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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19449
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have had severe stomach pain for over a week and was

Customer Question

I have had severe stomach pain for over a week and was hospitalised for 5 days due to suspected gallstones a mri scan showed that I have an abnormally large bile duct since my discharge on Wednesday I have been having recurrent stomach pain and bowel problems I also have type 2 diabetes which is out of control and hypertension can you help please
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

Was this a standard MRI or an MRCP?

What did the doctors provide for treatment when you were discharged from the hospital?

What is your blood sugar and blood pressure?

Customer: replied 1 year ago.
It was a mrcp Tey gave me analgesics and laxatives my BP was up at 200 over 150 and my highest be was 24.6
Expert:  Dr. D. Love replied 1 year ago.

Is you blood pressure still running this high?

What is your current blood pressure and blood sugar?

Customer: replied 1 year ago.
180 over 120 and 22.6
Expert:  Dr. D. Love replied 1 year ago.

Thank you for the additional information.

There are several issues to consider in this situation.

A dilated bile duct in someone that is suspected to have gallstones may be due to a gallstone that is trying to pass and gets lodged in opening of the bile duct into the small intestine. It is also possible that the gallstone has already passed, but irritated the bile duct opening into the small intestine, so that there is still some swelling after the gallstone is gone. An MRCP is more sensitive than a standard MRI at detecting a gallstone that is retained in the bile duct. If the MRCP did not see a gallstone, it is reasonable to try pain medicines for a few days while the swelling resolves, and see if the symptoms resolve. However, if the pain persists, it would be reasonable to consider the most sensitive test to detect whether there is a small gallstone that is still in the bile duct, called an ERCP. This is done through a scope that is placed into the small intestine. The level of urgency of when to perform the ERCP would depend upon the severity of symptoms. If the pain is continuing to slowly improve, then it is fine to give it some more time, but if the pain gets severely worse, then you may need to have the ERCP done more urgently.

Your blood pressure, though, is also an urgent issue. When the blood pressure is above 180/110, the current recommendation is to rest for a few minutes and then recheck the blood pressure. If either number of the blood pressure remains above 180/110, it is recommended that you should be seen emergently.

The treatment for the blood sugar should also be intensified, but it can be addressed after management of the blood preessure.

Of course, acute illness and severe pain anywhere in the body can elevate blood pressure and blood sugar, so any interventions to ease the abdominal pain can also help get better control of the blood pressure and blood sugar.

So, if the recurrent abdominal pain is more severe or the blood pressure remains above 180/110 after a few minutes of rest, it would be appropriate for you to return to the hospital.

If I can provide any further information, please let me know.

Expert:  Dr. D. Love replied 1 year ago.

Please let me know if I can provide any further assistance.