Abdominal pain after taking codeine post cholecystectomy

[BELLEJC1]

Hi there, I'm 39, I'm 5ft 10", and have not had weight problems and have enjoyed a balanced diet all my life.  In 1999 after the birth of my first child, I began to experience terrible pain after ingestion of fatty foods when people came to visit me in the weeks following the birth- I was diagnosed cholecystitis (which I was told developed in pregnancy) and had a laparoscopic removal of gravel from my gall bladder.   When my baby was 4 months old I had a severe headache and took paracetamol with codeine (16mg codeine) which I had taken episodically during my life with no adverse effect. Within 30 mins of ingestion I began to experience symptoms the same as when i had a gall-bladder attack and I went to the ED thinking I still had a bile stone trapped somewhere - the ultrasound of my liver was normal. I have take codeine at random times for severe pain  over 12 years since then, and every time I take codeine the same thing occurs - sudden severe abdominal pain that feels exactly the same as with cholecystitis-excruciating!  Milk helps a little but not much.   I've read a few things on the net and I now know there is a relation to Sphincter of Oddi dysfunction after gall bladder removal that may be triggered after ingestion of codeine, and there may even be a link to pancreatic cancer in later life.  I'd like to contact others experiencing similar problems.  Obviously I no longer take codeine and have not experienced an episode since.  Why don't doctors warn us post cholecystectomy of this possible occurrence?  A warning may have saved me one trip to hospital.  I'd like others who have had their gallbladder removed to know that this is quite a common occurrence and there is more documented evidence of this occurrence than there ever was in 1999. It may even be very bad for you.  

[shantoast]

I had my gallbladder removed seven years ago and have the same issue. I first noticed it with a prescription cough medicine. For as long as I can remember, Tussin with codiene has been the only thing capable of touching my cough when I become sick, and I'd never had any problems with it prior to having my gallbladder removed, but this is certainly not the case any longer. It took me a couple of times of taking it afterward to make the connection, but like all of you have said, it is the most excruciating pain I've ever felt in my life - even worse than the GB pain itself. It's like a vice grip around your stomach, ribs, and back, and the pain radiates through my abdomen and chest, even into my breasts. I feel like I'm dying, and that's no exaggeration. I literally feel like my insides are turning black and dying. I've been prescribed an antispasmodic, but it doesn't really even touch the pain.
Eventually, through my own searching, I finally learned the link between the medicine and the pain. It's caused by your Sphincter of Oddi - morphine and its opioid derivatives cause it to spasm, resulting in that pain. Look up sphincter of oddi disorder, and you'll see a lot of people in the same boat, and almost all (if not all) of the people that suffer from it are post cholecystectomy patients.
From what I've experienced and read, it seems that it's the natural class of narcotic pain medication (known as opiates)  that gives the most trouble (morphine, codiene, etc.) and the purer the medication, the worse the pain. Notice I say purity, not strength. Morphine is undoubtedly stronger than codiene, however both of them are naturally occurring, which is why they can both leave you susceptible to the reaction. I'd personally stay away from any and all opiates based on my personal experience with codiene and everything I've read about others' experience with morphine. I've never taken morphine, but you bet your behind that I list it right alongside codiene as an allergy.
Now the good news is that not all strong narcotics are naturally occurring - there are plenty of synthetic narcotics out there (known as opioids) that you have a good shot at getting relief from. Not all of them, though (personally speaking). What I've noticed, for me personally, is that I do okay with oxycodone (like Percocet), and not so okay with hydrocodone (lortab, Norco, etc.). I also handle Dilaudid quite well, which is an excellent choice if you need morphine-level pain relief. I've also heard that Demerol and Fentanyl are good choices.
In any case, I wish this connection between cholecystectomy and narcotic medication was more widely understood and communicated. Anyone who has experienced the pain knows that the connection is real, but we've all obviously also experienced being treated like we're crazy or making it up by medical professionals, which is extremely frustrating. Plus, it also needs to be communicated as a potential complication of the surgery, just so people are aware of it. It's really scary to experience!

[matscal]

Does this feeling go away? I took a Tylenol 3 + codeine yesterday. I've had my gall bladder removed during a liver transplant. I got a stomach ache and tight feeling in my upper stomach, near my transplant scar. Now it's 24 hours after taking the codeine and I still feel the tightness but the ache is almost gone.

[Merymarie]

ANSWER! It is GAS! (Just trapped in your chest) I have had this problem as long as I can remember and before i had my gall bladder taken out. I know this because for a long time now I have these same sharp excruating pains in my chest after eating sometimes. If I jump up and down, make myself burp it releaves the episode for a little. Gas pains are also not helped by pain medicine. I don't know why this isn't talked about more and why doctors don't give us this answer but I'm positive that is it. Try drinking something carbonated and making yourself burp.

[Wigolly]

GAS? What absolute rubbish. I had my gall bladder removed about 6 months ago and was warned by a couple of people who had previously been through the procedure to be careful with Codeine. I have recently had the flu and was prescribed a Codeine based syrup to combat a nagging cough. Prior to taking it, I was unaware of the presence of Codeine and didn't bother to check. I wish I had. Within an hour, I was experiencing intense abdominal pain across the top part of my stomach, emenating into my back, very similar but far more acute than the pain experienced when I had the gall bladder issue. The trip to the casualty ward and subsequent tests found nothing. The pain lasted about an hour and then disappeared completely. I put it down to the Codeine. I have never had any issues with Codeine based drugs in the past but will be vigilant in avoiding them in the past.

[houndgirl]

It is absolutely NOT gas, I promise you this is pain you cannot explain it is also a pain that gives you spasms feels like you are in a vice, almost like childbirth pain, it is awful and not gas.

[Luckykat67]

I am so so so glad to of found this page. I had my gallbladder out about 8 months ago last August. Last December I had my wisdom teeth taken out and they perscribed me Tylenol with codine. Upon taking it I layed down and was talking to my BF when it hit me about 20-30 mins after taking it. BOOM excruciatimg pain that was in the middle of my chest and went allnthe way through to my back. It felt like someone blasted me with a shotgun smack in the middle of my chest. Just like my gallbladder attacks. Well i didnt know what caused it, so tonight i had a medical issue and took one not thinking about that night.OMG. OMG. PAIN!!!!! Same familiar pain, same time frame. Its so distinct, i immidiatly knew it was the medicine. This time it lasted hours. I have been so scared til i found this page, which is why i am choosing to tell my story. If i can help just one person ease thier mind to know they are not alone and not going to die (i really thought i might, told my BF to keep checking me to make sure i dont die in my sleep). Anyhow im still in pain nut at least i have an idea amd know to never take Morophine....thanks to all you that warned me and others, i never would have known to avoid it as well.

[JeannieCr]

I had my gallbladder removed 35 years ago. I used to be able to take codeine, as long I ate something with it. Over the years it seemed like the pain got worse every time I'd take it. Granted I'd only take codeine once every few years as prescribed for root canals, etc. The last time I took it was for back pain that was keeping me awake, but the pain from the codeine was SO much worse! I swore then that I'd never take it again. I was in the hospital last year for diverticulitis & they gave me morphine. I told them I cannot take codeine, that it gives me terrible stomach pain. They acted like they've never heard that before, but said no problem, we'll give you morphine. Also, it was by IV not a pill, so I thought maybe I won't get stomach pain if I don't swallow a pill? Boy, was I wrong! That was the most excruciating pain I've EVER had! I'm glad that I was already in a hospital at the time, but it was extremely frustrating that everyone there kept saying it couldn't be the morphine causing the pain, it must be the diverticulitis. No, it was definitely the morphine. It is a very distinctive pain, nothing like it. The diverticulitis pain was much, much lower, and very mild by comparison. I've talked to my GP since then about it & he doesn't seem to understand why I have this pain either. I'm so glad to have found this site, I finally understand why! My GP said if codeine and morphine both cause pain, there are other pain drugs you can take, but I can't remember what they were. I think they started with a "d"? Is there any pain medication you all can take without getting this awful stomach pain? I've got shoulder surgery in a month & I'm afraid I won't be able to take anything for the pain.

[JeannieCr]

I had my gallbladder removed 35 years ago. I used to be able to take codeine, as long I ate something with it. Over the years it seemed like the pain got worse every time I'd take it. Granted I'd only take codeine once every few years as prescribed for root canals, etc. The last time I took it was for back pain that was keeping me awake, but the pain from the codeine was SO much worse! I swore then that I'd never take it again. I was in the hospital last year for diverticulitis & they gave me morphine. I told them I cannot take codeine, that it gives me terrible stomach pain. They acted like they've never heard that before, but said no problem, we'll give you morphine. Also, it was by IV not a pill, so I thought maybe I won't get stomach pain if I don't swallow a pill? Boy, was I wrong! That was the most excruciating pain I've EVER had! I'm glad that I was already in a hospital at the time, but it was extremely frustrating that everyone there kept saying it couldn't be the morphine causing the pain, it must be the diverticulitis. No, it was definitely the morphine. It is a very distinctive pain, nothing like it. The diverticulitis pain was much, much lower, and very mild by comparison. I've talked to my GP since then about it & he doesn't seem to understand why I have this pain either. I'm so glad to have found this site, I finally understand why! My GP said if codeine and morphine both cause pain, there are other pain drugs you can take, but I can't remember what they were. I think they started with a "d"? Is there any pain medication you all can take without getting this awful stomach pain? I've got shoulder surgery in a month & I'm afraid I won't be able to take anything for the pain.

[cooolio]

phethidine is a great strong pain killer but very addictive