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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Pain In Upper Stomach After Gall Bladder Removal?

Dear DR. I had my gall bladder removed in 2011 as they had found some sludge. After the gall bladder rem oval however, I continued getting fairly severe pain off and on High up in the stomach (under the rib cage) without being able to identify food triggers or anything that caused the same. So they did an MRCP (with contrast etc ) and found that the bile duct was dilated to 18 mm. So next an ERCP procedure was performed yesterday and they also did biliary sphincterotomy (ie. Cut a slit in the sphicter of the dilated bile duct) . Now I am in tremendous pain in my stomach, front and back rib cage. I cant even cough for the pain in the rib cage and back. There is also tremendous pain in almost each and every muscle and bone in my body especially upper thighs, bones, upper arms. My medical history is that of a breast cancer patient at stage 3c. I underwent chemo, mastectomy, radiation and Herceptin treatment for 52 weeks after radiation. This caused chronic pain and I have beenon Avinza ( morphine sulfate derivative for all these years.. I have reduced th eintake from 120 mg to 60 mg/daily but my body has definitely developed some tolerance after all this time of use. According to the Dr s instructions yesterday, I took the Avinza (60 mg), Nexium 40 mg, Aromacin 25mg(Estrogen inhibitor that I am required to take for 10 years following the breast cancer diagnosis), Hydrocodone 5-325 ( 2 tablets) , zantac 300mg and Hyoscymine (bentyl sulfate). I also took 0.5 mg of Xanax as I am prone to anxiety and panic attacks) In spite of all these medicines, I am in tremendous and unbearable pain right now and do not know the cause not what to do at this point. Could you please tell me if this is normal to feel, what are the probable causes of these symptoms, if I should continue as is and it will go away by tomorrow or what can I do . Can I change the medicines? I do need something stronger. I have a fairly high pain threshold but at the moment I am in unbearable pain and discomfort. Please HELP! God bless you if you can relieve this pain for me! Please tell me what to do and how to relieve this awful pain!
Wed, 19 Oct 2022
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Anesthesiologist 's  Response
Hello,

The causes of your severe upper abdominal pain might be peptic ulcer perforation, acute biliary colic, zollinger Ellison syndrome, diverticulitis, gastroesophageal reflux disease GERD, acute gastritis, esophageal tears, or inflammatory bowel disease.

I suspect an acute gastric ulcer perforation. Symptoms of a perforation are sudden, severe pain in the belly (abdomen), usually in the upper abdomen, pain spreading to the back or shoulder, upset stomach (nausea) or vomiting, lack of appetite or feeling full, or swollen belly or feeling bloated

You need to go to ER as there might be some perforation of peptic ulcer that is causing you severe pain. Please do go immediately.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Pallavi M., Anesthesiologist
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What Causes Severe Pain In Upper Stomach After Gall Bladder Removal?

Hello, The causes of your severe upper abdominal pain might be peptic ulcer perforation, acute biliary colic, zollinger Ellison syndrome, diverticulitis, gastroesophageal reflux disease GERD, acute gastritis, esophageal tears, or inflammatory bowel disease. I suspect an acute gastric ulcer perforation. Symptoms of a perforation are sudden, severe pain in the belly (abdomen), usually in the upper abdomen, pain spreading to the back or shoulder, upset stomach (nausea) or vomiting, lack of appetite or feeling full, or swollen belly or feeling bloated You need to go to ER as there might be some perforation of peptic ulcer that is causing you severe pain. Please do go immediately. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pallavi M., Anesthesiologist