What Is The Cause And Treatment For Biliary Dyskinesia?
Might be pancreatic duct SOD, please get evaluated
Detailed Answer:
Hello,
I understand your concern , as you are already diagnosed with Biliary dyskinesia, most of them get relieved after cholecystectomy, and even after 4- 5 years post cholecystectomy status patients might still experience some pain.
As you have crossed that phase , and in your case manometry of biliary duct was done and sphincterotomy as well as balloon dilatation was done , and still you have persistence of symptoms , then please check firstly if you have pancreatitis.
Check your serum amylase, serum lipase levels, serum lipid profile , stool routine and stool for fat, sugars - these will tell you if your pancreas are good or if there is any insufficiency, which usually should be seen on imaging like MRCP OR CT, but since they are normal , please go ahead with these tests.
Additionally, if these tests say you have pancreatitis , and other causes of pancreatitis are ruled out in you, then it might be pancreatic duct sphincter of oddi dysfunction.
In such cases please consult your surgical Gastroenterologist and the ideal thing will be division of both your biliary and pancreatic duct sphincters, this might cause relief in 70- 80% of the patients.
Please consult your Gastroenterologist as he/ she would direct you better after your thorough examination. Hope I could help you.
Thank you.
Gastroparesis should be evaluated .
Detailed Answer:
Hello,
Thanks for getting back and providing more insight, yes viseral hypersensitivity in IBS can cause symptoms as mentioned by you, but do you have urgency of stools?( as it one of the prerequisite) .
If it is visceral hypersentivity than there are four modalities that can be tried for your chronic pain.
1) To reduce acid over production in the stomach by giving a PPI.
2) To reduce nerve pain by giving anti convulsants ( by calming the nervous system)
3) Tricyclic analgesic s to reduce the nervous system sensitivity to pain.
4) lastly opiods are also an option but long term use of opiods can cause hyperalgesia (more pain).
But all these can only be started by your doctor as they have to monitored.
These medications can cause some amount of relief to you.
Secondly Gastroparesis should be confirmed by radionuclide studies and xrays and other studies.
If Gastroparesis is confirmed , the reason for gastroparesis should be evaluated as treatment can be given on those bases, more than 50% of cases of gastroparesis is because of Diabetes, long standing,please check your sugars again.
Hope I could help you.
Thank you.
Thank you so much.
Detailed Answer:
Hello again,
Thanks to you too for getting back and letting me know. Then as per your summary it might be visceral hypersentivity as mentioned above.
Yes please do consult your doctor and you can discuss with him the treatment options and hope you get relief. Do get back to me for any queries you have, would be happy to help.
Thank you.