Abdominal Pain - Internal Herni

**Don't know why it was posted twice!! Admin can delete the other one!!**

Hi, all! Long time lurker, finally joined and a first time poster. I had my LRNY on 12/24/2018 with little to no issues in my 3.5 post-op years. I dropped from almost 370 lbs to 185. I'm currently sitting at the 215 mark as my nutritionist and surgeon felt this was the best weight (I felt better at 190, so I'm working that way again)!

A week ago on Saturday, I woke up with some of the worst cramps I had ever experienced. 7-8 pain scale. These same cramps occurred almost a year ago, the intensity wasn't as bad then (5-ish?) It came in waves of cramps that lasted for a minute or two and subsided for 15 minutes over the course of about an hour and a half. It was mostly gone after a bowel movement. Woke up the next morning and was pain free for nearly a week. Today, I had a little more cramping (2-3 pain) but this time is started right after I ate and only lasted about 10 minutes and was gone. No nausea, vomiting, or fever. No constipation or diarrhea to speak of.

I'm currently out of town, but planning on leaving in the next two days. I called my bariatric surgeon and his office had an opening in a week, but they would put me on the cancellation list. That's never worked in the past...

My case would be a bit different as I'm on warfarin for a blood clotting disorder. My initial surgery was considered "high risk." I had an IVF filter placed 10 days pre-op and removed 1 month post-op. Emergency exploratory laparoscopy would be out of the question as I would need time to reverse the warfarin and have a filter placed. This is the reason I'm not going to the ER. It was enough of battle to do the WLS in the first place. Took me 5 years to finally decide.

Any ideas? I'm fearful of IH because of the need of another surgery that would almost be emergent. And I've read internal hernias drop in prevalence around the 3 year mark and I'm only 3.5 years out. My anxiety is kicking into overdrive.

Thanks! This community has always been a huge help for this long-time lurker!

Could be gall bladder. I hope you feel better soon.

Many of us ended up with gallstones and gall bladder surgery

Last year (about this time, maybe around April??) they found gallbladder sludge, but no stones. They said they would keep an eye on it. Guess it's time to have another looksie at it!

I didn't have stones but my GB was full of sludge. Plus I had Peterson space type hernia that was fixed at the same time.

It can also be constipation. Even if you have BM regularly, but not a complete BM, eventfully the large and small intestines' can become impacted and cause pain and cramps, specially if your GB is not working properly.
The gas that may start forming in small intestines may not have a space to go and start expanding the small intestines causing pains.

testing may show what is going on. May be a combination off all of the above.

PS: when I travel my routing is often off. I don't drink enough water, don't have my routine, so I often get more constipated than normal and I sometimes end up with a very nasty gas pains and cramps. That is one of my not-so pleasant long term side effect from RNY. It sucks, but it is what it is.