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Gastroenterology (Expert Forum)
Severe Pain and Tenderness, Nausea/Vomiting For Several Years and Just Want Answers
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.
Severe Pain and Tenderness, Nausea/Vomiting For Several Years and Just Want Answers
by diane304, Jan 11, 2008 09:34AM
To make a long story short had my gallbladder removed almost 28 yrs. ago. In the past 10 to 15 years when I have blood tests done my liver enzymes are elevated. I DO NOT have a history of drinking. I am 46, overall pretty healthy, never drank, smoked or done any type of drugs.
In 2000 I had to retire due to other medical problems, other medical problems include depression from being on CIPRO, disc degeneration in my back, thoracic outlet syndrome in left arm, numbness, tingling and burning sensation in right thigh, GERD and hiatal hernia - had a laproscopic fundoplication with multiple dilations of my esophagus after this, total of 3 ERCP one with stent placement, liver biposy, xrays, ultrasounds and CT scans, 2 c-sections, tubal ligation, hysterectomy, bladder repair surgery, colonoscopies, numerous blood tests, also have gastric pararesis, severe pancreatitis due to ERCP, dilalation of bile duct, and SEVERE NAUSEA, VOMITING AND PAIN comes on unexpectedly, for no reason and at different times. Also have osteoarthritis, IBS, told years ago liver enlarged couldn't find a reason for it, also told have fatty liver no explanation for it either, also told and I even did some research that it might be a sphincter of oddi problem. In 9/07 admitted for same problems and kept in hospital for 6 days.
Went to my gastro doc last week and all lab work repeated, Alkaline Phosphate 185 and AST up a little 68 have to go back in 3 weeks for repeat.
The only medication that I take is xanax .5 mg tid, lexapro 20 mg daily.
The dr in Virginia suggested botox into sphincter of oddi, but said that was not a permanent fix, or cutting the sphincter of oddi, my regular gastro doctor wants to wait. I JUST WANT TO TRY AND FIND OUT WHAT IS CAUSING MY PROBLEMS AND WHY MY TEST RESULTS ARE ALWAYS HIGH FOR NO APPARENT REASON.
One thing also, it seems like my stomach is a little swollen on the right side (underneath where my gallbladder scar is).
In 2000 I had to retire due to other medical problems, other medical problems include depression from being on CIPRO, disc degeneration in my back, thoracic outlet syndrome in left arm, numbness, tingling and burning sensation in right thigh, GERD and hiatal hernia - had a laproscopic fundoplication with multiple dilations of my esophagus after this, total of 3 ERCP one with stent placement, liver biposy, xrays, ultrasounds and CT scans, 2 c-sections, tubal ligation, hysterectomy, bladder repair surgery, colonoscopies, numerous blood tests, also have gastric pararesis, severe pancreatitis due to ERCP, dilalation of bile duct, and SEVERE NAUSEA, VOMITING AND PAIN comes on unexpectedly, for no reason and at different times. Also have osteoarthritis, IBS, told years ago liver enlarged couldn't find a reason for it, also told have fatty liver no explanation for it either, also told and I even did some research that it might be a sphincter of oddi problem. In 9/07 admitted for same problems and kept in hospital for 6 days.
Went to my gastro doc last week and all lab work repeated, Alkaline Phosphate 185 and AST up a little 68 have to go back in 3 weeks for repeat.
The only medication that I take is xanax .5 mg tid, lexapro 20 mg daily.
The dr in Virginia suggested botox into sphincter of oddi, but said that was not a permanent fix, or cutting the sphincter of oddi, my regular gastro doctor wants to wait. I JUST WANT TO TRY AND FIND OUT WHAT IS CAUSING MY PROBLEMS AND WHY MY TEST RESULTS ARE ALWAYS HIGH FOR NO APPARENT REASON.
One thing also, it seems like my stomach is a little swollen on the right side (underneath where my gallbladder scar is).
Doctor's Answer
by Kevin Pho, MD, Jan 11, 2008 04:21PM
, Jan 11, 2008 04:21PM
You have had a very comprehensive evaluation of your liver already. With the ERCP, liver biopsy, CT scans and ultrasounds, many of the major liver disorders would have been ruled out already.
I am also not aware of further tests that could be done. Indeed Sphincter of Oddi dysfunction can be considered - and can be done with a Sphincter of Oddi manometry. An MRCP can also be done to evaluate the biliary tree, to look for any blockages or biliary duct stones.
If the liver enzymes continue to rise, repeating the liver biopsy can be considered. The first biopsy may have missed disease, and a repeat may be warranted.
Another opinion can be sought at a major academic medical center.
These options can be discussed with your personal physician.
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 patients education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
www.kevinmd.com
I am also not aware of further tests that could be done. Indeed Sphincter of Oddi dysfunction can be considered - and can be done with a Sphincter of Oddi manometry. An MRCP can also be done to evaluate the biliary tree, to look for any blockages or biliary duct stones.
If the liver enzymes continue to rise, repeating the liver biopsy can be considered. The first biopsy may have missed disease, and a repeat may be warranted.
Another opinion can be sought at a major academic medical center.
These options can be discussed with your personal physician.
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 patients education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
www.kevinmd.com
