Severe abdominal pain attacks

[mlashton]

My fiance had laproscopic gallbladder surgery about 4 months ago. He has Hep c and hemochromatosis and his began to liver hemorrage so they ended up having to do an emergency removal. After the surgery he still had some residual pain that has now progressed to severe attacks. They are located just below his rib cage, right hand side near the center of his abdomen. They are not consistently triggered by anything and can come out of the blue or start as a burning sensation. It comes and goes in waves of pain that can last hours.I have seen his side spasm and he doubles over with pain. They are getting progressively more frequent, more severe and longer lasting. They have done a scope, ultrasound, ultrasound scope, x-ray, barium x-ray, CT scan and recently an MRI. Nothing has shown the cause of this pain and can only be managed by IV pain meds as oral takes to long to kick in and once they have started are difficult to bring under control. He has lost a tremendous amount of weight and is skin and bones. Doctors are ready to give up and tell him to live with and learn to manage this pain. Please, please help me with any ideas I can ask them to investigate.

[researchaholic]

I agree with calgal. SOD "attacks" are worse than gall or kidney stones and most people suffer for years and even end up addicted to pain meds before they are dianosed.  SOD wasn't even taught in med schools until the mid 80's and even though evidence based, some docs still prefer to think it is psycological.  It took 4 years,4 docs and losing 65 pounds before I was finally diagnosed. Be aware that in some cases, opiates can actually increase the spasms amd most importantly- bile duct procedures should only be performed by a specialist- ask the doc how many procedures (ERCP) they have done.  I started out with a simple SOD type 1 and ended up with type 1 & 2  (scarring and fibrosis) from the procedure. Any doc who has put him through so many tests without considering SOD is not the right doc.  Ask about antispasmodic meds- Levbid- Hyomax- they dissolve under the toungue and when they work (about 50% with me because of the type 1 & 2 ) they work completely and within 15 minutes- or not at all- they are non narcotic and your doc should have no problem letting you try them. I cannot believe they haven't offered him a trial of those- you won't believe the immediate relief if they work.  Good luck and let me know what you find out.  Google SOD and emedicine or merck for a pretty simple explan.to get you started and see if it doesn't exactly match his symptoms.

[CalGal]

You may want to check into the possibility that the condition is due to SOD, sphincter of Oddi dysfunction. Here's a decent link to the condition: http://www.hopkins-gi.org/GDL_Disease.aspx?SS=&CurrentUDV=31&GDL_DC_ID=320F4EDD-0021-4952-83D7-8B0C67B47BFF&GDL_Disease_ID=7AB086B0-AB01-446E-B011-2E67CAFEF96D

Narcotic-based pain meds will do little to control the problem, and many docs don't know how to handle the issue. The only definitive diagnosis can be done with ERCP with manometry. The manometry step is important.