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Pain below ribs, got gallbladder removed. Partner committed suicide. Are they co-related, is it psychosomatic?

my Mother is 73 and having right side pain just below the ribs. Better with leg pulled up while sitting in a recliner. She had her gallbladder out years ago, and seems to always have some kind of pain. My Father committed Suicide 3 years ago and I wonder if this "pain" is psychosymatic, or real. She actually cries in pain and claims to be unable to get up?
Asked On : Thu, 18 Apr 2013
Answers:  5 Views:  88
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General Surgeon 's  Response
Apr 2013
Hi and welcome to HCM.Thank you for your querry.
It is hard to say the exact cause. It can definitely be psyhosomatic pain, but I suggest to do some tests to rule out something more. usually stomach or pancreatic pain can manifest on this way especially if painkillers dont help. Also some lungs infections and hepatic disorders..
I suggest to do basic blood tests and abdominal ultrasound just to clear this out. If she has fever, vomiting or weight loss you should do tests as soon as you can.
Wish you good luck.
Answered: Thu, 18 Apr 2013
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General & Family Physician Dr. Jay Patel's  Response

Based on the information provided their are many possible causes, and they are as follow.
1) Pain due to stretching of healed fibrous bands inducing pain sensation (post operatively).
2) May be as Psychosomatic pain.
3) Some unknown underlying issues.

Consult the physician as the diagnosis needs subtle radiological investigation like ultrasound to see inner lying issues and the psychosomatic pain is a diagnosis of exclusion. Most of the time the pain is due to stretching of the fibrous bands which were formed during healing process after the gall bladder removal, are the cause and they need an medical attention.

Mean while -
1) Can use over the counter pain killer as needed.
2) Hot water bag sponging/ heat therapy may help reduce the pain.

Hope it makes a difference.
Answered: Thu, 18 Apr 2013
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General & Family Physician Dr. S. Jegadeesan's  Response
Your mother's gall bladder was removed ?long back. Your father committed suicide 3 years back.
Your mother is complaining of pain just below the ribs. I take it for granted it is in the anterior aspect (front). Definitely it is not connected with your father's demise. You have not told whether the gall bladder was removed by open surgery or by laprascopic surgery. Any how pain in the operated site or around that site has to be investigated by USG to rule out any post operative adhesion. If the pain is in the backside radiating to the front may be due to kidney stones. USG will reveal that also. Rest of treatment as per USG report. If USG is normal ordinary pain killer along with muscle relaxant may be of use. Better to have fat free diet.
Best wishes
Answered: Thu, 18 Apr 2013
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General Surgeon Dr. Grzegorz Stanko's  Response

Thank you for the query.

Psychosomatic theory should be considered only if all other reasons will be ruled out. Upper right abdominal pain in the patients after gallbladder removal can be caused by gallstones in the bile ducts, pancreas disease, peptic ulcer. Large intestine is in this area as well and some diseases affecting it can give the pain in this area.
Gallstones in bile ducts are more possible if the pain radiates to the back, nausea appears. Urine can get darker and stool whitish.
Peptic ulcer is more probable if the pain appears after 1-2 hours from the meal, does not radiate to the back.
Large intestine disease should be always ruled out in people older than 50. Symptoms which can be present with this condition are constipation, diarrhea, weight lost, weakness, bloating, blood in stool.

I suggest your mother to have abdominal ultrasound, blood work, liver tests (AST,ALT,GGTP), amylase, urine amylase, bilirubin, urine analysis. If nothing will be found, upper GI endoscopy should be the next step. If large intestine disease seems possible, also colonoscopy should be done.

Hope this will help.
Answered: Thu, 18 Apr 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

After removal of gall bladder, Common Bile Duct stone could account for this..
Liver and hepatic flexure need to be considered
See a gastro-enterologist...

Psychosomatic problem is possible, but should be an exclusion diagnosis..

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Thu, 18 Apr 2013
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