chronic epigastric abdominal pain

[jewelsdb]

I need help.  I have been having upper abdominal pain since oct 07'.  Left for Jamaica and the day of returning had upset stomach.  For two weeks had constipation and rectal bleeding.  The dull upper abdominal pain was intermitant at this time.  CT scan was negative and then had heita scan and showed 10% ejection rate for gallbladder.  Although I did not have typical gallbadder pain they recommend surgery.  Up into surgery pain increasing to constant and very dull,but intense.  Had surgery and had complications of bile that leeked.  I was in the hospial 5 days after surgery secondary to increase lower side abd. pain.  I notice that the dull upper abd. pain was coming back, but not as intense.  They treated me for severe pain and sent me home.  I saw a GI doctor for the continuation of upper abdominal pain.  It was intermitant and now is continuous again and strong dull pain.  They have done lots of tests to make sure no bile was leaking along with colonoscopy and upper endoscopy.  Negative for ulcer, chrones dz, no polips, no cholitis, no h. pylori, nothing found.  Had MRI and negative along with negative blood work.  They sent me to a different GI doctor and thought maybe IBS, and also saw another GI doctor and thought picked up virus from Jamaica inwhich irritated the gastric nerves.  Medications are not helping with pain.  Also, since hopital stay I have lost over 15 pounds inwhich I am unable to put back on.  I just recently saw an infectious dz doctor and he has tested me for parasites...negative.  I need help b/c I am unable to work and I need help getting better.  Does anyone has suggestions?  Please help me...I have been going through this for over 7 months.

[jewelsdb]

I have asked one of the GI doctors and they said the MRCP MRI was safer and would give them info that they needed versus doing an ERCP.  ERCP is invasisive and could may cause pancreatitis (so I have read).  On my next visit, with a new GI doctor, I will question him too about all procedures etc that have been done and not done.  Thank you for you help.  

[CalGal]

Please understand that I don't mean to sound like 'I know it all' because I don't, but the tests you've had - unless those tests included an ERCP with manometry - couldn't show that there was something wrong with the sphincter. The ERCP with manometry is the only one that can give the docs any indication that the sphincter has higher than normal pressures. All the tests you kind of listed did not include an ERCP. So if the docs are telling you it is not the sphincter without doing an ERCP they're not being truthful.

[jewelsdb]

Thanks for your comment.  I have asked about the sphincter,but they said my tests would show something.  I am seeing another GI doctor, which was a referal from the infectious dz doctor I saw a few days ago...we shall see what he says.  It is frustrating b/c I was a healthy 27 year old who ate well and exercised on a regular bases.  I never saw this coming...I can't even perform in my job b/c of this...so frustrated.  Thanks again.

jewelsdb

[CalGal]

If the pain you're currently experiencing is similar to what you experienced before your GB was removed, it's possible that it could still be related to your biliary system and the test's you've had to date will not find anything wrong. The condition is known as sphincter of Oddi dysfunction (SOD) and it's unfortunately not uncommon. You can read up on it here: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=3&disease=12&lang_id=1

The problem with this condition is that many docs either don't know about it, or for whatever reason they don't believe it exists - but it does. So if this is the problem, you'll need more testing via a doc who really knows about the problem.

In the meantime, if you're not following a low fat diet you may need to do so.