Epigastric pain with normal testing
Hi, I was hoping someone here would have an idea of what may be happening or any testing I could have done. I am 20 years old and last year I had roux-n-y and hiatal hernia fix with my highest weight at 299. I had intense pain in my epigastreum especially when I ate for an entire month right after the surgery and lost 40lbs till my doctor did a upper GI swallow study which showed a Mesocolic stricture. He fixed the stricture and did a cholecystectomy which was full of small stones then nearly everything was perfect. I have had increasing pelvic pain every month and the occasional painful stomach again when I eat. I also have developed orthostatic hypotension which I practically had to beg to be put on something and am now on fludrocortisone and have nearly no symptoms of I take it every day. The most current problem and the one worrying me is that a month ago I had some awful bronchitis with hypoxia then put on steroids for a week which cleared it all up but since then I have been having again the intense epigastric pain that waxes and wanes but especially bad whenever I try to eat. I have had two ct chest/abd which only showed an ovarian cyst then the rupture of the ovarian cyst, a normal endoscopy of my pouch, another upper GI which was normal, a UA which showed that I was dehydrated and had ketones, and my blood work showed elevated chlorine, high absolute lymphocytes, high absolute monocytes, low total protein and low albumin. My surgeon admitted me to the hospital for four days and they were only able to finally document the postparandial hypoglycemia that I had been telling him about. Neither of us want to do surgery again but he says that if I continue to lose so much weight so quickly (I lost 7% of my body right in three weeks) then he will go in and put in a g tube. I am barely a year out and I would very much like to avoid a g tube so if anyone has any ideas about what this may be I would really appreciate it!
It's not perfect but I only lost another 6 lbs before halting. I still have pain but it's no where near as bad. I've oddly been having some crazy bruising so I've been taking off the fludrocortisone which is hopefully the reason. I was hospitalized for three days before starting the hyoscyamine and the lab work only showed dehydration and signs of not eating.
Turns out I more than likely have an ulcer in my remanent stomach which is improved on daily PIP but not healed. I also have a condition not directly from the surgery but due to the hormone changes and being so young that my vessels constrict when I stand for long periods kind of like a vasovagal response but not the vagas nerve. Some days I feel optimistic and others I regret having surgery but today I'm feeling pretty good so that's all I can say.
