Q: I am 24 years old. Last year I had a laparoscopic cholecystectomy (removal of gallbladder). After a few days I had mild pain on the right side of my navel but this pain was temporary lasting only a few minutes. Even after one year I still have pain over there, which occurs once in 3 days for a few minutes. It also occurs following exercise or a long walk. Sometimes I get severe pain in lower abdomen in the middle. What could be the reason for this?

A:This is a very vague history of pain and at first glance I do not think there is anything serious about this patient. After cholecystectomy it is very difficult to investigate abdominal pain. There are a number of situations in which pain can occur after cholecystectomy. The patient may have pain even before cholecystectomy; hence cholecystectomy obviously has not sorted out this pain. The pain may be due to irritable bowel syndrome. Other causes of pain would be hypertensive sphincter of Oddi, which I feel is unlikely, and I presume his liver function tests are normal. If his pain is severe he should be investigated along the line of abdominal pain and not necessarily have it associated with laparoscopic cholecystectomy.