Chronic Biliary pain even after 2 procedures HELP!!

[JellyBeanJean]

Hello all,
Im hoping someone out there has experienced this and might be able to give me a little advice. First, it might help you to know that I am a 29/f and I have Crohn's disease. I was diagnosed with this about 1.5 years ago and since then have been under the care of a gastroenronoligist, who helped figure out what was causing so much upper right quadrent pain...it was a gallbladder full of huge stones. I had my gallbladder taken out in 5/2002. That helped for a few months. Then, the pain returned. This time he did an ERCP & sphincterotomy in 10/2002. This helped a great deal..totally eliminated the pain...until now.. The biliary pain has been back for about a week. I would say it is moderate to severe pain. I am doing all I know how to do to reduce the pain...which are switching to a low fat or liquid diet and no alcohal...to no avail. This time the pain is also starting to be on the left side as well, but not nearly as strong as the right. The pain on the right is worse than when I was carrying around a gallbladder full of huge stones! I am also getting the chills every night and go to bed dressed in layers and then pile the covers on.No fever.No jaundice..but I do look a little pale.  What could it possibly be this time? What is the cause for chronic biliary pain?

[Sicknurse]

I sympathize greatly with your situation. I had my gallbladder removed in Feb 0f 2000 thought every thing was fine until a week after my surgeon removed my t-tube. I had incredible pain with sweating and chills, no jaundice, it was like my gallbladder had returned fullof stones. Tomake along story short I was sent a major medical center and was diagnosed with a biliary stricture, which was repaired with hepaticojejunostomy surgery, since then I had to have this revised twice due to scar tissue and reoccurring stricture. None of the hospitals or MDs in my area were able to help, they had no idea what to do.Maybe you need a specialist too, good luck.

[JellyBeanJean]

I went to my Primary doc on Monday. He gave me some Tylanol 3 ( didnt help at ALL!) and did some blood work. His office is telling me that the blood results have not come back ( its been 5 days!) My GI doc finally called me back and I told him the other doc took blood so he is waiting for them to fax that info over to him. I told him the Tylanol 3 did absolutly nothing to help with the pain so he told me to try taking Bentyl and see if that helps. ( I was originally prescribed Bentyl for intestinal spasms) I followed his instructions and it did help me. I have taken two doses today but it doesnt seem to be helping as much as it did before. I cant get in to see my GI doc until Thursday the 30th. The feeling I get in the URP and ULQ just cannot be described in words..unless you consider " AAAAAAHHHHOOOUUUWW!!" a word. You know what I mean if you have ever had this pain. Im not exactly thrilled about the possibility of another procedure, but I cant stand the pain...so I dont know what else to do! Long soaks in the tub also help alot..but I cant exactly lay in the tub all day. Im really disappointed that this pain is back. I thought I was on my way to feeling good for once!

[werner]

if the sphincterotomy doesn't work, I think they can place
a tube in the sphincter.

You said you had no jaundice, had you had jaundice the
first time associated with the pain ?
Does the blood test show stenosis of bile ?

[schaeff]

Something else to ask your GI specialist about is stenosis from scar tissue from the sphincterotomy - a known complication of the procedure.

[Nanny]

Have you had any testing done to check the condition of your pancreas?  Pancreatitis and chronic pancreatic problems often develop after gallbladder surgery.  Pancreatitis pain is much more severe than gallstone pain.   It's usually located in the middle, left and right of the upper abdomen, and often radiates to the back.

I suggest you contact your physician and see what he says about the possibility of pancreatitis.  Meanwhile, you could avoid food, drink plenty of clear, non-alcoholic beverages, such as tea and water, to rest the pancreas.  A heating pad set on a low to moderate setting may help to calm the pain.

Good luck.
Nanny