Re: RUQ pain: Dawn

January 26, 2009

Dawn,

Thanks for your input. Interestingly, i do tend to sometimes get a colon spasm, but right after an ERCP. I was told that the reason is tje pushing of air during the procedure, i think. But that is in a different location. It will usually trigger nuasea and some abdomenal discomfort, but not an URQ pain. The Sphincter spasm that trigger your URQ pain, is interesting. And i am assuming that it did not occur after an ERCP. Have they told you what causes it? I am planning to mention that to my doctor, and he can determine what kind of a test i would need. It will be a miracle if that is the cause and muscle relaxers can help, plus a surgical procedure, if not. Because my type of URQ pain can be a high scale and ecxruciating and would radiates not only into back, shoulders, but arms, head-----etc. It has really been affecting my quality of life. The pain medicine is helping, but not at those

instants. And i do not want to increase the dose, because originally the medicine was used for depression and later for pain, too.

That is wonderful that they could determine your pain, source. Thanks again and i will let you know after i talk to my doctor.

Subject: Re: RUQ painTo: Date: Monday, January 26, 2009, 12:20 PM

,A while ago I had symptoms very similar to what you are discribing and they did some tests but I cannot remeber what they were called. But they determined that I was suffering from Spasms of the Sphicter of Odi. I was placed on a smooth muscle relaxer for a little while and it helped a lot, for the post part the don't happen any more, if the medication did not work, there was a surgical option. I don't know if this is what is happening to you, but I thought I would through it out there.Dawn >> > > > Hello Chaim,> > I am sorry to hear that you are suffering from the URQ pain. I have been, too, but for a good amount of time, now. Initially, it started as a mild pain in

my right upper, then very gradually progressed into a constant, moderate and sometimes intense and pinchy, kind of pain, that radiates into my upper right shoulder, back and if it is intense, then into the left parts, too and even the center. It would stay for a day or more and then i would go back into a mild to moderate, pain. I have read that some PSC'ers does have that same pattern. But, the majority and probably yours, might occur infrequently and with not much intensity, as mine. > > Antibiotics, might helps only if there is fever [i.e., infection in the BD]. And you know that too much of them causes an unwanted resistance. My theory was the usual understanding of having cholangitis. But my URQ pain, can exist with or without fever or other PSC known symptoms. I would go days, in mild and then suddenly it elevates and can be intense,

specially with my bowel irritation [iBD]. So only some months ago, my doctor came up with a reasonable explanation, in addition to cholangitis. That the nerves in membranes around the liver [as few in the groups has explained it too], might be sending some pain signals to other parts of the body. And in my case it is the IBD and UC, that is probably the cause. > > I am on constant pain meds, now. It is 30mg of Nortriptyline. But you you might not need them. The ERCP might help. And although my message is late, but good luck with the procedure and i do hope that you will feel much better, afterwards.> > > >

January 26, 2009

From what they explained to me, the sphinster of Odi is at the base

of the biliary tree at the bottom of the liver kind of, which is why

it causes URQ pain. The pain at times would start mild and then like

sart to let up and hit 10 all at once and sometimes it would just hit

10 and stay there some times it was 1-2 minutes and some times it

was hours. They checked me for billiary stones (my gall bladder had

been long removed) and several other things and then they ran this

other test. Here are parts of some articles and the links to the

complete articles with more information.

The sphincter of Oddi is a muscular valve that controls the flow of

digestive juices (bile and pancreatic juice) through ducts from the

liver and pancreas (the Ampulla of Vater) into the first part of the

small intestine (duodenum). " Sphincter of Oddi dysfunction (SOD) "

describes the situation when the sphincter does not relax at the

appropriate time (due to scarring or spasm). The back-up of juices

causes episodes of severe abdominal pain.

http://www.iffgd.org/site/gi-disorders/other/sod

Symptoms of sphincter of Oddi dysfunction:

The major presenting symptom in patients with sphincter of Oddi

dysfunction is abdominal pain. The pain is characteristically sharp,

postprandial, and located in the right upper quadrant or epigastrium.

The pain may be associated with nausea and/or vomiting, may last for

several hours, and may radiate to the back or shoulder blades. Fever,

chills, and jaundice are uncommon symptoms. Patients may also present

with acute recurrent pancreatitis

http://intmed.muhealth.org/gast/patient_resource/commondisorders/sphin

cteroddi.html

Hope these may be helpful

Dawn

>

> Have they told you what causes it? I am planning to mention that

to my doctor, and he can determine what kind of a test i would

need. It will be a miracle if that is the cause and muscle relaxers

can help, plus a surgical procedure, if not. Because my type of URQ

pain can be a high scale and ecxruciating and would radiates not only

into back, shoulders, but arms, head-----etc. It has really been

affecting my quality of life. The pain medicine is helping, but

not at those instants. And i do not want to increase the dose,

> because originally the medicine was used for depression and later

for pain, too.

>

January 26, 2009