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Forum Name: Gastroenterology Topics

Question: No Gallbladder No Appendix Still Severe Pain


 LilFrog9499 - Wed Mar 14, 2007 11:23 am

I am a 38 year old woman with 4 boys. Last July I felt a knot just below my sternum that was very tender. The pain increased quickly. I have IBS mostly constipation on the norm. However, I had severe Diahrea with this pain in the beginning. That has changed but the pain has not. I had my appendix removed when I was 12 and my gallbladder removed 9 years ago. I went to the ER several times where they did x-rays and Contrast CT's. I then spent a week in the hospital where they did an CT angiography, ultra sounds, upper GI's, 2 endoscopies, and an ERCP where they inserted a stent into my bile duct (just in case I had stones left over). Supposedly my blood work is fine. They checked me for Chron's, Ciliac disease, and a cancer biopsy. I was referred to UCLA and my doctor there requested the lab here in Las Vegas to check for Acute Intermittent Porphyria. When the lab did the test here, my doctor said they didn't do the test right, so results are inconclusive. Sometimes the pain is so severe I throw up to try to releave the symptoms. I also seem to get the hiccups when going through the severe attacks, but the pain is constant. Now, I have gotten fired due to this medical situation and have lost my insurance. I've lost 20 lbs because it hurts so badly to eat. I am completely lost as to what I do next. Any advice would be much appreciated.
 Dr. Chan Lowe - Wed Mar 14, 2007 4:43 pm

User avatar Acute intermittent porphyria can cause severe abdominal pain. It is certainly relevant to test for this. The diagnosis supported by looking for elevated levels of porphorins and coporphobilinogen.

Elevated levels of lead can also cause significant abdominal pain. Other causes that should be examined if they have not yet are pancreatitis and hepatitis. Inflammatory bowel disease is likely to have been found on the endoscopy if it was present. I think IBD is less likely given your normal tests.

Abdominal pain can be very difficult to diagnosis. I recommend that you continue to follow up with your gastroenterologist.

Keep us updated. Hope this helps.
 LilFrog9499 - Wed Mar 14, 2007 5:46 pm

Dr. Lowe,

Thank you very much for your reply! I appreciate your time. Do you know of any programs where I could get this testing at no or low cost. My husband is the only one supporting our family at this point and yet the state says we make too much money to receive Medicaid. However, we are barely making ends meet at this point. Like I said I have 4 boys and my husband is paying child support for his two children. I am unable to work due to the severity of my daily pain.
Any suggestions would be much appreciated.

Thanks again!
 Dr. Chan Lowe - Wed Mar 14, 2007 7:02 pm

User avatar You fall into the "notch group" of people that don't make enough to purchase medical insurance but make too much for the governmental sponsored plans.

There are often clinics that are set up to offer sliding scale fees based on income. Those that make less pay less. You can likely contact your local health department. They should be able to direct you to such a clinic.

Best wishes.

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