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What Causes Severe Pain In Mid Epigastric Area?

Posted on Sat, 21 May 2016

Question: i had gallbladder removed on XXXXXXX 30th, and have done extremely well since. no diarrhea or discomfort. however, on3/13/16, i had severe pain in the mid epigastric area lasting ~ 10 minutes. yesterday 3/14/16, after eating breakfast of 1 thin baked sauage pattie and a slice of bread, the pain returned and i needed and took a donnatol tablet to relieve the pain which took about 45- 60 minutes. after eating a small portian of spagetti last night the pain started before finishing the spagetti and became severe for ~ 45 minutes. 25 minutes after taking 2 donnatal i could feel the pain subsiding and was totally without pain and feeling normal about 1 1/2 hours later. this pain is exactly as it was when i had a blocked bile duct. i am at a loss what could be causeing this pain. i call the surgeon's office for advice and was told to contact my pcp who acually told me to call the surgeon. please advise

Answered by Dr. Amit Jain (20 minutes later)

Brief Answer:
get few blood test and ultrasound abdomen

Detailed Answer:
Hello. Thanks for putting your query in hcm.

This pain may be due to any of the two reasons. 1. Acid peptic disease as pain occurred in you after eating something but as you described that it was as similar as obstructive bile duct which may be the second reason for pain

There may be some stone in bile duct that can lead to such pain. If it is there then stone is to be removed with endoscopy procedure known as ERCP

So I will suggest you to get some blood test like complete haemogram and liver function tests and ultrasound abdomen to confirm whether there is any stone in bile duct. If all these tests are normal then it is due to acid peptic disease for qhich a proton pump inhibitor like omeprazole is required

I hope I have answered your query and this will help you. Wish you a good health

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Amit Jain (29 minutes later)

if the gallbladder is removed, can you still have stones?and wasn't the bile duct removed during surgery? i had had a ERCP the day before surgery and the stone had passed.

Answered by Dr. Amit Jain (54 minutes later)

Brief Answer:
get ultrasound abdomen to confirm whether there is stone or not in duc

Detailed Answer:
Welcome back

Sometimes during removal of gallbladder some stone may slip into the bile duct leading to symptoms. So to confirm it get ultrasound abdomen

No bile duct that is common bile duct is not removed during cholecystectomy

Wish you a good health

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Amit Jain (8 minutes later)

if gallbladder is removed, can you still have stones? and wasn't the bile duct removed during surgery? i had a ERCP the day before surgery and the stone had passed.

Answered by Dr. Amit Jain (13 minutes later)

Brief Answer:
get an ultrasound abdomen to confirm one of this possibility for pain

Detailed Answer:
Welcoe back. I have already explained that a stone may slip from gallbladder during removal fo gallbladder into bile duct. So onecan have stone Iin bile duct after removal of gallbladder.

No bile duct is not removed during cholecystectomy

It may be the possibility and to confirm it get an ultraaound abdomen

I hope I have answered your query which will help you. Wish u a good health

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Above answer was peer-reviewed by : Dr. Naveen Kumar