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Post cholecystectomy syndrome - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1775 Questions
Doctor :   Hi
User :   hello
Doctor :  
How can i help you?
User :   i've been in and out of the ER for the past two weeks
User :   I've been having trouble keeping food down and stabbing abdominal pain
Doctor :  
User :   I've had my gallbladder taken out in 2007 and 4 ERCPs and have still had problems since
Doctor :  
User :   It's been 2 weeks now since I started getting sick after meals and about 3-4 days where I haven't been able to keep anything down
Doctor :  
User :   I'm trying to get another look from someone outside to see if there are anymore ideas
Doctor :  
what is the diagnosis made at the ER?
User :   no one knows
User :   no one can seem to find a reason
Doctor :  
what investigations have been done?
User :   ERCPs, I had a colonoscopy and endoscopy over a year ago, They're doing a stomach emptying test
Doctor :   what did the reports say?

User :   the pain is in the RUQ and it feels like a sharp stabbing pain
User :   everything has been normal
User :   except for some gastritis last year
Doctor :  
User :   the ercps though they have done two bile sweeps and both have almost like a sludge like material
Doctor :  
after removal of gall bladder ERCP was done?
User :   i've had 4 ercps after and 2 sphincterotomies
Doctor :  
what was the reason for sphincterotomies?
User :   they thought i had sphinctor of oddi dysfunction
Doctor :   you are suffering from Post cholecystectomy syndrome
User :   what's that?
User :   anything to help with the pain and nausea/vomiting?
Doctor :   after removal of the gall bladder some upto 40% of people do suffer from pain in the RUQ and abdominal distress like vomiting and nausea
Doctor :   this is called post cholecestectomy syndrome
User :   is there anything that can be done?
Doctor :   the cause is not certain
Doctor :  
but sphincter of oddi dysfunction is suspected and treated
User :   yes
User :   so nothing?
Doctor :  
it is time
Doctor :  
the reason is the bile used to get collected into gall bladder before
Doctor :  
now as it is removed the bile directly enters intestine
User :   yea, i don't understand why this would cause the pain and nausea
Doctor :   previously there was a check of entry of bile to intestine now it is not there
Doctor :  
so it is causing irritation of the intestine
User :   ok
Doctor :  
causing sphincter dysfunction or adhesion and hypermotility
User :   thank you
User :   nothing can be done for it?
Doctor :   diet modification
User :   ok i've been trying that
Doctor :   it takes time for the intestines to get used to direct exposure of the bile
Doctor :   what diet restrictions you are observing
User :   it's been almost 3 years now
User :   no lactose and low fat
Doctor :   any medications?

User :   prozac, omeprazol, gabapentin, zofran
Doctor :   still using all of them?

User :   yea
Doctor :  
if you have nausea and vomiting it means the bile is entering the stomach so only the sphincter dysfunction treatment ERCP is done
User :   ok
Doctor :   if ERCP repair of the sphincter fails on repeated occasions than open surgery is performed
Doctor :  
but before deciding on open surgery sufficient time is given so that the sphincter may and in most of the cases start functioning normally
Doctor :   so it will take time for the symptoms to disappear
Doctor :   are you there?

Doctor :  
Are you there?
Doctor :  
Are you there?
Doctor :  
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