pain conected to pancreas/gall bladder

[mistral]

Hi,I am male 62 years.In 1982 I suffered a bout of cronic pancreatitus (pancreatitis).From that time on I had regular bouts of severe pain under r/rib cage,this increased when in the sitting or laying on my back position.After a test in 1995 I was told the neck of my pancreas had thickened.
In 1999 g/stones were found and my gall bladder was removed,since this procedure the pain has got much worse and has become a daily event.I can manage to hold down a job and do my daily chores sufforing only a small amount of discomfort,but as soon as I sit down be it driving or trying to relax in front of the tv or laying flat on my back the pain increases ten fold.The longer I sit the more intense the pain,to relieve it I have to get up and walk about for a while.The pain is a very strong sting or burning sensation.I start to take pain relief late afternoon onwards to enable me to sleep,but this often does not work and end up walking the floor through the night.
I also suffer very loose bowel movements and can go to open them sometimes 4/5 time a day.Have been prescribed Questran powders for this and find they help.As an example the pain has increased in the short time it has taken me to type this e/mail.The pain is always in the same place at the bottom of r/rig cage and slightly towards the centre.Thanks in advance.

[Kevin Pho, MD]

One consideration would be Sphincter of Oddi dysfunction - which can be exacerbated by removing the gallbladder.  Stones retained in the duct - as was mentioned below - can also be a possibility.  An ERCP with Sphincter of Oddi manometry would be a consideration for evaluating these possibilities.

You may also want to consider chronic pancreatitis - although typically the pain is manifested on the left side.  Blood tests looking for pancreatic enzymes such as amylase and lipase as well as imaging studies can be considered for evaluation.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

Chronic pancreatitis is a possibility; it's even possible there are stones remaining in the bile duct. To get a meaningful evaluation, you need to let your doctor know what's going on. A test that might be needed is ERCP (endoscopic retrograde cholanio-pancreatogram) which is done by passing a scope into the stomach and injecting dye into the bile/pancreatic ducts. There are various solutions to the problem, depending on the findings; ranging from a fairly simple procedure done with the same scope, to possibly surgery on the pancreas itself. It's hard to speculate.

[babuni57]

A related discussion, pancreatitis was started.

[Mountaintop93]

A related discussion, can't find the problem was started.