- Joined
- Sep 10, 2011
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- 693
Just a cautionary tale for anyone who has had a resection of the small intestine...
In March 2012 I had a right hemi-colectomy which later required a stoma reversal and up until a few weeks ago all was good in the world as I enjoyed a period of remission.
Then I started getting pain in the right upper quadrant, in the area above my stoma scar. Initially I just ignored it, like you do when you have a chronic illness, hoping it was just the normal sort of grumbles you can get that disappear after a few days. It felt a bit like indigestion and was uncomfortable, but nothing compared with an obstruction, so I didn't worry too much.
Then one weekend a few weeks ago, things took a turn for the worse and I realised that every time I ate a meal I was getting severe right upper quadrant pain. This would last a number of hours and I started to worry that I was heading for another obstruction. At the same time I also had a cold (or hay-fever), which made it even trickier to identify the underlying cause. In between the bouts of pain, strangely, I felt absolutely fine, but the only way I could avoid pain was not too eat.
After three days of eating only small amounts, my wife (who is a doctor) noticed that my eyes and skin were slightly yellow. She immediately recognised that I was jaundice and correctly identified the cause - obstructive jaundice caused by a gallstone obstructing a bile duct so sent me off to A&E (emergency room) where I was immediately admitted. A quick blood test confirmed I was jaundice and my bilirubin was off the scale abnormal (147 μmol/L, I think, when about 10 is "normal")
The problem with obstructive jaundice, is that it can lead to a very nasty condition called ascending cholangitis which can cause fatal septicaemia. Thankfully, I did not progress to this and following a number scans the following day (x-ray/ultrasound/CT/MRI) I had an ERCP under general anaesthetic which cleared the stone obstructing my gallbladder.
Due to the number of stones in my gallbladder, I have been told that I need to have it taken out. The surgeon has said he expects to be able to do it laparoscopically which should be a day procedure, but given my previous surgery and Crohns there is a risk I may need another open procedure. :-(
So, for anyone who has a damaged small intestine or has had a resection which has taken out part of your small intestine, just be aware that you are at increased risk of gallstones due to bile salt absorption issues and any pain in the upper right quadrant may be gallbladder disease rather than Crohns. Your gallbladder will secrete bile whenever you eat fatty food and if it is obstructed by a stone it will cause a constant, squeezing pain which does not come in waves like a bowel problem. If you become jaundice get to A&E immediately, as this is a medical emergency.
In March 2012 I had a right hemi-colectomy which later required a stoma reversal and up until a few weeks ago all was good in the world as I enjoyed a period of remission.
Then I started getting pain in the right upper quadrant, in the area above my stoma scar. Initially I just ignored it, like you do when you have a chronic illness, hoping it was just the normal sort of grumbles you can get that disappear after a few days. It felt a bit like indigestion and was uncomfortable, but nothing compared with an obstruction, so I didn't worry too much.
Then one weekend a few weeks ago, things took a turn for the worse and I realised that every time I ate a meal I was getting severe right upper quadrant pain. This would last a number of hours and I started to worry that I was heading for another obstruction. At the same time I also had a cold (or hay-fever), which made it even trickier to identify the underlying cause. In between the bouts of pain, strangely, I felt absolutely fine, but the only way I could avoid pain was not too eat.
After three days of eating only small amounts, my wife (who is a doctor) noticed that my eyes and skin were slightly yellow. She immediately recognised that I was jaundice and correctly identified the cause - obstructive jaundice caused by a gallstone obstructing a bile duct so sent me off to A&E (emergency room) where I was immediately admitted. A quick blood test confirmed I was jaundice and my bilirubin was off the scale abnormal (147 μmol/L, I think, when about 10 is "normal")
The problem with obstructive jaundice, is that it can lead to a very nasty condition called ascending cholangitis which can cause fatal septicaemia. Thankfully, I did not progress to this and following a number scans the following day (x-ray/ultrasound/CT/MRI) I had an ERCP under general anaesthetic which cleared the stone obstructing my gallbladder.
Due to the number of stones in my gallbladder, I have been told that I need to have it taken out. The surgeon has said he expects to be able to do it laparoscopically which should be a day procedure, but given my previous surgery and Crohns there is a risk I may need another open procedure. :-(
So, for anyone who has a damaged small intestine or has had a resection which has taken out part of your small intestine, just be aware that you are at increased risk of gallstones due to bile salt absorption issues and any pain in the upper right quadrant may be gallbladder disease rather than Crohns. Your gallbladder will secrete bile whenever you eat fatty food and if it is obstructed by a stone it will cause a constant, squeezing pain which does not come in waves like a bowel problem. If you become jaundice get to A&E immediately, as this is a medical emergency.
