Postcholecystectomy pain

[elpee]

In February of 2008 I had a lap chole just 2 weeks after giving birth to my second child. I also had severe acute pancreatitis (normal lipase is under 300 and mine was over 39,000) due to stones in my bile duct for which I had an ERCP the day prior to the surgery. A sphincterotomy was performed at this time (Sphincter of Oddi). At my 2 week surgical follow-up I had no pain whatsoever. Pain in the right upper quadrant developed within the next few weeks. I have now had the pain every day for over 4 months. It is not horrible, but it is annoying and distracting and diminishes my quality of life with my two little girls. The pain is sometimes burning, just under my rib cage. Sometimes it feels as if something is poking or stabbing me from deep inside. Sometimes it radiates to my ribs very far to the right side and sometimes into my back; sometimes it feels as if my entire abdomen is inflamed and screaming. I am breastfeeding, so the heaviness of my breasts seems to contribute to the pressure on this tender area. I have had a CT, MRI, rib, chest and abdominal xrays as well as blood tests for liver function and pancreatic enzymes (lipase & amylase). All were normal except for slightly elevated lipase which led the gastroenterologist and surgeon to believe I may have still been having mild attacks of pancreatitis. My last two blood tests have been normal, but I have read that one may still have mild pancreatitis with normal enzyme levels. The gastro thinks that since my first pancreatitis was so severe there may be some scarring which has led to an enzyme deficiency. He prescribed digestive enzymes which I have been taking for a month and a half with every meal. At first this seemed to help but lately seems to increase the burning sensation. I seem to feel some pain whether I take them or not so I have stopped taking them. I am also trying to eat a lowfat diet. Ice cream and bacon seem to be the only things that increase the pain, so I stay away from them. Any suggestions? Should I pursue more medical testing or get a second opinion? The pain is not debilitating, but I believe it is detracting from my quality of life and I do not wish to live like this. I just want to feel normal again!! I would like to get this taken care of before the end of the year since I have met my insurance deductible which is quite high. Every time I have to go for a test or dr. appt. I have to hire a babysitter, so it has been a real problem.


This discussion is related to Post Cholecystectomy pain for past 8 months, now with seizures.

[ohiogirl]

Your pain sounds like SOD, I have that as well but it has never been discussed with me as something that goes away.  You may want to discuss with your doc trying meds like Elavil and Levbid.  Elavil is an antidepressant that has a side effect used to manage pain, and Levbid is an antispasmodic which can help relax the SO.  i have had had tremendous luck with these meds and have not yet needed an ERCP.
Good luck!

[collins4113]

Have you lost weight due to malabsorption from chronic pancreatitis?  What meds do they have you taking?  I'm taking the enzymes, but I'm not sure they help.  But, Dr said if you don't take them it will lead to more weight loss.

[charsa]

I totally know where you are coming from there!!
I had Gallbladder removed due to stones 3 months ago. I have  pain up under my ribs all the time now. I think is getting worse not better. I also have continous pain in my right side of my back!
I also get the odd bout of diarrhoea and stomach cramps.
The only thing that has help with the pain in my stomach is antacid but this only a short term fix.
The other thing is plenty of water to drink! I too have a low fat diet, I don't know if it helping though.
I hope you find some help!

[collins4113]

I'm new to this area.  I too had SOD surgery about a year and a half ago.  Still having pain to this day.  They said it "could be" scar tissue, but the only way to know is to go back in again, which could set off acute pancreatitis.  I did have an internal sonogram done with a scope to verify I have chronic pancreatitis.  I too take enzymes with everything I eat.  But, I also had a test that determined my stomach empties slowly - so possibly an overall motility problem.  I eat no fat - mainly chicken, rice, fish, baked potatoes.  No raw vegetables, no raw fruits.  Not much fun, for sure.  If they haven't prescribed pain meds for you, they probably should.  I take Darvocet N 100 when my pain gets too intense.  But just like you, I have pain almost daily. Hang in there - make them keep testing and hopefully they will find out something.