abdominal enigma

[cey18]

My husband is 35 yrs old and unable to work due to a throbbing pain in his abdomen for over a year and a half. He's had his gallbladder removed in June 2002. He's also been diagnosed with GERD (which was questionable) but he did have H-Pylori. This was treated but led to little to no relief for his abdominal pain. He's had a host of test which included: Cat Scans, 4 Ultrasounds, 2 Thyroid tests, Video esophogram, multiple EKGs and Chest X-rays , Diabetic test, Anemic test, 4 Barium Swallows, 3 Upper Endoscopies, Colonsocopy, 24hr PH probe, Esophageal Manometry, Pulmonary test, ENT scope, MRI of brain, neck, abdomen and pelvic, 2 HIV test, Stomach Emptying test (r/o gastroparesis), 2 Stress test and a Holter Monitor test to which all of these test were negative.  In addition he's had several chiropractor sessions. Throughout the duration of these procedures he has lost about 15 to 20 pounds. Most recently he had a colonic marker test to which it showed 20 markers found in his descending colon and rectum sigmoid (oddly enough he was not put on a high fiber diet during this test). The GI doctor who performed the test seems to think he has a lazy colon. He has prescribed medications that induced bowel movements but the pain persist along with  hemorrhoids which already existed.  A second doctor stated that he may need a defecography  or anal rectal manometry.  He also mentioned biofeedback but was not experienced enough to elaborate.

However, we have heard of 4 or 5 other constipation test including Biofeedback and would desperately appreciate any professional advice.    
sincerely yours,
nomeg222

[Kevin Pho, MD]

There has clearly been a very extensive evaluation performed including multiple opinions by gastroenterologists.

One test that has not been mentioned would be an ERCP with Sphincter of Oddi (SOD) manometry to evaluate for SOD dysfunction.  SOD is suspected in patients who have biliary-type pain without other apparent causes.  It is typically more prevalent in those who have had their gallbladder out.  

If this is the case, treatment can be performed with medication such as calcium channel blockers or nitrates; biliary sphincterotomy endoscopically; or surgery.  

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.

[nadia]

Hi, sorry to hear about your husbands problem.  I also have chronic abdominal pain for over 2 years now and am unable to work because of it.  I have had my G/B removed last June as well, with no relief of pain. I have had all tests expect the MRI and PH probe.  Is his pain in the upper or lower abdomen?  When is it at it's worse?  Does eating affect it?  I have been told by my surgeon that it is not all that uncommon to have Functional Abdominal Pain and never get any resolution to it.  I know what it's like living everyday with this pain and I sincerely hope he can get some answers.  You may want to investigate Sphincter of Oddi Dysfunction as well, but that would mean getting an ERCP with Manemotry(sp?)