Amitriptyline/nortriptyline for abdominal wall pain

I understand your concerns about side effects of taking drugs to help a problem only to create different problems. You may want to review what others are discussing about adhesions and nerve entrapments. They may have ideas of non-medical options.

- Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES) Discussion
https://connect.mayoclinic.org/discussion/acnes-abdominal-cutaneous-nerve-entrapment-syndrome/
- Abdominal adhesion, symptoms, and therapy or surgery? Discussion
https://connect.mayoclinic.org/discussion/abdominal-adhesion-symptoms-and-therapy-or-surgery/
If you haven’t reviewed, here is information drugs your gastroenterologist recommends:
- VeryWell Health Nortriptyline vs Amitriptyline
https://www.verywellhealth.com/nortriptyline-vs-amitriptyline-similarities-and-differences-8410179
- Mayo Clinic Nortriptolyne Overview
https://www.mayoclinic.org/drugs-supplements/nortriptyline-oral-route/description/drg-20071998
- Mayo Clinic Amitriptyline
https://www.mayoclinic.org/drugs-supplements/amitriptyline-oral-route/description/drg-20072061
I am tagging @artemis1886, @findbecky and @emo. They may have information from their or a family member’s experience with amitriptyline or nortriptyline that may help you. While you wait for them, and others to comment here you may want to search for the drugs from the home page. From there you can browse through what others have been discussing.

You mention having issues. If you are comfortable it may help others to know how to comment if you provide more about the symptoms/problems you are having. Also, do you have specific concerns about either of these drugs, and do you take other medications that may interact?

@jlharsh
Thank you for your comments and information.
You asked about symptoms, currently my pain and discomfort is across my mid abdominal area mostly right and mid but is sometimes completely across. There are stabbing, tingling, needle prick sharpness, slight numbness, and when I lay on my stomach on the floor I feel that area almost as if it is tight or firm. The area where one of the laporascopic incisions was for the GB surgery, on the right side mid ab, is quite tender most of the time. None of the imaging I've done, CT or ultrasound, has shown anything. The Gasto Dr thinks either ACNES or adhesions, and is suggesting the amitriptyline. I've been hesitant to try it due to the side effects that may effect GI function. But the trigger point injection I had didn't do anything, and finding the nerve to do ablation might be problematic. I might just have to try the medication and see how I react.

@kremer1 It must be frustrating to continue feeling like you are chasing this pain and not finding answers. I understand why you want to find relief without causing other problems.

I was told by my doctors they wanted to help me by addressing one symptom at a time and that it would be a marathon. This was in 2021/22 (time blurs). We are making progress but there have been times that I have just wanted to quit. I do take medications but a lot of what helps is my diet and activity. I am absolutely bought into addressing each step as conservatively as possible because otherwise, like you I know it will be a trade off of dealing with something else. I say this, I guess to support conservative approaches. Various forms of physical therapy have been slow but super helpful for me.

I found an article preview published in Science Direct you may find interesting if you haven’t seen it. I particularly noticed in the Discussion section, “The diagnosis of entrapment neuropathies has many challenges. Often, those who are looking for a simplistic textbook case of predictable symptoms from patient to the patient will forever keep searching.”

- Conservative management of anterior cutaneous nerve entrapment syndrome: A case report
https://www.sciencedirect.com/science/article/abs/pii/S1360859220302497
Has your doctor recommended other more conservative things to try? Have you tried physical therapy?