably right and it is my Gallbladder even though external tests are saying not. One of the reasons I decided not to have my Gallbladder removed after the 1st attacks is because I know that many patients still get pains after the op so I want to be absolutely sure this is the cause before letting the surgeon loose on my body because the amount of people who have their gallbladder removed but still have the pain is quite shocking.
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Avatar_m_tn
It's been 4 months since I last posted on here but as everything has been sorted I thought it right that I post my story so others can hopefully find a resolution to their own similar problems.

Back in november I thought that I probably had an ulcer as the hospital was sure I was not having gallbladder attacks due to normal blood tests and nothing showing up in x-rays OR ultrasounds (in the ducts) although I did have small stones in my gallbladder. The H-Pylori test came back negative and I ended up back in hospital twice again before Christmas. Both times I had X-Rays & Ultrasounds come back negative for stones in my ducts. Blood tests were also normal and I was told in A&E by one doctor/consultant that he is 100% certain the pain I was having was NOT because of the stones in my gallbladder. With this news I accepted this (who wouldn't) and went home after another bout of Morphine to ease the pain. Just by luck/chance I was ok over christmas & new year which was probably because I was so weary of what I ate and drank.

So into the new year and a few days in I start to feel off one day and ok the next. I could tell something was not right but for about a week it stayed this way, one good day one bad day then suddenly one morning BANG. Major pain in the centre of my stomach just below the breast line. This pain was like the very 1st pain I had when these attacks 1st started (see initial post). I did not wait to see a GP or phone NHS direct I simply went straight to A&E and was seen immediately despite A&E being packed as it was obvious I was in a really bad way.

In A&E the pain is so bad they have to give me Morphine via IV rather than injection so the pain goes away quickly. Blood tests come back elevated and I am told I have obstructive Jaundice. I have ANOTHER x-Ray & ultrasound and yet again NO STONES show up in my ducts only in the gallbladder and my gallbladder is NOT inflamed. I am told I should go home and come back in the morning for anoter blood test to see if my levels change but I insist I am going nowhere until this is finally sorted. They give me a bed for the night and I need regular Morphine injections to ease the returning pain. My jaundice gets worse and after seeing multiple consultants during their walkarounds one finally suggests I have an MRCP scan to see if anything shows up as she is sure I have a stone blocking somewhere.

I have my MRCP scan and guess what? TWO STONES are found, one is in my cystic duct and the other has already passed through the cystic duct and is sitting at the bottom of the common bile duct (the entrance area to the duodenum which is also right next to the pancreas. They were worried I might get pancreatitis and my jaundice was getting worse each day. They perform an ERCP operation on me to remove both stones which is a complete success and I recover from the pain & jaundice within 24hrs. I was in hospital for a week and a half in total this time and in that time lost one and a half stone. I go home and return 6 weeks later to have my gallbladder out. This op is also a total success (keyhole) and I go home next day. I even drive the car two days later and although sore can do most things straight away. The soreness goes after about a week.

So my advice to ANYONE who has similar pains to what I had and your told its not the gallbladder/stones to insist on having a MRCP scan and this will once and for all tell you one way or another. I had 10 months of hell dealing with this and if they had done an MRCP when I was admitted that very 1st time I would have been fixed long ago.

for those of you waiting for a gall bladder removal or even the ERCP op please don't worry. You're asleep for the gallbladder removal and although the ERCP is a little uncomfortable (your awake but sedated) its amazing how they can do such a procedure.

Good luck to anyone who is going through this and I hope my own story helps you get to the bottom of your own gallbladder/abdoninal problems.

Also a special thank you to JayBay for replying to my thread.
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Avatar_f_tn
I was having the same pains, and had my gallbladder removed in August. About a month after my surgery, I began suffering from the same constant upper abdominal pain again, along with chronic nausea and some vomiting. The doctors are chalking it up to IBS, but I don't agree with them.
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Avatar_f_tn
P.S.: Have you had a HIDA Scan? My ultrasound was normal, but my HIDA Scan came back showing that my gallbladder was functioning at around 18%.
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Avatar_m_tn
I'm no doctor obviously but based on personal experience I would go with your instinct. If you don't think its IBS there is a good chance it isn't. I thought mine was an ulcer simply because they said with 100% certainty it was not gallstones causing the pain and some of the symptoms did match those of having an ulcer. In the end the sonsultant was proven to be completely wrong about the gallstones.

If I was in your position right now I would be asking them for a MRCP scan to see if any stones are in your ducts. It IS possible that although the gallbladder was removed a stone(s) had already left the gallbladder and are now in one of the ducts EVEN IF blood tests come back fine and ultrsounds/x-rays show nothing. Trust me I have been here... MRCP is the ONLY way to find the stones if indeed you have them.

Another possibility is you have an ulcer in your duodenum or stomach. This seems less likely but there are two tests that can be done to check. One is the Endoscopy (which I had) and the other is the H-Pylori test (Bacteria found in the gut). The H-Pylori test simply involves drinking orange juice in your local GP's then breathing into a tube. H-Pylori are the most common cause of ulcers in the gut. Both these tests came back negative for me which in a way helped as I then disbelieved the consultants comments that it was not my gallbladder/stones.

Other than that all I can say is as long as your blood tests are coming back normal please don't worry too much.
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