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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Gallbladder Removed. Having Pain Under Right Ribs, Twitching, Constant Gas. Same Type Of Pain Before Removal. Suggestions?

Had gallbladder removed March 2012. Last 4 months have developed pain under right ribs (lower, almost at the bottom of ribcage), almost constant gas, and I can at times feel my right side twitching. I take Nexium and Carafate for GERD and Welchol when needed for excessive bile , which I get frequently since the GB surgery. I had a colonoscopy (clear) and endoscopy (minor gastritis, 3cm of Barretts and 1 diverticulosis ) last May. Im concerned about the gas and pain under right side lower ribs. It is the same type pain I had prior to gallbladder removal.
Mon, 25 Feb 2013
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General Surgeon,  's  Response
Hello!

Thank you for the query.

Your symptoms are most likely caused by stones in the bile ducts. Adhesions which has appeared after the surgery are also possible.
I suggest you to have blood work, liver tests (AST,ALT,GGTP,AP), amylase, bilirubin, urine amylase and abdominal ultrasound. If stones will be found, ERCP procedure will be necessary and will cure this conditions.
If no findings in this tests, abdominal CT should be performed to see if the pancreas is fine and if there is no other things inside the abdominal cavity.

Hope this will help.
Regards.
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Had Gallbladder Removed. Having Pain Under Right Ribs, Twitching, Constant Gas. Same Type Of Pain Before Removal. Suggestions?

Hello! Thank you for the query. Your symptoms are most likely caused by stones in the bile ducts. Adhesions which has appeared after the surgery are also possible. I suggest you to have blood work, liver tests (AST,ALT,GGTP,AP), amylase, bilirubin, urine amylase and abdominal ultrasound. If stones will be found, ERCP procedure will be necessary and will cure this conditions. If no findings in this tests, abdominal CT should be performed to see if the pancreas is fine and if there is no other things inside the abdominal cavity. Hope this will help. Regards.