Hep C Discussion Forum

Paul B · Senior Member

RE: Right sided pain.

mallani · Guru

Post Clolecystectomy Syndrome is well recognised.

Here's a current link:

http://emedicine.medscape.com/article/192761-overview

Paul B · Senior Member

I have had quite a lot of pain on the right side over about 14years. Had the gall bladder removed about six years ago and things improved, but gradually it returned and eventually it has become present all the time, though the position and intensity varies.

Diet does impact it. I love eating yoghurt but have given it up as I find that really exacerbates the problem. Strong coffee has a similar impact so I have given that up also.

I am hoping that when I complete treatment (in 20 weeks) that the problem will be resolved. One can only hope

Northern · Veteran Member

About 6 months ago was my last check and I was called cured at that point. It has been exactly one year now post treatment. I had a rough treatment. I was on Incvick, in and out of hospitals, in all total I got 6-7 units of blood and had to go on Procrit. My blood counts recovered nicely after treatment but within a month or 2 of completed treatment I went into Afib. This resolved after a DCCV and a new med. I know there is no past correlation with treatment, HepC and Afib but it just seemed strange that it happened then.

I did my 6 month labs, everything was good and about that same time my Lichen Planus started to become irritated. I had only a couple of spots of it left, on my right foot. It has not spread and I use a topical on it so I don't scratch it bloody But it has not developed any place else. About that same time I started feeling discomfort in my upper right quad of my abdomen. I just ignored this for a couple of months but it started increasing in instensity, becoming out right pain. I have been seeing the MDs and ultrasound and CT has turned up nothing. My GI Doc has talked about a invasive procedure that goes into the liver and looks at the bile ducts but this could cause more problems. Not going to do that. That's why I'm thinking milk thistle extract. If the liver is enlarge maybe this could help shrink it. Yes, I do have cirrhosis and the last US says I have portal hypertension now.

So I turn here, where there is decades of experience in this forum and see if anybody else has or is having right sided pain post treatment. That's it in a nut shell :) thanks everyone!

Tig · Admin

Hi Mike,

It's amazing when you realize the number of ways HCV manifests itself. I haven't met anyone that had trouble with Lichen Planus following Tx. I understand that it's a signal to test for possible HCV infection, but haven't heard an exacerbation of it from successful Tx. I have to ask, when did you have your last PCR? Although very unlikely, it might be worth ruling out a relapse (if you haven't already). Could there be a relationship to a medication reaction?When I read about the condition, there is mention of interferon (gamma) involvement and polymerase inhibitors. Could there be an immune response resulting from treatment being possible? May I ask, do you have cirrhosis? That can be a triggering event as well.

Thanks for sharing your information Mike. It's interesting to get the opportunity to research this a bit. I understand a lot of what I said is conjecture, but I hope through discussion we might find some ideas that lead to valid conclusions. Talk to you later and good luck! I hope you get some relief from these issues soon.

Tig

Northern · Veteran Member

Interesting, thanks but not sure that's the problem. My pain at that time was resolved after the removal of the gall bladder and that was at least 5 years ago now. This pain came on post treatment. Almost as if my liver is mad because the virus is gone. Another thing that is happening post treatment is I'm having flare ups of my Lichen Planus that has been in check for years while infected. It to seemed irritated since removal of the virus. Both these things started happening about 6 months post treatment.

Tig · Admin

That's an interesting article and not info you hear much about. I have seen many that had varying degrees of phantom pain post procedure, but it's good to know that there is a valid explanation of post op difficulties for those with real issues. One thing I noted in the article was the post cholecystectomy development of hyper bile production and its effect on the digestive process. I'm dealing with that and see the "eliminated" proof of it. Even though the gallbladder can be removed and most witness few if any negative after effects, it would serve the post op patient well to know that there are things to be aware of and to recognize as a result of surgery if they experience it. Good article, thanks for sharing it.

Tig

Harvoninme · Senior Member

Northern wrote:
I had my gallbladder removed a few years ago. That wasn't workimg right then and causing quite a bit of pain. About 5 months ago I started getting pains from my right upper quad, diffenitly from the liver area. I was just ignoring them for a while, then started taking OTC pain relievers, and as it get worse I started taking narcotics for the pain. It has been 3 months now with the narcs and it has not gotten any better. Matter of fact it has gotten worse.

Yesterday I went to the ER for it, labs where fine, I did expect to see a increase in lipase because the pain has also has started on the left too. CT was clear and I was partly relived in that but also frustrated as well. My GI MD is talking about a possible procedure that is invasive to look at the bile tubes but he warned me that could cause more problems than help.

Im thinking that my liver is enlarged and causing pressure around it. I don't want to take anymore narcs. I was thinking of trying a milk thistle extract. Any thoughts on this? Anybody else having post treatment upper right quad pain?

I had my gallbladder removed about 6 months ago and am also experiencing occasional pain in the area. I found this: (excerpt)

Postcholecystectomy Syndrome

[The term postcholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy.]

United States statistics

During the late 1990s, approximately 500,000-600,000 cholecystectomies were performed each year in the United States; most of them were laparoscopic. With at least 10% of patients developing PCS, approximately 50,000 or more cases of PCS occur each year. Study-to-study variability is great. PCS is reported to have been found in 5-30% of patients, with 10-15% being the most reasonable range.

McHardy found that 7.5% of patients with PCS required hospitalization.^[6]The international incidence of PCS is almost identical to that in the United States.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Good webicle with lots of information on PCS. Apparently, pain after gallbladder removal affects a good number of people. I also have an enlarged liver which surely contributes to my pain.

I'm trying to control it through diet. Certain foods seem to make it worse (especially too much sugar/starch or fat). Overeating definitely makes it worse. I did take milk thistle for a while, but it did not have any effect on my GB pain.

Do keep us posted. Hope you are feeling better soon!

Tig · Admin

Hey Mike,

We've discussed the use of Milk Thistle and other supplements quite a bit. It's a topic that has two distinct views here. One thing we do agree on is that you should never take any supplementation while on any treatment protocol because they will alter your liver function test results. Some believe they are a waste of money, while others believe they have served a vital purpose in their healthcare. Milk Thistle is claimed to be an excellent supplement to control liver inflammation. I took it faithfully for years and found that it reduced my LFT's and kept them lower. When I stopped using it to see what happened, my LFT's elevated. Whether it had a hand in keeping my liver healthier over the years I took it remains an unknown, but it didn't hurt and my biopsy score after 35 years was A2/F2-3. Some doctors encourage their use, some believe they are a waste of money. The choice is yours...

Tig

Tig · Admin

I agree that you can have gallstones that cause no immediate problems. In our ultrasound business we see our share of gall bladders, some with and w/o stones and I agree that there are dietary causes and fatty foods are often the culprit. There is both acute and chronic cholecystitis without stone involvement, but less often. That could be based on several factors though. There is also the possibility of a polyp that is causing an obstruction and is sometimes difficult to image. The BMI plays a part in that sometimes. We see the stones adhered to the GB wall as well as floating in the GB sac and they aren't causing any problems at all. When they obstruct the CBD, problems start quickly. But if they are present, the U/S tech and Radiologist should make note of them on the work up and report, that's important information. If there is limited or no apparent reason but the GB can't be ruled out, a HIDA scan should be considered to check the ejection factor, but like so many things, it's an expensive exam and insurance often hesitates unless it's a chronic problem. Isn't medicine wonderful!

Tig

Northern · Veteran Member

I had my gallbladder removed a few years ago. That wasn't workimg right then and causing quite a bit of pain. About 5 months ago I started getting pains from my right upper quad, diffenitly from the liver area. I was just ignoring them for a while, then started taking OTC pain relievers, and as it get worse I started taking narcotics for the pain. It has been 3 months now with the narcs and it has not gotten any better. Matter of fact it has gotten worse.

Yesterday I went to the ER for it, labs where fine, I did expect to see a increase in lipase because the pain has also has started on the left too. CT was clear and I was partly relived in that but also frustrated as well. My GI MD is talking about a possible procedure that is invasive to look at the bile tubes but he warned me that could cause more problems than help.

Im thinking that my liver is enlarged and causing pressure around it. I don't want to take anymore narcs. I was thinking of trying a milk thistle extract. Any thoughts on this? Anybody else having post treatment upper right quad pain?

Michaele · Guru

Tig . I have gallstones and never had bladder removed. The drs and I are all aware that there are stones there. So unless they are causing a blockage noted on US, they may say neg for cause of pain. Ive had a dozen or so US and they never even mention them, they are to busy looking at my liver or the cysts on my spleen and pancreas. But if a stone were blocking a duct; then they would mention it. North is an nurse, and I was an RN. Michaele

-- Edited by Michaele on Thursday 18th of December 2014 12:31:34 AM

-- Edited by Michaele on Thursday 18th of December 2014 12:33:46 AM

-- Edited by Michaele on Thursday 18th of December 2014 01:01:21 AM

Tig · Admin

The CT would've shown gallstones if there were any, so it's not that, but it could still be originating in the gall bladder and further studies would be required to determine it. I had mine removed after they discovered it would fill with bile but not eject it. That was painful! It certainly sounds like you need to present your symptoms to your doctor again. Narcotics can help but they aren't really a good long term solution when you don't know what's causing the pain. Let us know more when you get time.

Tig

Michaele · Guru

Hi , do you have gallstones, and if you do ; what did you eat?......Michaele

Could it be referred pain from gas causing pressure . If I dont move bowels I get wicked URQ pain

-- Edited by Michaele on Wednesday 17th of December 2014 10:18:52 PM

Northern · Veteran Member

Hi Guys!

I have been having a lot of right side upper quad pain. Labs are wnl and CT scan was negative. Been using pain meds to control the pain. Any thoughts as to what could be causing it. I'm at work right now and will give more details later but the pain is not getting any better. Thanks!

Hep C Discussion Forum

Postcholecystectomy Syndrome

[The term postcholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy.]

United States statistics

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