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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes severe abdominal pain after a gall bladder surgery?

Answered by
Dr. Hari Charan Perigela

General Surgeon

Practicing since :1995

Answered : 2534 Questions

Posted on Mon, 22 Aug 2016 in Liver and Gall Bladder
Question: Hello,
I have been awaiting a capsule endoscopy. Previous Bilroth surgery, gall bladder removal and a 90 % bowel stricture. 4 days of abdominal pain & not really wanting to eat. Calprotectun levels were 260. Called Gastro clinic this morning, told me not to eat/drink anything for 6 hrs and to take buscopan. I can't go through this everyday though and not eating I don't imagine is going to help anything.

I had 6 polyps removed a couple of months ago, Colon looked ok, one polyp had moderate dysplacia, no clear diagnoses yet. I am 34 years old. 166cm and 63kg.
Answered by Dr. Hari Charan Perigela 6 hours later
Brief Answer:
Pain could be due to Adhesions.

Detailed Answer:
Because of previous surgeries, adhesions might have formed in the abdomen. It could be the reason for abdominal pain.
I would like to have some additional information.
1.What is the reason/indiacation for Billroth surgery?
2.What is the reason for Gallbladder removal?
3.Do you have vomiting and /or Constipation?
Capsule endoscopy will give a clue to the inner layers of the Gastrointestinal tract.
Please take small,frequent feeds.
Avoid spicy foods,cool drinks etc.
I prescribe Proton pump inhibitor like RABEPRAZOLE 20mg twice daily along with Levosulpiride tablet to my patients with similar complaints.
Please come back after Capsule endoscopy report.
I will clarify further.
Hope I answered your query.
Wish you good health.
Above answer was peer-reviewed by : Dr. Priyanka G Raj
Follow up: Dr. Hari Charan Perigela 12 hours later
Thanks for getting back to me. Had gastric bypass in 2013. Surgeon said that Lapband wouldn't work for me as had bad reflux. 2014 15 months after bypass, had severe pain and vomiting. Found 32 stones in the gallbladder, whilst in theatre they found the bowl blockage. Since the gallbladder removal I have been back to the doctor multiple times as bowl movements have been hard to deal with, border line incontinence with blood and mucos present
Referred to gastroenterologist, gastroscooy found nothing. Polyps removed from bowl.

If the pill camera finds no chrones or cancer. Are adhesions treatable ? I can't go week in and week out like this. Do adhesions cause increased calprotecin levels?
Answered by Dr. Hari Charan Perigela 56 minutes later
Brief Answer:
Increased Calprotecin levels suggest Inflammatory bowel disease.

Detailed Answer:
Adhesions doesn't increase Calprotecin levels.
It is raised in Inflammatory bowel disease like Crohns,cancer,bacterial infection. But,the location of the inflammation will not be known.Endoscopy , Colonoscopy will give a clue.
There is no medical management for Adhesions. If you develop abdominal distension, vomiting, constipation then surgery is indicated.
Please come back after Capsule endoscopy report, I will clarify further.
Wish you good health.

Above answer was peer-reviewed by : Dr. Yogesh D

The User accepted the expert's answer

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