stomach pain and nausea

[tadpole2]

I have been experiencing stomach pain (mid - upper right) and constant nausea.  This has been going on for about 6-7 months.  I have had numerous test and they all come back fine.  I have had an EGD and will have an ERCP a week from tomorrow.  I have been hospitalized with "chest pains".  My heart is fine and the 2 ultra sounds of my gallbladder show no stones. I do have 2 kidney stones and am lacking in Vitiman D.   I am literally about to go crazy.  Can anyone please give me a ray of hope to what might be my problem?

[CalGal]

Hope this posts: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=3&disease=12&lang_id=1

[CalGal]

There unfortuantely isn't a lot more to suggest other than for now to keep you diet very, very low fat to see if that helps a bit.

Manometry is theoretically simple - all they're doing is using a small pressure probe and measuring the amount of pressure that is found at and around the muscular opening. If it's very high, then it means that area is exerting too much pressure - squeezing down - and it's not letting up enough to let the bile flow through. In some cases, botox can be used, but it only lasts about 3 months and it may or may not break the cycle of the muscular spasm. If the muscle is cut, yes there is a chance it will scar and cause problems. But that chance seems to be less with the presence of high pressures.

If the pressures are normal and the sphincter is cut, for some unknown reason the chances of further problems after the 'cut' is very high. So although some docs routinely do a sphincterotomy (the cut), unless the pressure is high, or unless that sphincter is SO impossible to get through to get into the bile duct, that sphincter should remain intact.

The stent is similar to a heart stent, but it's not left in place. It will need to be removed at a later date, or some of then 'fall out.' The use of the stent is to keep the duct open so that both the bile and the pancreatic enzymes drain. Some docs don't feel a stent should be used if a sphincterotomy is done, but there's no guarantee that cutting the sphincter will mean the duct/sphincter remains open. The stent gives you added 'security.' It also reduces the probability of your contracting pancratitis. There's no guarantee, but you may be better off with it than without it.

Your best defense if knowing everything you can to try to help yourself.

Let me go find the link to SOD that is fairly explanatory. I just hope this format will allow me to paste it in, and it will show up so that you can access it. Be back...............

[tadpole2]

Thanks - I didn't know anything about manometry!  I am calling the office in the morning and asking IF this is part of the plan.  I definitely will not let them cut  the sphincter without some serious discussions!  I truly feel it's my gallbladder.  Even though stones aren't visable, I still say it isn't operating correctly.  Do you have any other sugestions?  I don't know where else or what else to look at.  I have been taken Nexium and reglan with very little help.  The 1st week or 2 seemed to help, but just as before - it started back up and I am just so tired of being nauseated - ALL THE TIME!  
What does it mean to be stented - is that like heart stents?

I really appreciate your insight!

[CalGal]

Sorry, my post should have been addressed to tadpole, not Kat

[CalGal]

Please make sure the ERCP is done WITH manometry. It's important because many docs will do an ERCP without manometry - measuring the pressure in the ducts - and they will routinely cut the sphincter (the muscular opening) without measuring the pressures. That sphincter should NOT be cut unless the pressures are raised. For reasons no one knows yet, if the pressures are not raised and if the sphincter is cut, it causes more problems down the line. There's enough of a drawback to the ERCP as it is without adding that to it.

If the doc says they can't do manometry because he isn't trained or the facility doesn't have the equipment, please find a doc who can do it. I know you want to be out of pain, but the problems an unwarranted sphincterotomy can cause are something you do not want to face.

Also ask to be stented. It will decrease your possibility for developing pancreatits and that's important.

The ERCP will only allow him to look at the ducts within you biliary system and remove any stones if they're found within the ducts. It will not really allow the doc to 'look' at the gallbladder itself.

[tadpole2]

I have only seen this doc 2 times - once in the hospital and Monday of this week.  I am going to go ahead and have the ERCP on Friday of next week.  He kinda acted like he was at a lost.  He asked me if I had ever had back trouble.  The answer to that is no.  He asked me if I was stressed out - I said yes!  This pain and nausea is stressing me out!  He even mentioned sending me to Charleston, SC or Emory in GA.  I told him to please look good at my gallbladder while he was in there.  He said the ERCP would let him look at my gallbladder, pancreas, and liver.  I am so afraid he gonna come back and say they are all fine.  Which will stress me out even more.  How can something that makes you hurt and be so sick - not show up!
I am sick and tired of being sick.  This has gone on for 6-7 months straight.  I had been nauseated off and on for over 2 years.  The pain just jumped on board around October.  Both ultra sounds showed no stones.  I asked about sludge.  He seemed to think it will show up next week if that's the problem.  I have had kidney stones numerous times and this is so not them.  I actually was told I have 2 small stones on my kidney when I was in the hospital.  They aren't bothering me at this time.  The pain is SO different.  
I have heard stories about people like you having to wait for years for a diagnosis.  I think I'll go crazy soon if this doesn't end!

[Kat70]

I was having pains like that for 3yrs they did ultrasounds on me to check my gallbladder for 3yrs until they finally saw the stones. The stones were up in the Ducts of the gallbladder and had finally fell down into the gallbladder. I had my gallbladder removed in 1997. About 2 yrs later I started having severe pains mid upper right between my ribs cages,like at the end of the esophogus and come to find out I had Bilary Diskenyshia (i spelled that wrong) it is spasms of the ducts that are left after the gallbladder is taken out. But since you have not had yours taken out it could be your gallbladder they just can't see the stones yet. The nausea is from the pain. Now both my mom and dad had their gallbladders removed and their symptons were like they were having a heart attack, chest pain etc. You may want to change Gastro doctors.