Persistent Upper Right Quadrant and Back Discomfort Six Weeks Post-ERCP for SOD Type II
Greetings, I am a 45-year-old female, measuring 5 feet 4 inches tall and weighing 118 pounds. I do not smoke and am not currently taking any medications aside from occasional Tylenol. My medical history includes gallbladder removal in August 2024 and a diagnosis of sphincter of Oddi dysfunction confirmed in July 2025, which led to an ERCP with sphincterotomy on July 8, 2025. Following the procedure, I experienced mild to moderate acute pancreatitis, with a recorded lipase level of 540, necessitating a three-day hospital stay. Now, approximately six weeks have passed, and I continue to experience the following symptoms: - Upper right quadrant pain most mornings prior to meals. - A burning sensation and aching in the mid to upper back after eating, occasionally radiating towards the flank. - The pain often intensifies, reaching a peak of 5 to 6 out of 10, before gradually subsiding later in the evening. - Aside from this, my digestion seems normal. I am awaiting a follow-up appointment with my gastroenterologist, but I am curious if lingering pain after an ERCP and pancreatitis is a common occurrence, or whether this could indicate potential ongoing complications. I appreciate any insights you may provide.
Answers (1)
8/18/2025, 12:02:24 AM
OpenHealth AI
It's understandable that you're concerned about the ongoing discomfort after your recent ERCP and episodes of pancreatitis. While some residual pain can occur following such procedures, the nature and persistence of your symptoms warrant closer attention to rule out any complications.
Key Points:
- Discomfort after ERCP, especially if accompanied by a history of pancreatitis, can be common but may indicate the need for further evaluation.
- Symptoms like upper right quadrant pain and back discomfort may connect to several factors, including irritation from the procedure, residual bile duct problems, or ongoing sphincter of Oddi dysfunction.
Understanding Your Symptoms:
- Upper Right Quadrant Pain: This can stem from various sources, including the bile ducts, changes post-surgery, or digestive issues. It often occurs before meals when bile is released into the intestine.
- Back Pain (Burning and Aching): This may be linked to referred pain from abdominal issues or muscle tension due to altered eating behaviors or stress.
- Radiating Pain: If you notice the pain radiates, it’s essential to be mindful of how it correlates with meals and any other symptoms that may arise (nausea, vomiting, etc.)
Next Steps:
- Symptom Tracking: Keep a detailed diary of your symptoms, noting when they occur, their intensity, duration, and any food triggers. This will be invaluable for your gastroenterologist in assessing your situation.
- Dietary Adjustments: Consider smaller, more frequent meals and avoiding rich, fatty foods that may provoke your symptoms. Maintain hydration to assist digestion.
- Pain Management: Continue with occasional Tylenol for discomfort, but avoid pain medications that can irritate the gastrointestinal tract, unless prescribed. Monitor your response.
- Follow-Up Appointment: Prepare specific questions and observations from your symptom diary for your upcoming appointment with your gastroenterologist. This input can help identify whether imaging studies or further evaluation are needed.
In summary, while some discomfort can be typical following ERCP and pancreatitis, it’s crucial to communicate your specific concerns and symptoms with your gastroenterologist. This will help ensure you receive appropriate care and management for your ongoing issues.
Related Questions
Persistent Swelling of Lymph Nodes: A Cause for Concern?
Hello, I’m a 19-year-old female experiencing swollen lymph nodes for the past six months. The first one appeared near my collarbone, soon followed by one in my neck. Initially, I was unaware of what these lumps were, so I consulted a doctor who advised me to return if they didn’t go away. They didn’t, and he then requested a blood test, which, although limited in scope, returned normal results. An ultrasound was also performed, but I never received the results; I was merely informed that the lymph nodes were too small to be of concern. Unfortunately, additional lymph nodes emerged, and my previous doctor attributed this to anxiety, suggesting I might be imagining the symptoms. I sought a second opinion where I was diagnosed with Lyme disease and am currently undergoing treatment with antibiotics. At present, I have swollen lymph nodes on both sides of my collarbone, under my chin, in my groin, and at the nape of my neck, with what feels like a lump even behind my knee. Some of these nodes are tender, and I’ve observed that they appear slightly reduced in size in the morning, only to become much larger later in the day. Most of the nodes are soft and movable, except for one beneath my ear, which feels somewhat fixed. I regret indulging in internet searches about my symptoms, especially since I wasn’t taken seriously in the beginning. This has led to a surge of anxiety, particularly since I’m currently on vacation and unable to see a doctor. Although there are no particularly alarming symptoms now, this absence of symptoms is heightening my fears about potential asymptomatic metastatic cancer. I understand if I sound irrational; I’ve always had a deep-seated fear of that possibility which surfaces in my thoughts. I’m wondering if this condition requires urgent medical attention, even while I’m away, or if I should try to ease my worries instead.
Skin Rash on Chest and Neck During Illness
Over the past year, I have experienced episodes where I develop a prominent, splotchy rash on my neck and chest shortly after falling ill or receiving vaccinations. Specifically, this has occurred following a flu vaccination, two doses of the HPV vaccine, and during several instances of what I presumed to be a regular cold; importantly, COVID tests have consistently returned negative results. The rash appears bright pink and takes on a distinct inverted triangle shape, extending from the lower part of my chest down to my stomach, while also encircling the back of my neck in a U-shape. Additionally, I notice scattered patches across my chest. After researching possible conditions, I came across the term "viral exanthem rash." However, the images I found of viral exanthema show small dots or papules, unlike my rash which is characterized by a smooth, bright pink surface without any raised spots. Generally, this rash is not itchy or painful, though its size does make it quite noticeable. It tends to fade away once the illness resolves. Given that it emerges during various sicknesses, I suspect it might be an autoimmune reaction, but I remain uncertain if there is an underlying issue that warrants further investigation.
Experiencing Head Sensations Before Using the Toilet
A 30-year-old female weighing 90 kg, who uses a vape and has a history of second-degree heart block type 1 along with anxiety, is inquiring about a peculiar sensation. This individual is on medication, specifically venlafaxine. She reports that each time she visits the restroom, she experiences a tingling feeling in her head. This unsettling phenomenon used to occur frequently during her childhood, disappeared for a significant period, but has now resurfaced. Does anyone have insights into what might be causing this?
Navigating Ongoing Health Issues After Autoimmune Diagnosis and EBV Infection
**Patient Profile:** 33-year-old transgender male, Caucasian, Canadian **Medical History:** Hypothyroidism (normal TSH), Gender Dysphoria, Binge Eating Disorder **Surgical History:** Hysterectomy (December 2022), Double Mastectomy (June 2023) **Medications:** - Synthroid 175 mcg - Vyvanse 30 mg (discontinued due to severe fatigue) - Testosterone Enanthate 50 mg weekly (testosterone levels are normal) **Vitamins/Supplements:** None **Substance Use:** None Over the past year, I’ve been facing some minor issues related to my vision and bowel function. However, everything escalated in late April when I contracted Epstein-Barr Virus (EBV) for the first time. Despite not knowing it was EBV at the outset, I sensed that something was off, and my body felt unreliable. Night after night, I would awaken drenched in sweat, and while my fever peaked at 100.4°F, it typically hovered around 99°F. I felt achy, exhausted to my core, and my body ached inside and out. This state lasted for nine days of intense night sweats. On my scheduled visit to the doctor, my general practitioner advised me to head to the emergency room for quicker testing. Upon visiting the ER, I was mostly dismissed, being assessed simply for abdominal pain and with my fever having resolved. However, a series of tests commenced, including a liver panel, and when the results emerged, it raised significant concerns: - ALT - 489 u/L - ALP - 603 u/L - AST - 180 u/L - Bilirubin, Total - 49 umol/L Given that I lead a sober lifestyle and had normal liver function results just a year ago, these findings were alarming. To rule out contagious conditions, I was placed in isolation, while further blood tests followed, querying recent travel, unusual foods, or chemical exposure, none of which applied to me. Many vials of blood were drawn, showing elevated white blood cell counts amongst other abnormalities, but tests for common viral infections like COVID or measles returned negative. This led to imaging of my abdomen through a CT scan, which revealed an enlarged liver and spleen, dimensions measuring 21 cm and 16 cm respectively, but no significant damage was noted. An endoscopic ultrasound to check for gallstones yielded only signs of pancreatic fibrosis and prior gastritis without any acute concerns. With no clear diagnosis, the prospect of a liver biopsy loomed. Fortunately, a hepatologist queried about recent illnesses, leading to mention of my spouse's mild sore throat a couple of months back, which had cleared without serious issues. This prompted additional blood tests, uncovering crucial insights. **Epstein-Barr Virus Serology Panel Results:** - EBV VCA IgM - Reactive - EBV VCA IgG - Reactive - EBV anti-EBNA-1 IgG - Nonreactive Later, an **EBV NAT Panel** revealed: - EBV (DNA) NAT, Blood - Detected - EBV (DNA) Viral Load, Blood - 625,618 IU/mL - EBV (DNA) Log Viral Load, Blood - 5.80 Log10 IU/mL This warranted the cancellation of the liver biopsy unless my liver condition deteriorated (happily, after 4.5 months, my levels have normalized). Yet, my post-viral recovery has been troubling. Constant fatigue plagues me; I awaken feeling drained (having tested negative for sleep apnea previously) and now find myself exhausted after even the lightest tasks—reading, chores, or simply sitting and standing. This exhaustion manifests itself two to three days after exertion. I still experience night sweats, albeit they are milder now, and dizziness when bending over. I frequently need to rest, struggling to sustain any upright position for long due to weakness in my hands and tremors in my left hand when grasping objects. My previous level of physical activity has significantly declined; walking 20 kilometers daily is now reduced to a struggle to manage even 5 without feeling utterly drained afterward. Recently, I've also noticed increased visual disturbances that we ruled out as structural eye issues, and an MRI is on the horizon. Despite having encountered surgeries before, my recovery from this episode feels far less manageable. I understand that it hasn’t yet been six months since my EBV diagnosis, but my doctor remains perplexed by my ongoing challenges and has referred me to an internal medicine specialist. I am uncertain about the future or what this could imply for my health, though my desire to improve is strong. There has been speculation regarding the potential of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Additionally, I had already experienced bladder and bowel issues, along with vision problems that warranted the MRI, prior to this EBV event. Could these conditions be interconnected? With a family history of autoimmune diseases—my mother has multiple sclerosis and various relatives have autoimmune conditions—it adds to my anxiety regarding my health. I've urged my family doctor to permit my return to work, though he is cautious, clearly thinking it best for my wellbeing not to rush back into things. This caution frustrates me. Mental health concerns like anxiety and depression have been evaluated and deemed not to apply at this juncture. Despite everything, I maintain a positive outlook supported by a network of friends and family. **Next Steps:** What should I prioritize during my consultations with the internal medicine physician? Should I gradually push myself with exercise? What further tests should I consider requesting? Previously, I had an autoimmune panel that mostly returned negative results, only revealing a slight positivity in one. Recently, I also tested positive for celiac disease, but it was suggested that this could be due to the acute EBV incident, necessitating a follow-up test in six months. Would it be prudent to wait and observe until that timeframe?
Endless Wheezing and Frustration
(M18) Living with asthma has taken a turn for the worse as I have been dealing with persistent wheezing for an entire year. My physician prescribed omeprazole, but unfortunately, I have not experienced any relief from my symptoms. Without a car, I'm reliant on my mother for transportation, but she’s skeptical of my condition and believes I am exaggerating, especially since I appear to be in good health. The doctor advised me to return if my symptoms do not improve, yet my mom is unwilling to take me back. I'm at a loss for what steps to take next.