lower rib cage pain that radiates to the lower right back

[ferdie1984]

My wife has been having heavy pain with her right lower rib cage abdomen that radiates to the lower right back, sometimes accompanied by on and off fever. Her liver enzyme is sometimes elevated. This problem is ongoing since 2001. First, they told her it could be hepatitis and to be sure they gave her hepatitis shots. Then they said it was the gall bladder that is not functioning anymore, so they removed her gall bladder in 2007. But after all of these she still complains of the same problem. Her gastroenterologist did series of blood tests for different possible causes (around 40 already),they also did blood tagging, 5 X-ray, 3 ultra sound, 4 CAT scan, 4 MRI for the last 8 years. All came out negative, (blood works sometimes came out with elevated liver enzyme) no sign of cancer. They did a colonoscopy, and an  endoscopy, they just found 2cm esophageneal hernia that they said is not the cause of the pain.They prescribed nortripyline 25mg at bedtime  that makes her fall asleep and rest but the pain is still there when she wakes up. The doctor told her they already did all possible test and they can't
say what is causing the problem.They advised her to see an acupuncturist. Acupuncture relieves the pain for a couple of days only and then the pain comes back. This pain is an everyday event. Pain level range from level 2 or 3 and some times goes up to level 7 or 8, and only on this pain level that she takes nortripyline which makes her fall asleep and then on the next the day the pain level starts at level 2 or 3 again. He last lab work and visit to her gastroenterologist was just last August, 2009. Please help.

[ferdie1984]

Thanks michell221! My wife will call her gastroenterologist this Monday to ask more info about ercp..

[michell221]

I doubt its the hernia.   I would suggest she get checked for spincter of oddi dysfunction.  They can do an ercp test to check for this.  Endoscopy and colonoscopy would not find this.  Spincter of oddi dysfunction can cause pain similar to gallbladder pain and cause elevated liver enzymes.

  Normally, this sphincter functions as a one-way valve to allow bile and pancreatic secretions to enter the bowel, while preventing the contents of the bowel from backing up into these ducts.

When the sphincter malfunctions, it becomes overly tight and does not allow adequate drainage of the pancreatic and bile ducts. The result is a pressure build-up in the ducts, leading to recurrent episodes of pancreatitis or biliary pain mimicking gallstone disease.

They can cut the spincter and this often relieves the pain.  I would insist on this test with a Dr. that is knowledgeable and has done many of these procedures to reduce complications. If you get a doc who has not done many than you have a greater risk serious complications.  

[ferdie1984]

Thanks Surl, I will tell it to my wife about it.

[ferdie1984]

they did endoscopy and colonoscopy they just found 2cm esophageneal hernia.anymore sugestions? thank you.

[Surl]

I suffered with a pain in my upper right rib cage area.  It would continually decrease and I would think it was going away.  Then I would do a normal task that I have done all my life and I would get a severe pain and the cycle would start over again.  I had several tests, ultrasound, xray, and upper GI and blood work.  Everything was normal.

I decided to go to my chiropractor....couldn't hurt.  ( I must say that I did some praying to know what to do.)  He told me of two recent patients, one had paid $62,000.00 and had had open heart surgery.  The other one had paid $57,000.00 and both still had pain like I had described to him.  He said both of these patients got total relief, one after one visit and the other after 2 visits.

I got relief after one, but because I still had what I would call a ghost pain in the area, I got another treatment.  That was many months ago and I am fine still.

I have read so many with symptoms like mine.  I would suggest a visit to a reputable chiropractor.

Surl

[michell221]

have they done an ercp to look for spincter of oddi dysfunction?