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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Abdominal Pain After Eating?

I have a dear friend who has had most of her large intestines removed-last November. Then had her gall bladder removed and a few weeks later had a total hysterectomy. In the last few weeks she has started having severe abdominal pain-usually after she eats-that has caused her to go to the ER. They did a CT scan and told her that some of her lymph nodes were enlarged. She had a follow-up with her surgeon and he examined her and found a fissure. He is doing a sigmoidoscopy tomorrow. But he told her there was nothing he could do for the abdominal pain. My question is, could she be having some kind of ischemic event/spasms to the arteries supplying her stomach-since most often it is after she eats? I had her ask that question and he said, No, because she had so few intestines left. But, I would still think it could be a problem with the stomach/ mesenteric enteric arteries.
Mon, 22 Feb 2016
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General Surgeon,  's  Response
Hi.
Thanks for your query and an elucidate history about your friend.
Since the lymph nodes are enlarged after so many surgeries, it is possible that the inflammation is irritating the small intestines which go into spasm as a reflex mechanism after eating, this is a well known fact.
Once the CT scan is done, it must have been contrast enhanced and would have shown any ischemia is present. Please ask the Radiologist to review, I do not think it is present as the Radiologist would have definitely noted such a gross thing.
A proper antibiotic and anti-inflammatory and if required a short course of a steroid should help.
Another possible reasons is the presence of intestinal obstruction of sub-acute nature that can cause the similar lesions.
Enteroclysis if the CT scan shows doubtful intestinal pathology will be confirmatory.
I hope this answer helps for a proper diagnosis and treatment.

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What Causes Severe Abdominal Pain After Eating?

Hi. Thanks for your query and an elucidate history about your friend. Since the lymph nodes are enlarged after so many surgeries, it is possible that the inflammation is irritating the small intestines which go into spasm as a reflex mechanism after eating, this is a well known fact. Once the CT scan is done, it must have been contrast enhanced and would have shown any ischemia is present. Please ask the Radiologist to review, I do not think it is present as the Radiologist would have definitely noted such a gross thing. A proper antibiotic and anti-inflammatory and if required a short course of a steroid should help. Another possible reasons is the presence of intestinal obstruction of sub-acute nature that can cause the similar lesions. Enteroclysis if the CT scan shows doubtful intestinal pathology will be confirmatory. I hope this answer helps for a proper diagnosis and treatment.