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Had her gall bladder removed. Had constant diarrhea and symptoms of IBS. Having stabbing abdominal pain. What to do?

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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Pediatrician
Practicing since : 2002
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My 13 year old daughter had her gall bladder removed in 2012 after many tests and medications tried- for pain in upper right quadrant. Hydia Scan showed gall bladder was non functioning. Since then she has had constant diarrhea and symptoms of IBS. She has to watch what she eats or drinks, never knows what will set her stomach off. Last two days she has had sudden acute stabbing abdominal pain right above her naval and pain in upper left quadrant. The pain gets so severe she ends up curled up in the fetal position crying-the pain is unrelenting. I have taken her to the ER the last two mornings, since anything I tried ie heating pad, hot water bottle, or any otc meds or perscriptions she has had no effect on the pain or lessoning it. In the ER they have given her GI cocktails, and some stomach meds thru her IV, and finally a pain med. She says the pain helped somewhat, but pain never completely goes away-it just becomes more bearable. Tonight she is once again curled in fetal position with severe stabbing pains above navel. She has not had a period yet-has not yet started her menstral cycle. I understand that the medications given will take time to take affect. But what is causing, and what can we do with the flare up of the acute stabbing abdominal pain that seems to happen towards evening without any let up!?!
Posted Thu, 7 Nov 2013 in Child Health
 
 
Answered by Dr. E Venkata Ramana 42 minutes later
Brief Answer:
continue drugs as prescribed. Evaluate her further

Detailed Answer:
Hi,

Thank you for your query on Healthcare Magic.

This type of severe pain in left upper quadrant abdomen is seen in peptic ulcers disease, pancreas problems such as pancreatitis, and intestinal problems.

Investigations like erect abdominal X XXXXXXX ultrasound abdomen, CT scan of abdomen, blood investigations for serum lipase and amylase, and upper gastrointestinal endoscopy will help to rule out the above conditions.

Physical examination by the doctor will help to narrow down the possibilities and will help to plan for appropriate tests to detect the cause for pain.

Therefore I suggest you to consult the Pediatrician for clinical examination, to review her medical history, and to plan appropriate investigations.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had her gall bladder removed. Had constant diarrhea and symptoms of IBS. Having stabbing abdominal pain. What to do? 2 hours later
Her first ER visit on the 16 th she had a urinalysis dipstick done....all normal. Pregnancy test...negative, Control passed, and a cbc differential all values were within normal range. The results of her comprehensive metabolic panel had some abnormal values ie chloride was 111 (98-107 meq/l) Protein total was 6.2 (6.4-8.3 gm/dl) Globulin was 2.0 (2.4-3.7 gm/dl) A/G Ratio was 2.1 (1.1-1.8) Alkaline Phosphatase was 359 (25-345 u/l) Her Lipase was normal. Urinalysis normal. Bedside Glucose was normal. Does this make you think of any more possible advice?
 
 
Answered by Dr. E Venkata Ramana 8 hours later
Brief Answer:
Gastritis, peptic ulcer, renal stones

Detailed Answer:
Hi,

Thank you for getting back.

The results you sent are not suggestive of any particular condition which will cause this type of severe pain in left upper quadrant of abdominal pain.

Imaging studies such as ultrasound abdomen will give a clue to the possible cause.

Some times intestinal obstruction (due to postoperative adhesions) will present with colicky abdominal pain, but it is associated with vomitings and distended abdomen.

The other possibilities are gastritis, peptic ulcer, renal stones, and spleen problems.

Rarely porphyria, abdominal migraine will present with pain abdomen.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
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