Resolved question:
Hx cholecystectomy in 2008, but have a gnawing ache on and off in the same place. Esr is 35 and crp is 5.1, at the moment, and I have that pain again. My liver tests are normal, apart from a low bilirubin of 3.
Could I have a gallstone again.
I am putting on weight too, so got my thyroid bloods done which are normal.
I have also noticed that I can't put my feet flat on the ground in the mornings after getting up. My mother has rheumatoid arthritis, and it took a long time to get the diagnosis right for her.
Submitted:
4 Days
Category:
Family Physician-GP
Hello and thanks for your queries at DoctorSpring.com.
I am concerned about the pain in the abdomen you are experiencing at the operation site. It is possible that you are experiencing complications of the cholecystectomy which could be anywhere from infection, stone reformation, to biliary strictures, post cholecystectomy papillary stenosis, or a remnant gall bladder. I suggest you make an appointment with your local surgeon (preferably the surgeon who performed the operation if possible, or any reputable surgeon) as you need to be evaluated as to what could be the cause of the pain.
Your ESR levels are suggestive of infection, however you will need to do imaging studies to be certain of the underlying condition. Imaging studies will include an MR cholangeopancreatogram and/or endoscopic retrograde cholangeopancreatic studies and possibly a chest x-ray to rule out conditions involving the medastinum. This will give your local physician a visualization of structural abnormalities if present.
In the meantime, watch for signs of jaundice, colicky abdominal pain, or esophagitis causing chest pain as these could be a sign of post cholecystectomy syndrome caused by the alterations in bile flow and reserve. This requires a full evaluation and further treatment may be necessary.
To answer your other question, about rheumatoid arthritis, yes it is also highly likely that you are suffering from the condition. Morning stiffness of joints and your ESR and CRP levels are highly suggestive of rheumatoid arthritis. Furthermore, there is a tendency for it to run in families. Another blood test you can do is a test for Rheumatoid Factor. If the pain is causing you quite discomfort, you can take ibuprofen for temporary relief. Make an appointment with a joint specialist or a general practitioner for further treatment with disease modifying agents for rheumatoid arthritis. Considering your concomitant illness, I would recommend steroid or glucocorticoid injections that can reduce the inflammation and not compromise your immunity to fight infections. Start therapy in consult with your local physician.
I would consider your abdominal pain a priority and suggest you make an appointment with your local surgeon first.
Hope this helps. Please ask any follow up questions if any. Take care and feel free to update me if any concerns.