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Have been experiencing upper abdominal pain, back pain

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(particularly shoulder blade area), ocassional...
Have been experiencing upper abdominal pain, back pain (particularly shoulder blade area), ocassional diarrhea, nausea and vomiting only a handful of times. I am seeing a GI Dr but wanting to get another opinion. I have had the following teats: Blood panel
twice- within ranges Ultrasound to check for stones-normal Endoscopy-small hiatal hernia, but no other findings otherwise Gastric empting study-normal Lipase levels check twice- within range CT of entire abdomen- normal I had my gallbladder removed in april.
This pain started about a month after procedure. I'm starting to worry about the possibility of chronic pancreatitis. I've never had an acute episode but from my understanding you don't necessary need to have one. How common is cp? What other diagnoses could
be a possibility?
Submitted: 2 years ago.Category: Medical
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7/28/2015
Doctor: Dr. David, Board Certified Physician replied 2 years ago
Dr. David
Dr. David, Board Certified Physician
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This is Dr. David
chronic prostatitis is not too often
it can easily be checked with blood test for amyase and lipase levels.
chronic prostatitis would cause you to loose weight as well.
gastritis and inflammation of the stomach is much more common to cause upper abdominal pain and acid reflux can cause upper back pain.
have you tried any stomach acid blockers like nexium or protonix to see if that helps?
how old are you?
the upper endoscopy scope procedure will check for H Pylori bacteria infections in the stomach.
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Doctor: Dr Basu, Experienced Specialist replied 2 years ago
Dr Basu
Dr Basu, Experienced Specialist
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Hi there,

This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

That is likely known as postcholecystectomy syndrome or PCS.
Sphincter of Oddi dysfunction can precipitate postcholecystectomy syndrome.
There is a possibility of a growth or obstruction at the opening of the sphincter of Oddi--this is where the pancreatic duct opens into the duodenum.
Sometimes bile stone can cause this blockage.
Also excess bile acid circulation through the intestine in the absence of gallbladder can precipitate similar symptoms.
To check the sphincter of Oddi dysfunction or biliary dyskinesia you will need a test specialized to look inside the duct.
MRCP is one such good test --a noninvasive test by MRI but specially focused to check the pancreatic duct and sphincter od Oddi.
Sphincter of Oddi manometry is another good option.
ERCP is another test which is invasive that can be considered as well.

Best wishes,
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Customer reply replied 2 years ago
I'm 27 and no issues like this prior to the gallbladder removal. Wouldon't gastritis be observed during my endoscope? I've been on prevacid it helps slightly but the discomfort is still there. As far as SOD, would the ultrasound not of picked up on a stone blockage?
Doctor: Dr Basu, Experienced Specialist replied 2 years ago

Hi there,

I never mentioned about gastritis.

You are correct that is not likely --endoscopy would have shown that easily.

However, sphincter of Oddi will not show up in ultrasound or even in CT scan sometimes.

And lipase may not be elevated.

That is why you need a MRCP at least for further evaluation.

Best wishes,
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Customer reply replied 2 years ago
at this point would you be concerned that this is pancreatitis? I've lost some weight bit have also been really stressed about this. It's been mentioned that since my lipase levels are fine I shouldn't be worried, but can't you have normal levels and scans but yet still have cp?
Customer reply replied 2 years ago
My appologies, another Dr responded as well and he mentioned gastritis
Doctor: Dr Basu, Experienced Specialist replied 2 years ago

Gastritis is not likely.

That is a good concern --CP is still possible.

In fact Sphincter of oddi dysfunction can cause obstruction to the pancreatic duct drainage and can result in CP.

That is why it is important to get a MRCP first.

Best wishes,
It was my pleasure to help you today.
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Customer reply replied 2 years ago
Thanks for your assistance
Doctor: Dr Basu, Experienced Specialist replied 2 years ago

Very welcome

You should discuss with your gastroenterologist about this.

I will also suggest a dietary modification.

Avoid any fat in your diet.

Only follow a high fiber diet as tolerated.

Best wishes,
It was my pleasure to help you today.
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