sphincter of oddi complications after gall bladder surgery

[astraealegal]

I am 59 years old and have had two fundoplication operations, removal of my gall bladder and removal of my appendix in the last 5 years.  The gall bladder operation was in 2003 and it seems to be the beginning of my problems with pain and inability to keep food down.

I have severe pain that feels like a knife being driven into my back, usually in the middle between the shoulder blades or under the right shoulder blade.  I have recurrent pain in and around my right shoulder after these attacks.  Sometimes I have as many as 10 or 12 attacks a day.  Drinking water seems to cut the acute pain, but I still have a feeling like a wound after being stabbed (not that I really know what it feels like to be stabbed, but you get the idea).  

I also have bouts of spasms in my esophagus that do not allow anything to get to my stomach, even water.  Because of this particular symptom, my fundoplication surgeon redid that procedure to loosen the wrap, but it did not stop these attacks.  I live in a small town with only one gastro-enterologist, and he has told me there is nothing wrong and nothing that can be done for this.  I cannot believe that I will have to live with these horrific pains the rest of my life.  Could this be sphincter of oddi dysfunction?  Sometimes I think these are two different problems as they rarely occur at the same time.  The not keeping food down is not painful, it is just that I eat and immediately feel the need to vomit, although it is probably not true vomiting as the food never really reaches the stomach so no stomach acids have mixed with it.

It seems that the doctors are all attributing these problems to the fundoplication operation, although I had none of the symptoms until after I had my gall bladder out, which occurred only 5 months after the first fundoplication.  I do not believe either problem lies with the fundoplication but I can't seem to get the doctors to listen to me.  A barium swallow test done while I was having trouble keeping food down showed that the esophagus was completely blocked above the operation site.  Please tell me what I should do about this as I am miserable most of the time.  Also, stress sometimes brings on the stabbing pains, but not always.

Thanks


This discussion is related to upper right quadrant pain after gallbladder removal.

[astraealegal]

It's nice to know there are people out there that are suffering some of the same problems I am.  As I said in my first post, I live in a very rural area with only one gastro-enterologist.  My sister had very similar symptoms 10 year ago and he said he would not even attempt an ERCP because the it was a dangerous procedure.  I doubt he has changed  his mind, but I am going to try to get back in touch with my fundoplication surgeon to have him  refer me to a good gastro doc in Spokane.  Unfortunately, some of the doctors around here feel that if they aren't the one who discovered the true problem, they aren't really into dealing with a diagnosis that the patient brings up as a possibility.  I am going to see my GP on Wed. and I plan to ask him to refer me to either my Spokane surgeon or a gastro guy closer than Seattle.

Please let me know how your ERCP goes because I am really worried about complications of any kind, since I have had so many with the procedures I have had.

Take care,

Astraealegal

[gknfyi]

I had gallbladder surgery Nov 2016. Two days later I had to be hospitalized for a week because of uncontrolled bile and blood which then lead to diarrhea. I was sent home with meds and was on a rice and broth diet to manage the diarrhea. Now 3 months later I am experiencing similar symptoms prior to the surgery.  I have a lot of pressure and throbbing under my right rib cage. Occasionally I experience burning stabbing pain. It hurts to lift my right leg and do most exercises.  I don't know what it is but it took the doctors all summer to figure out I needed gallbladder surgery. No one was believing my pain until they did a HIDA test and saw it needed to come out.  I put off calling the doctor because of how they didn't believe me and also I keep hoping it will go away. Help anyone?   Frustrated in PA

[frannie57]

I'm having an ERCP this week to determine if I have a Spincter of Odi.  I don't have trouble swallowing or anything like you describe--just severe pain in upper left quadrant.  My bili rubin count was a little elevated when I last had blood work--so that's why I think they are doing an ERCP.  The pain is just about the same as it was before I had gallbladder surgery.    Can your current doctor perform an ERCP?

[astraealegal]

Thanks for the info.  Unfortunately, the nearest med school is about 450 miles away, so that isn't too feasible at this time (gas money being the main problem, as well as the costs associated with staying overnight in Seattle.)

Do you have any thoughts on why water seems to stem the acute pain, but not the chronic pain?

Thanks again for your help.

Astraealegal

[CalGal]

This could be SOD, but it can only be diagnosed via an ERCP with manometry. Here is a link to some information on the subject: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=3&disease=12&lang_id=1

SOD unfortuantely isn't well-recognized by a lot of docs. So if you believe this could be going on, you may have to contact a doc at the GI portion of the largest teaching/university hospital near you.

But it's possible you may have 2 separate things going on. If the esophagus has spasmed above the fundoplication, you may also need to look into doing esophageal manometry.

Was esophageal manometry done before the fundoplication? It should have been done, so you should have some 'baseline' levels for comparision. Many unfortuantely find that esophageal spasms can result after the fundoplication.