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What Causes Pain In Upper Epigastric Area After Gall Bladder Removal?
Question: After having my gall bladder removed, I always have dull pain upper epigastric area that radiates to back. Sometimes it is only abdominal and no back pain, sometimes it is only the back. Not sure if it occurs after meals because I sometimes wake up at night with these pains, 6-8 hrs after my last meal of the day. Have had an MRCP MRI and it came back normal. Liver and pancreas enzymes normal, IGg subclass tests normal, ultrasound normal except for a mild fatty liver. Had a fibroscan of liver and confirms mild fatty liver. Have tried digestive enzymes and Prevacid and sometimes I feel better, sometimes I don't. Any other tests or imaging I might try?
Brief Answer:
Hi
Detailed Answer:
Hello,
Thank you for the query.
I understand your concern.
Well there are three main possibilities
1) Post cholecystectomy syndrome - in which pain similar to gall bladder pain may persist may occur after meals in right upper half or epigastric region radiating to back. Associated symptoms may be upset stomach, nausea, and vomiting.
Gas, bloating, and diarrhoea
2) peptic ulcer disease like duodenal ulcer or gastric ulcer usually associated with burning, vomiting, nausea, reflux symptoms (but may not be there)
3) dyspepsia (as commonly called acidity) where all tests including endoscopy are normal but commonly associated with bloating, fullness, burning.
4 ) Many other rare causes are there like sphincter of oddi dysfunction, adhesion (post operative) .
All these can be evaluated with endoscopy, endoscopic ultrasound if deemed necessary depending on severity of symptoms as deemed necessary after evaluation by your gastroenterologist.
Also some time mild anxiolytics work (which can be prescribed after consultation with a practitioner only.
Hope this answers your query.
Happy to help.
Wish you a speedy recovery.
Hi
Detailed Answer:
Hello,
Thank you for the query.
I understand your concern.
Well there are three main possibilities
1) Post cholecystectomy syndrome - in which pain similar to gall bladder pain may persist may occur after meals in right upper half or epigastric region radiating to back. Associated symptoms may be upset stomach, nausea, and vomiting.
Gas, bloating, and diarrhoea
2) peptic ulcer disease like duodenal ulcer or gastric ulcer usually associated with burning, vomiting, nausea, reflux symptoms (but may not be there)
3) dyspepsia (as commonly called acidity) where all tests including endoscopy are normal but commonly associated with bloating, fullness, burning.
4 ) Many other rare causes are there like sphincter of oddi dysfunction, adhesion (post operative) .
All these can be evaluated with endoscopy, endoscopic ultrasound if deemed necessary depending on severity of symptoms as deemed necessary after evaluation by your gastroenterologist.
Also some time mild anxiolytics work (which can be prescribed after consultation with a practitioner only.
Hope this answers your query.
Happy to help.
Wish you a speedy recovery.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Could you please give examples of adhesions? Also, what about the constant pumping of bile into the gut, can this cause irritation, especially if there is back flow of bile into the stomach?
I've also been old that at the time of my gall bladder attack, there was probably some infection that may have altered the sensation of nerve endings making them more susceptible to irritation, or that the infection may have altered my immune response where there is a chronic lymphocytic response, similar to an autoimmune reaction. If the latter were true, could an endoscopic biopsy confirm this? Could naturopathic remedies that work on inflammation help, such as curcumin, Resveratrol, green tea, etc?
I've also been old that at the time of my gall bladder attack, there was probably some infection that may have altered the sensation of nerve endings making them more susceptible to irritation, or that the infection may have altered my immune response where there is a chronic lymphocytic response, similar to an autoimmune reaction. If the latter were true, could an endoscopic biopsy confirm this? Could naturopathic remedies that work on inflammation help, such as curcumin, Resveratrol, green tea, etc?
Brief Answer:
Hello
Detailed Answer:
Hi
Thank you for the query.
Adhesion means after surgery at the place of gall bladder empty fossa (from where it is removed ) or at the cholecystectomy tiny incision site adhesions occur where in the intestine may get slightly adherent, but it seems to be unlikely in your case if is usually associated with vomiting.
Constant pumping of bile into gut is unlikely to cause problems it will not leak back.
The reaction that you mentioned is unlikely. No need of biopsy if endoscopy is normal. I am not sure of the naturopathic remedies and being an allopath will not recommend them as they have no evidence.
Hope this answers your query.
Best wishes.
Hello
Detailed Answer:
Hi
Thank you for the query.
Adhesion means after surgery at the place of gall bladder empty fossa (from where it is removed ) or at the cholecystectomy tiny incision site adhesions occur where in the intestine may get slightly adherent, but it seems to be unlikely in your case if is usually associated with vomiting.
Constant pumping of bile into gut is unlikely to cause problems it will not leak back.
The reaction that you mentioned is unlikely. No need of biopsy if endoscopy is normal. I am not sure of the naturopathic remedies and being an allopath will not recommend them as they have no evidence.
Hope this answers your query.
Best wishes.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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