instruction: i have had a history for years of abusing co codamol often taking ex 30 500mg several times a day I have some mild right upper quadrant pain that is persevered for a few weeks after stopping all codomol use over the last year I have had abdominal al ultrasounds many liver function tests and urinalysis which have all come back in normal ranges or clear I have been told sometimes the liver can still be damaged but still present normal liver function tests and it can be hard to see on ultrasounds is there a chance I have some liver damage
output: hello I welcome you to icliniq first of all I give you a vote of appreciation that you were able to stop using co codamol for chronic users of these opioid medicines it is merely impossible to stop well once you stopped taking these medicines it is unlikely that the effect will remain within you and can harm you in long term so I do not think that you should be worried about this now the pain you mention which has started nearly at the time of stop of these medicines suggest narcotic bowel syndrome nos in nos the patient became insensitive to the usual doses of opioids and kept on increasing the doses to relieve the same amount of pain intensity with subsequent higher doses this happen because of chronic use of these medicines would potentially increase the numbers of receptors controlling pain once the medicine is reduced in dose or completely stop in your case a rebound pain develop and it remain until another painkiller or similar opioid is restarted so actually it is vicious cycle pain and increased dose cycle is sometime inevitable and requires a close monitoring of switching to other safe painkillers while at the same time decreasing the dose of opioids the treatment is termed as opioid detoxification therapy to be honest I am not an expert in it but tried my best to explain to you to help you understand your symptoms if you want further guidance on how to control your pain which is possibly be secondary to nos I suggest you to meet with pain management specialist in near by hospital since you already stopped the medicines I suggest to use paracetamol which is rather safe medicine for controlling pain plus you can use cap pregablin 75 my at nigh time daily to control your symptoms I hope this will help you take care and have a good day narcotic bowel syndrome nothing pain assessment only functional abdominal pain syndrome nerve entrapment syndrome nos tab paracetamol which is rather safe medicine for controlling pain plus you can use cap pregablin 75 my at nigh time daily to control your symptoms follow up if you have any concern or want to discuss nos in detail and its management