Definition: Persistent or recurrent abdominal symptoms (RUQ pain, flatulence, dyspepsia, diarrhea) weeks to years after cholecystectomy. c
Etiologies:
Biliary: Retained CBD stone, CBD stricture, cystic duct remnant, sphincter of Oddi dysfunction (SOD).
Extra-biliary: GERD, PUD, IBS, pancreatitis.
Functional: Bile acid diarrhea (excessive bile acids entering the colon, treated with cholestyramine).
Clinical features: Commonly RUQ abdominal pain associated with GI symptoms (e.g., nausea, vomiting, diarrhea), but often variable and often nonspecific