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Swollen stomach, constipation, pain in the abdomen under the ribs. Gall bladder and appendix removed. Need a proper diagnosis

Swollen stomach,conspitpation,pass no gas,pain in upper right abdominal area under ribs,pain in middle of upper abdominal area going into back,walking makes my stomach swell more than it already is. I had gallbladder removed,complete hysterectomy,had appendix removed. Been like this for 2 years.Had all the test that can be done and still no answer to my problem, can you help me?
Asked On : Sun, 28 Apr 2013
Answers:  1 Views:  64
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General Surgeon 's  Response
Hi! From your history of repeated surgeries you underwent, there are a few possibilities which should be looked into. Without having the details of the investigations you have undergone till now, following is suggested:
1) With the surgeries you have undergone, immediate clinical diagnosis which comes into mind is multiple post operative adhesions of the intestines to the previous scars, due to which the intestines are not able to move smoothly and propel both liquids and solids resulting in sub acute to acute intestinal obstruction. In this case the person gets recurrent pain abdomen with inability to pass stool or flatus. Since you have got the problem since last 2 years, it seems more like a sub acute one than acute. For this you have to consult a general surgeon, who will examine you clinically preferably during an attack , and may advise you for a few investigations, like TLC, DLC, HB%, X- ray abdomen with diapragm in upright position, and an ultrasound.
2) Next, with history of cholecystectomy, one has to consider stones in the CBD, and any pathoogical process n the pancreas. This will also need some special investigations like ultrasound abdomem, or may be a CTscan of the abdomen if advised by the doctor. Along with this, serum amylase, lipase, and a LFT might also help.
3) Sometimes irregular dietary habits may also be the culprit. Try to take fat free meals at regular intervals, with more of roughages, and liquids and a regular exercise programme depending on your age and body weight.
4) Ifall these investigations are already done, and nothing could be detected till now, then you may have to consult a laparoscopic gasto enterologincal surgeon, who may consider to do a endoscopic examination of your intestinal tract and also a diagnostic laparoscopy of the abdomen if thought appropriate in your case.
Wishing you an early recovery.
Answered: Sun, 28 Apr 2013
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