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Abdominal Pain. Ultrasound Showed Debris In Gall Bladder And Polyp. Still Have Pain. Taken Analgesic For Hip Problem

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Posted on Wed, 10 Apr 2013
Question: my amylase levels were 366 (blood test) when I was admitted to hosital with severe pain in my central upper abdomen (behind the stomach). The doctors suspected pancreatitis and I was on a drip for two days. They did a CT scan which showed no inflammation of the pancreas. The sonographer doing an ultrasound reported 'debris' in my gall bladder and a 4mm polyp. She sugested that the gall bladder might not be working well and could be irritating the pancreas as the ducts appeared inflamed (but the consultant did not seem to see this as being a possibility).The doctors have discharged me and do not seem to know why I am ill. I am still in pain which radiates to my back and shoulder blades. I have been experiencing this pain on and off for two years. The doctor had thought I had a stomach ulcer but a gastroscopy showed NAD. I was taking high doses of analgesics for a hip problem from 2007 including tramadol, ibuprofen and Buprenorphine patch.
doctor
Answered by Dr. Charles S Narasi (4 hours later)
Hello, XXXXXXX,
The photographs of your hand show swelling of the joints
along with what appears to be a red rash. This might indicate
active arthritis.
You mentioned that the sonogram of the gallbladder showed
debris. This usually refers to "Gravel or sand " like cholesterol
crystals which indicates there is higher concentration of this
in your bile. Gallbladder disease can cause pancreatitis.
Common bile duct drains into the duodenum and the duct from
the pancreas also drains close by. Because of the closeness , there
could be inflammation of the pancreas. The CT-Scan however may
not show as much changes as it would if it were primary pancreatitis.
The 4 mm. polyp is not of concern. I am concerned about you being
on high dose analgesics , especially Ibuprofen. Eventhough the
endoscopy did not show ulcers in the stomach , they could be located
beyond the reach of the gastroscope in the small intestine. If you are
not taking any protective agents for acid control , you should be on
it . I would recommend Esomeprazole type of medications that will
prevent damage from the Ibuprofen to the stomach lining.
I also suggest that you have a HIDA scan which will confirm acute
inflammation of the gallbladder. You will need surgery for removal
of your gallbladder. This can be done through a laparoscopic approach
and you will be in the hospital one day or less and recovery is faster.
In the mean time stay on a low fat diet , avoid all alcohol.
Hope this helps you.
I wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (5 hours later)
Thank you for your response,

Just to clarify that I am no longer taking any analgesics even though I am in severe pain because I recognise that I may have caused long term problems through their use.
Can you see the blister type lumps on my hands? They become itchy, then the blisters come and they go very quickly.
Do you know of any link with breast cancer and this gall bladder/pancreas problem. I am high risk for breast cancer with strong family links but they have decided to leave the lump and monitor it because I have implants. Couls implants cause this problem if they were leaking?
You seem confident that I will need to remove the gallbladder? Is this on confirmation of the HIDA test or purely due to my symptoms?
KR XXXXXXX
doctor
Answered by Dr. Charles S Narasi (11 minutes later)
Hello, XXXXXXX,
The rash and the blister like lesions could sometimes be
related to auto-immune conditions. Lupus type of disorders
have been reported with breast implants leaking. You should
have blood tests that are markers for Lupus which includes
Antinuclear antibodies, Anti-DNA antibodies, Serum Complement
levels etc.
Since you do have gravel in your gallbladder, it does indicate
chronic inflammation or you are prone to have future attacks.
HIDA scan is good to confirm acute inflammation.
You do need surgery , more on an elective basis.
Breast cancer and gallbladder disease are not necessarily connected
but may occur in the age group you are in.
Wish you well.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Abdominal Pain. Ultrasound Showed Debris In Gall Bladder And Polyp. Still Have Pain. Taken Analgesic For Hip Problem

Hello, XXXXXXX,
The photographs of your hand show swelling of the joints
along with what appears to be a red rash. This might indicate
active arthritis.
You mentioned that the sonogram of the gallbladder showed
debris. This usually refers to "Gravel or sand " like cholesterol
crystals which indicates there is higher concentration of this
in your bile. Gallbladder disease can cause pancreatitis.
Common bile duct drains into the duodenum and the duct from
the pancreas also drains close by. Because of the closeness , there
could be inflammation of the pancreas. The CT-Scan however may
not show as much changes as it would if it were primary pancreatitis.
The 4 mm. polyp is not of concern. I am concerned about you being
on high dose analgesics , especially Ibuprofen. Eventhough the
endoscopy did not show ulcers in the stomach , they could be located
beyond the reach of the gastroscope in the small intestine. If you are
not taking any protective agents for acid control , you should be on
it . I would recommend Esomeprazole type of medications that will
prevent damage from the Ibuprofen to the stomach lining.
I also suggest that you have a HIDA scan which will confirm acute
inflammation of the gallbladder. You will need surgery for removal
of your gallbladder. This can be done through a laparoscopic approach
and you will be in the hospital one day or less and recovery is faster.
In the mean time stay on a low fat diet , avoid all alcohol.
Hope this helps you.
I wish you the very best.