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I have history of bowel obstructions over several years but…

I have history of...

I have history of bowel obstructions over several years but not over the last 5 or so, I have lower right quadrant pain and right sided back pain in liver area, I have recent history of liver bile duct stones as well. My pain is at level 5 to 6 all day and last night as well.i deal with extreme diarrhea for 10 years.but not today which highly unusual. I have not slept last night, or through the day and tonight I cannot sleep because of the pain. This evening, since pain got worse I took 2 five milligram Lortabs since pain was level 10, about hour later I vomited lunch and I did try a very small meal this evening which has caused nausea but so far I have not vomited but no sleep from pain either. What should I do?

Doctor's Assistant: Have you had any recent injuries? What seems to make the pain better or worse?

Since my husband cannot lift I had to lift several boxes yesterday that I know is a contributing factor and with around 12 abdominal surgeries with formation of Uristomy on left side 13 years ago I have overdone. And I am minus right kidney as well. Been healthy over last several years however.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

R kidney removed for stone damage but the pain is all right sided and at level 8 to 9 this evening about 7 now and climbing a bit

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Answered in 19 minutes by:
3/27/2018
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,259
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Can i ask did you have the gallbladder removed after the stones were diagnosed? Currently do you have tenderness (pain on pressing down on the abdomen)? Any fever?

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Customer reply replied 1 month ago
Gallbladder removed years ago.last year a stone formed in the bile duct and was removed. No fever and yes tenderness lower right quandrant

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins.

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Customer reply replied 1 month ago
I know it would be easier to talk but husband and 7 year old daughter sleeping.

The phone call request is an AUTOMATED site response, i did not send it, i am writing down your answer just a few minutes.

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The presence of tenderness in the region along with radiation of pain to the back can be indicative of a couple of conditions. The first one which comes to mind is that there could be a stone in the ureter (if it was not removed along with the kidney) that could cause pain of this sort to occur as well but it is more likely that a stone in the bladder can also cause this sort of pain. An ultrasound would be diagnostic in this situation.

The second possibility can be that the stones have formed in the bile duct again and that is leading to the development of this sort of pain. The diagnosis again can be with an ultrasound of the abdomen or if necessary an MRCP of the region can be done again.

If you still have your ovaries and uterus then it is possible that this is an infection of the female genital tract which can lead to this sort of pain as well. Again the ultrasound would be diagnostic in this situation. Simi9ialrly ovarian torsion can cause this sort of pain as well and it can lead to the death of the ovary if not treated in time.

You have mentioned 13 surgeries, that could mean that you could have developed intestinal obstruction especially if you are unable to pass stools or air. This can develop because of formation of adhesions within the abdominal cavity which can lead to this sort of [problem. An x-ray of the abdomen along with an ultrasound of the abdomen would be diagnostic here.

the fact is that you have tenderness in the abdomen which is not improving and given this situation, it is imperative that you have this evaluated in the ER. Appendicitis is a possibility if it has not been removed previously as well. You can use OTC ibuprofen for the time being at a dose of 800 mg but I would STRONGLY suggest that you do visit the ER.

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Dr. Muneeb Ali
Category: Medical
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Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Customer reply replied 1 month ago
I was afraid you would say this. Been down that rode of obstruction several times. Unforunately. The pain not as severe but a day without 6 or more loose and liquid stools highly unusual fo me, been chronic for last 14 years due to formation of urostomy than several of these issues, but I will endure until later in am so daughter can get to school and won’t have t deal with momma being sick and we can get her to school. Thank you Doctor, unless it gets worse I will endure for my daughter than traumatizing at this point.

I understand your situation, just keep a close eye on it, dont let it get too worse.

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