sphincter of oddi problems after surgery

Hi, just wanted to know if any one out there is having post op problems as i am. I had my surgery 6-30-1999. they also took my gallbladder out. The last four months i have had severe pain in my stomach on both my left and right side of my naval and also in my back. My pain is only after eating. I have been through the gammat of tests and they always come up with nothing until now. They did a Hida scan and found out my sphincter of oddi is not functioning properly. Has anyone else had this problem or know of anyone who has? Pain pills do not help and narcotics make the pain worse or doesnt help at all. the pain is so severe at times all i can do is cry and moan and it lasts for hours without any relief. the longest attack was 12 hours of screaming and wantimg to die. I have found out that alot of people go threw this who have had there gallbladder removed even without bariatric surgery. Any thoughts on this would be helpful.

My initial thoughts are gall bladder. It is very common for a post WLS person to develop a bad gall bladder. And diagnosing gallbladder is sometimes tricky and takes a while. Doctors tend to depend on "tests" too much and not enough on intuition and plain ole feeling your abdomen. I would go to a surgeon and get an opnion. I don't know where you are at, but Dr. Smolik, a WLS surgeon in Des Moines, is also a general surgeon and very well able to put the fact that you have had bariatric surgery in persepctive with your present abdominal pain. The fact that you are post WLS means sometime. your anatomy is not just like everyone else's now. You need someone who knows what they are doing. If you don't like that idea, why not go back to your WLS surgeon and get their opinion? This pain you are experiencing is ridiculous to have to endure forever. I would be afraid of something bad going on in there and causing you to become septic. I had abdominal pain (from bowel obstruction) for only 6 hours and already was almost septic. The portion of my bowel that was affected had already turned black in that amount of time. Don't sit on this, seek more medical attention. Oh, and the pain pills not working, is probably due to malabsorption from your gastric bypass. See if the doc will prescribe it in liquid form for you. Lortab comes in liquid form. Keep us posted and let us know how you are doing. jean

Dear Jean As I have stated earlier, I have already had my gallbladder out at the same time i had my roux n y. I have found out that almost all patient who have had there gallbladders removed especially woman have this exact problem. The reason the pain pills do not work is also because of the extent of the problem. It is not because of my wls but because of this type of pain. Narcotics makes the pain worse for it shuts down your sphincter and causes more pain. I know that there are others out there who have to be going through what I am going threw. I would like to know what they have done and how there pain got resolved.

I had this for years after I had my Gallbladder removed. It was so bad at one point they gave me nitro glycerine for the pain. My husband would rub my back for hours. Sometimes tums of all things would work. Lea Ann

Jenny: what you're going through sounds like me! I had my GB removed at the same time as my RNY. I get "attacks" that usually wake me up from a sound sleep. The pain is a terrible cramping type of pain that goes through to my shoulder blade. The only thing I can do during these attacks is get up and walk around in circles until it passes. I try to control my breathing, rub my own back, and pace until it stops. (I'm sure I look psychotic!!) Sometimes it last longer than others. It might come several nights in a week, and then not for several weeks. I went to a regular surgeon about adhesions which were causing pain also. i told him about theses attacks, and he blamed it on being post wls, so I got no help there. My WLS Dr left the state, so I am just livivng with it. Please let me know if you find more out!! DeeAnn R

http://www.ercp.ucla.edu/pages/info/biliary/sphincter-of-Oddi-dysfunction.html http://www.ddc.musc.edu/ddc_pub/patientInfo/surgeries/pancreatic/page16.htm http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&disease=12&organ =3&lang_id=1 ERCP -- the procedure: http://www.ddc.musc.edu/ddc_pub/patientInfo/tests-treatments/interventional/endoscopies/er cp.htm Hi Jenny! I'm sorry that you are experiencing pain!! The John Hopkins site gives a lot of excellent information on SOD. I did a lot of research on SOD earlier this year. I was having URQ pain and after several tests, SOD became a suspicion (actually that I had asked about *rolling eyes*). I didn't believe that was my problem but I was asked to do the HIDA Scan which I did not. I chose not to do it because not only did I not believe that it was my problem but because what would happen if SOD was still suspect after a HIDA Scan was shady, scary, and without a large amount of success. SOD is a malfunction and/or spasm/ inappropriate contraction of the bile ducts that are still present after the gallbladder removal (it is possible to have SOD and still have the gallbladder - hence the different "types" of SOD to identify). At any rate, the best or "gold standard" of determination/confirmation/diagnosis of SOD is through an ERCP. An ERCP is an endoscope procedure whereby they go through the mouth and stomach to the bile ducts which empty into the Duodenum and measure the pressure of the ducts. Elevated pressure confirms SOD which can then be treated while there by using BOTOX or severing the ducts and/or nerve endings. The difficulty lies in that since we are post GBS, a Gastrointerologist can't just go in and check your ducts b/c the Duodenum has been bypassed and there is not channel to get there anymore. There are a few doctors who claim that there are two doctors in the USA (one here in Houston where I live) that can get there on their own who are highly skilled or the ERCP has to performed with the Gastro doc and the Bariatric Surgeon. A laparscopic procedure and endoscope would occur where the GD goes in with this endoscope after the bariatric surgeon has cut a hole in the pouch and then the scope is moved through the opening of the pouch to reach the bile ducts to measure and then treat. That sounded very frightening to me. At the time I researched this condition and possible remedies, the stats were that out of all the patients suspected of suffering from SOD, the ERCP confirmed only 20 percent actually had SOD. In addition, only 20% of those patients who were treated during the ERCP by the predetermined resolution reported pain relief/resolution of URQ pain. The numbers were too small for the risk -- at that time - for me - in my opinion. There are other possible medical treatments such as calcium channel blockers and anti-spasmotic medications that can be tried which are also used to treat other digestive spasms caused by IBS, Chron's, esophogeal spasms or others as diagnosed. As it turned out for me, I did not have SOD (I refused the scan, etc and opted for exploratory surgery) but was suffering from an internal hernia which had my bowel incarcerated in Peterson's space and a large mass of scar tissue (adhesion) both of which were causing abdominal pain. A few months later, when I suffered from a partial bowel obstruction and was experiencing spasms (rejection) of food, we had to try a few medications to control the spasms but finally found one that worked very well for me. The medication controlled the spasms enough for me to drink and eat enough to sustain my life until a diagnosis. Of course when the partial obstruction was later confirmed and repaired through exploratory surgery, the need for the medication was eliminated. I hope that you have found this information beneficial. I also hope that I've made sense (I am currently on a Morphine patch and I fear confusion of type, grammar, structure, and even spelling! If I have confused you, please feel free to ask specific questions on what I have shared and/or the information you obtain through your own research. You can get a lot of information through google if you key in "Sphincter of Oddi Dysfuction" and will be able to determine which sites are reputable. My email address is [email protected] if I can assist you in any way. I wish you all the best! Vanessa