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Suggest treatment for severe pain after cholecystectomy

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Posted on Wed, 22 Feb 2017
Question: i just had my gal blatter takin out 2.5 weeks ago and haveing very strong pain upper right side a few times daily with out eating faty foods is ther anything i need to do diffrent in my diet or do i need more testing to see whats going on i aslo can only eat a quter of my normal meal

i had taken already an ultrasound and blood work and did not find anything

Side Note: My friend has suffered for 11 years post gall bladder removal. Every time she ate, she suffered extreme pain in the upper right quadrant. Her GI finally found the source of the pain: scar tissue that formed around the surgical site was constricting the small intestine.
Can this be my problem too, or is it too soon after surgery?
If yes, what do I do?
My surgeon sent me for an MRI. Would this show up on an MRI, and would it show up so soon after surgery?
doctor
Answered by Dr. Tayyab Malik (4 hours later)
Brief Answer:
NOTHING TO WORRY IF ULTRASOUND AND BLOOD WORK IS NORMAL

Detailed Answer:
hi.
thanks for posting query at HCM.
read your question thoroughly and understood your concern.

differential: surgical incision pain, fat intolerance/ gastritis or stone remnants in common bile duct.

as per your presentation, ultrasound abdomen is "normal", so stones in common bile duct has been ruled out and the tissue underlying incision maybe normal .

Scar tissue formation constricting small intestine is very UNLIKELY in your scenario.

gall bladder primary role is to store "bile".
when gall bladder is intact, bile is usually secreted after having a meal rich in fat; bile plays a vital role in fat digestion.

after gall bladder is removed, bile is continuously being secreted in small intestine and may reflux into stomach. as a result, gastric inflammation may occur causing pain and discomfort.
moreover, high fat meal induces more bile synthesis - further affecting gastric mucosa.

advise:
NO fat intake or decreased fat intake
few weeks trial of OTC proton pump inhibitor (omeprazole/pantoprazole)to combat gastritis ( after discussing with treating physician)
mebeverine maybe used for cramping pain
small meals


hope to answer your concern
wish you good and sound health.

regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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Suggest treatment for severe pain after cholecystectomy

Brief Answer: NOTHING TO WORRY IF ULTRASOUND AND BLOOD WORK IS NORMAL Detailed Answer: hi. thanks for posting query at HCM. read your question thoroughly and understood your concern. differential: surgical incision pain, fat intolerance/ gastritis or stone remnants in common bile duct. as per your presentation, ultrasound abdomen is "normal", so stones in common bile duct has been ruled out and the tissue underlying incision maybe normal . Scar tissue formation constricting small intestine is very UNLIKELY in your scenario. gall bladder primary role is to store "bile". when gall bladder is intact, bile is usually secreted after having a meal rich in fat; bile plays a vital role in fat digestion. after gall bladder is removed, bile is continuously being secreted in small intestine and may reflux into stomach. as a result, gastric inflammation may occur causing pain and discomfort. moreover, high fat meal induces more bile synthesis - further affecting gastric mucosa. advise: NO fat intake or decreased fat intake few weeks trial of OTC proton pump inhibitor (omeprazole/pantoprazole)to combat gastritis ( after discussing with treating physician) mebeverine maybe used for cramping pain small meals hope to answer your concern wish you good and sound health. regards Dr Tayyab Malik