Severe abdominal pain

Hey guys, I am at a loss here.(post lap rny 3/08, gallbladder removed 7/08).  I have been having severe stomach pains since april.  the pain was so bad i went to the er in april, couldn't find anything wrong, saw my surgeon he decided to do exploratory lap(not expecting to find anything because all tests were normal).  I had surgery may 7, and i had intussusception.  now i am still having the same pains as i had before surgery.  I went to er last week for the pains had ct scans, egd(scoped) yesterday, all normal.  after the egd yesterday went to eat had a couple bites of chicken, black eye peas and spinach.  about 30 min later severe pain.  this pain is so bad i can't breathe,or move, i could scream.  I have to clench my fists to get through it.  the pain lasts about 1 min but comes in waves about every 5-10 min apart.  usually this last for 2 hours.  i get bloated, and after the pains my stomach is so tender i feel like i've been beaten.  i have been keeping a diary of what i ate and when i get the pains, seems like i get the pains weekly, not every day, and not always after eating.  i called my surgeon yesterday during the pain episode, spoke with them today, they think i am dumping.  now, i have a hard time believing this because i have dumped in the past and this is totally different.  not to mention the fact that i haven't changed my diet in the past 2 years.  the dr seems to think i am eating to many carbs, but why would i dump on white beans and rice if i've been eating this, probably weekly for the past 2 years with no problem?  i am very frustrated at this point, i am on FMLA leave for work. I feel like i am being blown off.  what if the intussusception is coming back or something else?  i just don't buy the dumping syndrome as an answer.  i am going to try a bland diet for a week to see what happens.  anybody out there have any of this, or any advice?

My wife has been going through similar episodes for about a year now. Initially, they thought she had cardiac problems. 3 days in CCU and every test under the sun ruled that out. Then they said it might be an abdominal hernia or adhesions. Back to the Bariatric Surgeon for a "look see" and the results were "nothing abnormal found". After several other visits to various doctors, she finally saw a Gastroenterologist who made a diagnosis of Irritable Bowel Syndrome. She's on a restricted diet as well as Citracell and an antispasmodic. His prognosis is, in about 6 weeks, all should be calm again. Hope he's right. Good luck with your situation.

The best advice I can give you is to listen to your body.  Do not worry about hurting a doctor's feelings, or feeling awkward, if you are not getting answers, then seek out the right doctor that has the most experience possible.  I would suggest a major university hospital or a place like Cleveland Clinic (where I have been going).  They do more of these surgeries and they have seen all of these problems, it's not a mystery or a guessing game to them.  It probably sounds like I'm bitter, but it is just that I have had so many issues from the surgery and suffered much longer than I needed to, and I don't want to see this happen to others.  Feel free to read my blog and email me if you have any questions.  Good luck and I truly hope you feel better and get to the bottom of this :)

thanks jbird1972, still to this day having nausea(taking zofran 2-3 times a day), pain and bloating.  And, after having an EGD with ballon enteroscopy last friday i have been running a low grade fever.  my GI and surgeon know about this but keep blowing me off.  i am getting mad at this point.  i am tired of being sick, the gi dr is not sure what is wrong and my surgeon told his physician's assistant that surgery(exploratory) will not show anything.  well i'm tired of the run around and told the PA that i want to speak with my surgeon myself.  funny, when i had surgery in may my surgeon didn't think he'd find anything but i ended up having intussusception and adhesions.  i feel like he needs to take a look since all other tests have been done, what else is there to do?  anyway, sorry for ranting, i just want some answers.

You are not ranting, I have totally been there.  I do not regret having WLS, my only regret in the last two years is waiting as long as I did, and trusting for so long before seeking medical help elsewhere.  I'm not saying that Cleveland Clinic is the only place that is good, or the only place that can help you, but I have learned that if you even feel a slight feeling of being put off, or feel uneasy about the doctors you have, you owe it to yourself and the people who love you to get the right minds on your case, ok, now I'm ranting :)

I understand the frustration as well but try having it since day 1 and now have other major vitamin deficiencies despite high dose supplementation, pain mostly upper left quadramt have been on zofran for 4 1/2 years along with promethazine.  i am getting work up at ucla right now can see my post that I did today with more info. 

Has any of the doctors suggested a camera endoscopy.  You swallow a small camera capsule that takes pictures from ingestion to excretion.  this way images can be seen that imaging studies may not be able to see?

Be your own advocate and if something does not seem right listen because only you know what is normal and know when something is not right.

Need be get second opinion.

thanks for the reply.  i have had 2 egd's and multiple ct scans.  all normal.  now throwing up almost everytime i eat and i'm scheduled for a hida scan tomorrow.  i called my dr to let them know about the vomiting and abdominal pain, they told me there is nothing they can do until i get the hida scan.  i was going to go to the er, but, i knew what would be done, so i sucked it up and stayed at home and dealt with it.  i know something is not right, but what i don't know.  my doctors just make me feel like it's all in my head.  i'll be seeking a second opinion soon.

GL with HIDA scan, if for some reason you are really bad off it will not hurt to goto ER.  In mean time start looking for physicians in your area that you can see for second opinion and make sure they are in network for insurance.  By doing some investigation now, and knowing which ones may be viable sources for second opinion will be helpful.  This way you have the info and give to primary care physician with name address phone fax and contact person in office.

Do what you think is right for yourself, listen to you, because only you know really know yourself no one else.

It is difficult when doctors think it all in your head and seem demissive. Letg them know you do not like the demissive tone and that it makes you feel insignificant.  Basically stating you do not like tone used and appreciate that it be used. 

After having gallbladder removed the liver continuously makes bile that is secreted into small intestine and stomach which is extremely irritating causing many digestive issues from nausea, pain, gas, bloating ect.  And yes gallstones can still be formed after the gallbladder is removed.

If the HIDA scan is inconclusive there is always the possibilityy of using a pediatric endoscope and do a modified ERCP and the pediatric endoscope can go further into small intestine and into roux limb so biopsoies can be taken from areas not done before.

Other idea camera endoscopy, even look at issues that may have been preexisting before surgery that manifested worse afterwards.

I will keep you in my thoughts of wellness and hope answers found soon.

mother1991,

thank you for the kind words, i'd like to keeep in touch with you and you can let me know how things are going with you and vice versa.  thankfully i have been doing good the past 2 days, no vomiting, just nausea and abd pain.  i am glad i posted, i was hesitant.  i don't feel alone in this. i feel like my surgery was/is sucessful, but are these problems related to gastric bypass or is this something i had before?  i had stomach problems before, GERD.  still take nexium for that.  my gi diagnosed me with ibs a few years before my GB, but he was grasping, not really sure what was wrong with me.  i'm looking into a second opinion, i'll give my surgeon and gi dr's this week to get results of the HIDA scan(the tech told me today during the test that i had a lot of reflux from my small intestine) but he could be wrong, have to wait for the official report.  i'll keep you posted and in my prayers.

that would be great i added you as friend.

i am not sure if you saw the post on how IBS actually shows brain differences compared to women that do not have.  the difference was in women who had pain as its primary complaint with IBS.  It is under roux en Y i believe.  if can not find it let me know and i can get it to you.  i even emailed the researchers to see if the same process could be for those after gastric bypass as well.  this just shows the brain gut hypothesis are correct and there is deffinately a change after symptoms so no longer a stress thing and no longer can be said nothing wrong