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Abdominal pain, gurgling sounds, nausea, stomach discomfort. MRCP, gastroscopy negative. Had cholecystectomy. Can this be a hernia?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 922 Questions
58 ,female. Cholecystectomy 2004. Since XXXXXXX 2011 several pain attacks, always around 3 am. When lying in bed.Colicky upper right abdominal pain. Like someone squeezing intestines. Gurgling sounds. Attack XXXXXXX sept, oct, dec, feb. Last for 24 - 48 hours. Nauseous. Feel ill for several days afteerwards. Very tired. Feel like been kicked in stomach. Now continual discomfort , feels like something inside "Caught up". Also itching over right side of upper abdomen, towards back also. Uncomfortable to lie on right side. Discomfort when lift heavy articles with right arm. MRCP negativ, Gastroscopy negative, biopsi neg . Neg. Helicobacter pylori. Recently "stretch " pain while lifting. Can this be a hernia ? Other suggestions? Am very ill when these attacks occur and now am finding daily life challenging due to tiredness, discomfort etc
Posted Tue, 22 May 2012 in Digestion and Bowels
Answered by Dr. Ajit Naniksingh Kukreja 1 hour later

Thanks for posting your query

You have been very precise in your description, this will help me sort your issue easily

The only data that I need is the type of surgery performed-Was it an open or a Laparoscopic Cholecystectomy - This is just to rule out the possibility of Hernia that you have mentioned in your history

Most symptoms that you have described are related to What we commonly know as Post Cholecystectomy Syndrome

The only issue is initiation of symptoms after 7 years is a question

Did you have any of these symptoms in between ?
Do you have any laboratory investigations done ?

In the mean time I would advise you take care of your stress levels

Avoid fatty and spicy meals

Avoid fermented meals

Take small and frequent meals

If you are used to smoking or Alcohol avoid the same

Take a proton pump inhibitor like Rabeprazole along with Domperidone to control the symptoms

Get back to me with the details asked for and I will help you out
Get Well Soon
Above answer was peer-reviewed by
Follow-up: Abdominal pain, gurgling sounds, nausea, stomach discomfort. MRCP, gastroscopy negative. Had cholecystectomy. Can this be a hernia? 7 minutes later
My op was in 1994 not 2004 , sorry. Yes, have had some attacks earlier, 2000,2004?Laparoscopic cholecystectomi. Gallbladder ultrasound ok. All labs ok. Feel blown up. What is post cholecystectomy syndrome? Treatment ?And what is the itching ? Do not drink alcohol. Profession clinical nutritionist so diet ok. Am taking nexium.
Answered by Dr. Ajit Naniksingh Kukreja 14 minutes later

Thanks for the prompt response

As I told you all the symptoms are typical of Post Cholecystectomy Syndrome [PCS]

Usually this is seen in some 10-15% of patients operated for Gall Bladder Removal

These symptoms may actually represent either :

(1) the continuation of symptoms that had been interpreted as resulting from pathology of the gallbladder or

(2) the development of new symptoms that might normally be attributed to the gallbladder.

PCS is also the development of symptoms, such as gastritis and diarrhea, caused by removal of the gallbladder.

We have observed these symptoms increase when the stress levels rise

The treatment is usually with the management of symptoms and stress after all Lab Panels are normal as in your case

Itching could be some local lesion in the skin around that area

Nexium is OK, Continue it as per you needs

My final word is a word of reassurance with all reports normal, do not confuse yourself with uncommon diseases

Hope I have replied to your satisfaction

If there are no more doubts, do accept my reply and rate it
Am available for followup queries

Get Well soon
Above answer was peer-reviewed by
Follow-up: Abdominal pain, gurgling sounds, nausea, stomach discomfort. MRCP, gastroscopy negative. Had cholecystectomy. Can this be a hernia? 2 hours later
The itching has only started recently, after the last two episodes. I find this strange. What would cause a local lesion? Also, Why do these attacks come only during the night / very late evening?
Answered by Dr. Ajit Naniksingh Kukreja 43 minutes later

Thanks for your followup

I am sure itching has nothing to do with the Gall Bladder surgery

Local lesion can be any skin condition or allergic condition

The attacks come at night or late evening as the acid out put is not utilized with light food consumed in the evenings

Also by evening the body also gets fatigued

My advise again is reduce stress and reassure your self

Hope this helps
Get well soon
Above answer was peer-reviewed by
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