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Old 10-27-2009, 02:29 PM   #1
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right shoulder blade pain and nausea for 2 years

I have been suffering with right shoulder blade pain and nausea for 2 years. Sometimes I have constant nausea for 4 or 5 weeks at a time and almost continuous burning pain on the inside of shoulder blade.Also tender over liver area. I had a HIDA scan which showed gall bladder not performing so had it removed last April. Pain continued so had a series of tests which included CT scan of abdomen and liver ultrasound because of mildly elevated LFT's. Gastroenterlogist does not think it is Sphincter of Oddi as he said pain is more intense and under ribs. Was taken off cholesterol medication and told not to drink any alcohol for 6 weeks. After this, new liver tests showed high normal LFT's. Now just don't know what to do next. I have also in the last few months developed constant ache in right jaw as well. Has anyone have any idea what might be going on ?

 
Old 11-01-2009, 11:02 AM   #2
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Re: right shoulder blade pain and nausea for 2 years

Hi, statins can have unwelcome side effects such as muscle pain. Liver enzymes can become elevated. Even though you stopped taking the statins it may take a while for your muscles to recover, and your LFT to show normal..

Pain in right shoulder blade can be referred pain from anywhere in the upper abdomen. It is sometimes due to g/bladder inflammation, but not in your case as you had it removed.

I have chronic pain in my right shoulder. In my case it is due to chronic small bowel inflammation with probable stenosis having caused a stricture. I am awaiting small bowel barium swallow xray to confirm this. I also have frequent problems with nausea.

Small bowel conditions can be difficult to diagnose. I have had 6 different xrays or scans over 4 years, all which reported nothing worrying until recently when a very vigilant experienced sonographer found significant changes in the small bowel that were there all along (as I had the same symptoms for 5 years)..

Have you had any small bowel investigations?

One thing that might help you in the short term, is to try a liquid diet for a few days, or a week if you can manage it. Home made soups, freshly made fruit juices and veggie juices are all good. I have found the liquid diet has really helped to keep the nausea at bay, and a lot of the pain too. What I do is make a big pot of soup (usually chicken, or pumpkin, or lentil, or mushroom) at the start of each day and drink it all day long.

 
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Old 11-01-2009, 03:48 PM   #3
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Re: right shoulder blade pain and nausea for 2 years

Quote:
Originally Posted by suejan View Post
I have been suffering with right shoulder blade pain and nausea for 2 years. Sometimes I have constant nausea for 4 or 5 weeks at a time and almost continuous burning pain on the inside of shoulder blade.Also tender over liver area. I had a HIDA scan which showed gall bladder not performing so had it removed last April. Pain continued so had a series of tests which included CT scan of abdomen and liver ultrasound because of mildly elevated LFT's. Gastroenterlogist does not think it is Sphincter of Oddi as he said pain is more intense and under ribs. Was taken off cholesterol medication and told not to drink any alcohol for 6 weeks. After this, new liver tests showed high normal LFT's. Now just don't know what to do next. I have also in the last few months developed constant ache in right jaw as well. Has anyone have any idea what might be going on ?
My summer was spent taking all kinds of test. They found nothing wrong with me. All my symptoms started when I got my gallbladder removed. I had to do my own research and found out that it was too much bile being released in my stomach because I no longer have a gall bladder to hold it anymore. I was experiencing pain under the right rib, real bad indigestion, diareahea, phantom pains throughout my body. My sinuses got worse too and I experience intense jaw pain and shoulder pain. I know I have a fatty liver which I am controlling my losing weight. Recently, I had my blood checked and my liver enzymes were slightly elevated. What I do now is really watch what I eat - my food is bland and i avoid all carbs. I just eat like a sweet potato no carbs that are white in color. I notice my pain in my liver area has reduced. I take Welchol for the bile assorbption. The jaw pain I guess is from the stress and pain of the liver so I think I grind my teeth at night and don't realize it. Gas in your stomach can spread throughout your body and cause your shoulders to hurt. Yoga works for me and acupuncture too.

 
Old 11-01-2009, 03:51 PM   #4
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Re: right shoulder blade pain and nausea for 2 years

do you have stress in your life right now. I had so much stress it caused me to get gastritis - I also had nausea with every meal. As soon as I controlled my nausea and calmed down the nausea went away. That is what I went through anyway. Have you had an endoscopy done yet?

 
Old 11-02-2009, 01:30 PM   #5
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Re: right shoulder blade pain and nausea for 2 years

Thanks for the replies. Have had an endoscopy. Would that have shown inflammation or stricture in small bowel? Also my symptoms were there even before having gall bladder removed. Saw gastro doctor yesterday who said only three things cause right shoulder pain - gall bladder, liver or back. He thinks my pain may be caused by back problem and that nausea is a separate thing, which I don't believe as the symptoms get worse together and calm down together. He called my nausea functional dyspepsia and asked if I was depressed!. I told him definitely not and the only thing that gets me down is when I feel like throwing up day in and day out! One of the medications I was given to try is sucralfate, which is really a duodenal ulcer medication which lines the stomach. I have been taking it for a week and symptoms seem to have improved a bit. One thing I have found is that whatever medication
I take for the nausea, it only works for a few weeks and then have to go on to something else..

 
Old 11-03-2009, 05:56 AM   #6
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Re: right shoulder blade pain and nausea for 2 years

Hi suejan, I must respectfully differ in opinion from your doctor, as I have right shoulder pain and I do not have anything wrong with my g.bladder, liver or back. The pain in my shoulder developed 5 yrs ago at the same time as the abdominal pain. If I go on a liquid diet the pain in my bowel lessens because there is less congestion, and the pain in my shoulder lessens too.

An endocsopy would not show the whole of the small bowel, only the first part, the duodenum, so if you had a stricture lower down, it would not show.
The usual small bowel tests are an u/s scan of the abdomen, or a barium swallow small bowel follow through. Sometimes a capsule endoscopy might be used for the small bowel (you swallow a pill sized camera which transmits pictures to a receiver for 24 hrs).

However, my radiologist says none of these tests are good at detecting strictures, as the small bowel needs to be under pressure for them to be seen. The barium swallow is perhaps the most useful in this respect, but still the bowel is not under pressure, as the barium only trickles through from the stomach, and once the stomach is full the patient cannot drink any more without feeling very nauseous. But, if the radiologist is prepared to take plenty of time, and is very observant, it is possible a stricture could be seen.

The state of the art test for small bowel is the Double Balloon Enteroscopy.
It was developed in Japan in 2001, so there are not many places doing it yet, mostly hospitals that specialise in bowel dieases. In fact the test needs to be done by a very experienced operator as there are risks, which can be minimised if the operator is skilled. A tube is put down the throat through the stomach into the small bowel and the small bowel is examined in minute detail. Biopsies can be taken, and even some therapies given this way. Sometimes the tube is put through the rectum, & colon into the small bowel, depending how far up the bowel the stricture is suspected to be. The test can be given under sedation, or under general anaesthetic. If under sedation the patient is usually Ok to go home the same day.

Feeling nauseous a lot could be a symptom of stricture, as narrowing causes the bowel to be under pressure, and it is the constant pressure that can cause the nausea. As a test, have you tried going on a liquid diet for a couple of days (soups, juices) to see if it makes any difference to the nausea? Liquid diet usually reduces the pressure in the bowel and also gives the bowel a bit of a rest if there is inflammation.

Last edited by coolbunny; 11-03-2009 at 05:59 AM. Reason: typo

 
Old 11-03-2009, 10:21 AM   #7
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Re: right shoulder blade pain and nausea for 2 years

Suejan ~ just to add to my earlier remarks, that with the capsule endoscopy, if there is suspicion of a stricture the patient is given a dummy pill to swallow first before the camera pill is given. This is so that if the dummy pill gets stuck at the stricture it will dissolve and pass harmlessly out of the body. Whereas if the camera pill were to get
stuck it would have to be removed by surgery.

Some radiologists like to give the dummy pill and then track it in the body with partial CT scan, so the exact point where it sticks (if it sticks i.e.) can be identified.

 
Old 11-04-2009, 02:05 PM   #8
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Re: right shoulder blade pain and nausea for 2 years

Hi coolbunny,
Thanks for info on procedures, very interesting. Was wondering do you get nausea and shoulder pain at the same time that intensifies together and do you get it even when you are on a liquid diet, or have you had long periods with no problems? Mine seems to have no pattern, have even tried fasting to see if that makes it any better but does not seem to have much effect. You must be so frustrated after five years, I hope I can get an answer before that long!
My situation is a bit more complicated as I also have Factor V Leiden which is a blood clotting disorder and just before onset of symptoms, I had a pulmonary embolism, a clot that passes through heart to the lung. Doctors don't think there is any connection but have referred me to a cardiologist later this month, to rule it out. I still definitely think is is connected to digestion, but have to wait for the outcome of this appointment, before i can book another appointment with gastro doctor. The thing I get upset about is that after numerous tests etc, you really do get the feeling that the doctors are no longer taking you seriously. On occasions I have felt like giving up trying to find out what is wrong and just get on with it, but then when I get a really bad day or week, it gives me a push to carry on. Let me know the results of your tests, it will be good for you to get an answer now

regards

 
Old 11-05-2009, 11:00 AM   #9
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Re: right shoulder blade pain and nausea for 2 years

Well yes of course it could be many different things not functioning right admist your biliary tree, however I can tell you, that you are probably jaw clenching in your sleep from the pain and stress and causing some TMJ. See a dentist, whether this is TMJ or trigeminal nueralgia, this is a separate issue.

 
Old 11-05-2009, 05:41 PM   #10
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Re: right shoulder blade pain and nausea for 2 years

hi suejan ~ yes I do get the nausea and the shoulder pain together, and if one intensifies so does the other. But both are less if I am on a liquid diet.

My pattern of illness from teenage yrs onwards was regular bouts of inflammation & pain in the small bowel for about a week, then I would be fine for months afterwards as long as I kept to my diet. This is a usual pattern with Crohn's -- flares every so often.

What changed 5 yrs ago is that the pain has been constant, no respite at all, just less severe sometimes. I did not know why the pattern changed, but it has turned out to be due to a stricture which has developed over the yrs due to the many bowel infections I have had due to the Crohn's.

I am sorry to hear you had a pulmonary embolism, that must have been very scary for you. It is hard to know for sure, as you say, whether your other health issues are affecting your digestive problems....it seems unlikely, but on the other hand it is amazing just how systems are interlinked in the body.

 
Old 11-07-2009, 12:46 AM   #11
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Re: right shoulder blade pain and nausea for 2 years

Hi coolbunny,

Sorry to hear you have had to deal with Crohn's- such a debilitating condition, I hope you can get the stricture sorted out.

I am just taking each day as it comes and think that eventually I will find out what is wrong, even if it takes something bad to develop to get it sorted. I think of all the people who are living with horrendous problems and realise that I can live with mine, uncomfortable though they are.

Best Wishes

 
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