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Severe Epigastric Pain - HCV active infection
Jul 31, 2001

For 2 years, I've experienced severe upper (middle) abdominal pain (off and on). I've also had severe insomnia and fatigue (duh!!) Anyway, after several scrips for ulcer and acid reflux (not to mention the anti-depressants), none of which had any effect, I became fed up and scheduled a GI appt. He found out that I had HEP C (stage 1 fibrosis and stage 2 inflammation) and gallstones. I had my gallbladder removed. Horrible experience. The closure leaked and for 2 weeks I was "pickling" my organs in bile. This causeed perionitis and it almost killed me. After recovery from that (2 months) I began Rebetron therapy. I've been on for 3 mos. now. Normal symptoms, tired, forgetful, aches, etc. 2 months ago, my severe upper abdominal pain came back and is a lot worse now. The pain is intolerable and lasts for 15 to 45 minutes and occurs at least 3 times per week (sometimes 7). My GI did a CT with contrast. Found swollen lymph nodes and a "lesion" on my liver. ?? He thinks it is a cyst and all is reactive to the previous infection. Doesn't think any of that can cause the pain "attacks" I'm having. He will look again in 4 mos. Lately, I've taken Librax, - no help. The "attacks" are increasing in frequency and I am at the end of my rope. Any ideas?? I am 36 years old. I believe I've had HEP C for 16 years.

Response from Dr. Dieterich

Well for one thing, now you can switch to pegylated interferon and ribavirin, that should make your life easier. I would add medication for the stomach and maybe do an endoscopy. The other thing that your MD should think of is post cholecystectomy syndrome or a retained bile duct stone. To treat that I would use ursodiol to dissolve small stones, but to diagnose a common duct stone, I would do an ERCP. Ask your MD about these things. Good luck! DTD



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