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4 years RNY post op

 
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  • Answered by:Dr. Dan
  • Bariatric Physician (MD)
  • Positive Feedback: 99.4 %
  • Accepted Answers: 317
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in Bariatrics

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Customer Question

I am 4 years RNY post op. I have been having pains in my right side off and on for a while now. The pain pretty much stops me in my tracks for a while and then goes away. I have had a sharp twisting pain in my right side now for about 50 minutes. I have had ovarian cysts and then they disappear. I don't have my appendix and my last ultrasound showed no gallstones. I am having a hard time with the pain today.

 

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Gender: Female
Age: 50

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I have been to the ER and Urgent Care a few times and each time they do ultrasounds and etc. They know the pain is real but they don't know what to do. My bariatric surgeon, who is now not part of my medical plan, said it might be my intestines twisting and or getting stuck and then working themselves back out again. I don't know what to do now. I cannot handle this happening all the time.

Submitted: 476 days and 13 hours ago.
Category: Bariatrics
Value: $30
Status: CLOSED
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Expert:  Dr. Dan replied 476 days and 13 hours ago.

Hello,
I agree with your bariatric surgeon, that you might be experiencing symptoms of an internal hernia. This happens not uncommonly in bypass patients. If your gallbladder workup is completely normal, meaning normal ultrasound and a normal HIDA scan (tests gallbladder function), the next step would be an elective diagnostic laparoscopy.

The laparoscopy should be done by a bariatric surgeon familiar with gastric bypass and it's complications. If the HIDA scan is abnormal, the surgeons taking out your gallbladder should also be familiar with gastric bypass and it's complications, so s/he can look for an internal hernia before taking out the gallbladder, and fix any hernias that are there.

I cannot stress enough the importance of an experienced bariatric surgeon providing your care. In the long run, it will save you a lot of extra steps and reduce your risk of having unnecessary procedures.
Good luck,
Dr Dan

Customer replied 476 days and 13 hours ago.

I have been to a bariatric surgeon within my HMO who is also familiar with my bariatric surgery. I saw him about a month ago and told me that I have enough colon for two people and that I am literally full of S--t. He suggested that I get a flush. BACKGROUND INFO: I tried go-lytly, milk of magnsia, magnesium citrate, ducolax pills, senna pills, cascara, and enemas in a 24 hour period and no I did not go to the restroom. I finally ended up going a few days later. I have been having pretty regular BM's since. I have IBS and am usually constipated. I just don't want to go to ER or my surgeon if this is only constitpation. Although I am used to the pain, I am tired of it and cannot function at work and so forth. My HMO doctor did say he would do a laprascopic if the pain persisted. I thought it had gone away because I haven't had the pain in about two weeks.

Accepted Answer

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Expert:  Dr. Dan replied 476 days and 13 hours ago.

If your pain symptoms are coming from one spot on the right side of your abdomen, then your symptoms are likely NOT from constipation, which tends to have a migratory pain presentation (pain can be anywhere, but usually down in the pelvis). My original recommendation stands that you should complete gall bladder workup with an eye towards evaluation of internal hernia.

Good luck,

Dr. Dan

Expert TypeBariatric Physician (MD)
Category: Bariatrics
Pos. Feedback: 99.4 %
Accepts: 317
Answered: 12/27/2011

Experience: ASMBS Centers of Excellence Bariatric Surgeon

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