Stones?

[Mommi]

Hi I am a 43 year old mom, had 3 kids all in my thirties and am  overweight. I had my gallbladder removed 2 weeks after the birth of my 1st child. I had a pain in my gut that I had never expierienced before. For about 9 years after that, I had occationally had what I call attacks in my gut, felt like the one I had when my gall bladder was removed. They were very painful, bent over and in tears kind of pain, but was always told I had gas or heartburn. I lost and gained weight so many times and had two more children, during this period as well. I finally had an attack about a year and 1/2 ago that I almost called 911, I was shopping with my daughter and I started having my old familiar attack, only this time it would not subside like the other times. They would usually last anywhere for 5 minites to 30 minutes or more sometimes. I took myself to emergency and was told I had a nupset stomach from stress, I was given all kind of stomach medications. While I was in line at the pharmacy, I was crying, knowing that this was NOT a tummy ache, but what could I do. Well 3 days later I was still in pain and now someone discribed anti-depressants and blood work, I went home again and now there was liver issues from my blood work, like off the chart numbers apparently, so I was tested for every letter in the alphabet kind of hepititus, no, that wasn't it. Mean while I am yellow, itching and feeling VERY ill.Then a scope down my throught, this was fun, and nothing. They decided I must have had a stone in my bile duct? Could this be what all the attacks were for the last nine years? Something left out side my gallbladder? Or new stones? I am haveing pains again right now for the last 3 days, nausea, very tired, and am terrified that I will have the BIG one just like before. I also have had these fluttery feelings, like a baby kicking, ever since I had that scope thing down my throat. They say it has nothing to do with it, that it's in my head or a coinsidence that a new problem has occured.Can you please shed some light on whats going on in my body. I know the weight issue is't helping, and I don't smoke, and drink occationally.I usually have a lot of energy and am always on the go, it feels strange to me to feel down, I am a hypher person, believe it or not. I was told once that maybe I was having a spasym in my asophygus, and that was the pain.I have occational heartburn when somthing spicy is eaten, but not bad.I have normal bowls, nothing weird, and no other health issues, exceopt thyroid. I have been on medication for 10 years, and one more thing before I run out of letters, I feel VERY bloated, as if I put on more weight, but the scale has not changed.I know I am all over the place with this letter, but don't want to forget a thing.I have never had the chance to tell all the history at once. Thank you for your time, and I hope you can shed some light on this problem, I want to enjoy the summer with my family and I fell very YUKKY!

[Kevin Pho, MD]

Hello - thanks for asking your question.

Without examining you, it is impossible to say what you have.

You have mentioned you had an ERCP with sphincterotomy.  Surgeon has also kindly commented on possibilities.

Sphincter of Oddi dysfunction can be a possibility - it is a disease that is more prevalent after a cholecystectomy.  This can be diagnosed during the ERCP by doing manometry of the Sphincter of Oddi.  If they did the sphincterotomy (as it seems like you are describing), studies show it is between 30 to 60 percent effective.

You may want to consider repeating the ERCP to see if there is further dysfunction.  Other alternatives to treat this would include surgery or injection with botulinum toxin (currently experimental).  

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.

Thanks,
Kevin, M.D.

[surgeon]

Yellow and itchy ought to be pretty easy to diagnose: did they do an xray of your bile duct??? . You certainly could have a stone in your bile duct, which would generally be a very simple thing to take care of. Your post mentions all the symptoms but not the findings. It ought not to be mysterious if you had the procedure done to look for and treat bile duct stones (ERCP). Has it been done? If not, why not? If so, what did it show?

[Mommi]

I did have the ERCP procedure, but they said nothing was there, by the time it was done (they think) it had past itself and thats why I was in such pain, I was suffering for about a week before they did it, and by this time I was on the mend. It's just happening again a year and hailf later. I am not yellow or anything like that...yet. But I don't want to wait around for that, so just wondering what I can do, or what makes it happen....fat? Also the fluttery thing happening after proceedure just a weird thing? I also forgot to mention that when they did th ERCP, they made a small whole so that if it happened again it could pass easier. Does this help? I forgot about that when I wrote to you before.Would I have pain then it goes away faster? Is there more to do if this isn't working? Thank you for your time, this is better that going to a Doctor's office and it's kind of fun! Now I know why my kids are always on the net!Take care, mommi

[surgeon]

what you had -- the ercp and the cutting to make it larger -- is what I was thinking you should have had: so, that's good. If this time there's not jaundice, it's not so sure that it's really the same thing. Time will tell. It's possible for the wider opening they made to close down again; but if it really was a stone that passed, having had a wider opening even for awhile means it's pretty unlikely that any more remain.

[Mommi]

Thank you so much for all your time, and just one more thing, if this is somethig different, what else would cause an attack like this, it hurts so much I can hardley breath. I won't bother you anymore, have a nice day.