Sphincter of Oddi?? or what else Help please

[JanesMa]

Please help, I had my gallbladder out 6 years ago.  No problems since then.  I do have IBS but have had it for years and deal with it.  2 months ago I was on a steroid dose pack for pinched nerve in neck & shldr.  2 days after it was finished I had incredible pain right where my gallbladder used to be.  I couldn't eat and or sleep.  Laying down on my back was take your breath away type pain.  3 trips to hospital and no answers.  Said my liver enzymes were slightly above normal..but nothing to worry about.  Finally go to a GI dr after 8 weeks and had an MRCP.  Showed my pancreas duct and liver duct are dilated "more that what you would find after gallbladder surgery" according to dr.  Just had endoscopy said my duct looked normal had moderate gastritis but not related to my pain and to take carafate.  WELL, I'm still in pain and eating makes it worse, terrible constipation (which my usual IBS is occasional diarrhea).  I am having Constant nausea that is unrelenting (I feel like I'm pregnant, which I'm not (menopause).  I am at my wits end.  All they want to do is give me pain pills and zofran with no answers.  My Question:  Where do I go from here?  What should I be asking for?  Would the MRCP & cat scan show a ductal cancer?  Do all pancreas cancers show up on those 2 tests? Does SOD dysfunction give you Constant nausea?  My GI says SOD only lasts for a few hours and then its gone.   Thank you for any help.

[JanesMa]

I finally got the approval for an out of network referral to the specialist in Boston.  He said I have a stone stuck in the CBD and it needs to come out.  I will the procedure in a few weeks.  I'm just hoping this reallly helps.  I am grateful the info that I have found on this board.

[JanesMa]

Thanks for the info.  I received my mrcp results, and my ducts are dilated 11mms and radiologist said can't rule out small stone in duct.  my liver enzymes are only slightly elevated.  My GI dr wants me to go into Boston to have the ercp w/mamometry but I have an HMO that probably isn't going to approve it.  My entire digestive track is at a stand still.  Nothing is working.  

[Kevin Pho, MD]

I agree with the workup done thus far.

The MRCP is a pretty thorough test of the biliary tree and should be able to show ductal cancers.  

If there continues to be concern about pancreatic cancers, an endoscopic ultrasound can be considered.

Yes, SOD can cause constant nausea.  If that is suspected, an ERCP and Sphincter of Oddi manometry should be considered.

These options can be discussed with your personal physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd