Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Gallbladder problems?

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Gallbladders


I first had heartburn attacks in June of 1996. I continued having them intermittently. I also had some upper abdominal pain and itching toward the middle between my ribs and to the right that next fall. I got a mild case of shingles??? in that area ( I had recently started on a fairly high dose of estrogen after a hysterectomy). Finally in the spring of 1997 I went to a gastroenterologist and had endoscopy. He found esophagitis grade II, gastritis, and duodenitis at that time and started me on 30 mg of Prevacid. This helped for a while, but I still continue to have problems. Sometimes I feel a "gurgling" sensation in my throat and I get hoarse. I have never had food come back up, but do get a bitter taste in my mouth sometimes. I sometimes feel a tightness below my ribs that feels somewhat like the "heartburn", but it's more of a sick nondescript pain. Sometimes I have pain behind my sternum that feels like gas is stuck. This usually starts slowly, reaches a peak, then subsides in about an hour. Antiacids don't help. My stools have been pale, yellow, intermittently. I have burning and stinging sensations in my arms and legs, that I have been told is a mild neuropathy. I have occassionally had a severe pain in the right side that doesn't last very long. I have been on and off of antibitotics during this entire time for chronic low-level sinusitis. I keep "coughing" up small amounts of brown mucus. An ultrasound of my gallbladder showed multiple stones with shadowing a year ago. Another endoscopy at that time showed the esophagitis had cleared. A 24 hour pH moniter did not show reflux, but I wasn't having symptoms at that time. Another gastroenterologist said I might have to have reflux surgery. That is an absolute last resort. I can't get anybody to make sense out of any of this. I never had any of the symptoms until the fall of 1994 when I had a really bad sinus infection that I didn't get treated for a long time. I'm probably dealing with several things, but my doctor is now considering gallbladder surgery. I'm having a test to see if if is functioning correctly Thursday. After reading this forum, I don't know whethere to have gallbladder surgery or not. Do you think it will help any of this?

___
Dear Kathy,
Your symptoms are nonspecific. The physician is correct that the gall bladder is not functioning properly but it is not evident to me that your symptoms are the result of this gall bladder dysfunction. Moreover, it is not certain that removal of your gall bladder will make you feel better. The closer your symptoms are to classicial biliary colic ( RUQ pain that starts approx 45 min after eating and increases in a step-wise fashion to a maximum and then gradually subsides) or to acute cholecystitis, the more certain one can be that the symptoms will improve with surgery.

I suggest that you have a detailed conversation with your physician so that you can understand his thinking regarding surgery, before you make your final decision. It is possible that your doctor understands your symptoms differently than they way they were presented in your posting.

This information is presented for educational purposes only. Always ask specific questions to your personal physician. If you wish a second opinion, we would be happy to see you in the Division of Gastroenterology of Henry Ford Health System. You can make an appoinment with Dr. Ben Menahem, one of our experts in biliary tree diseaase, by calling our Physician Referral Line at (800)653-6568

HFHSM.D.-rf
*keywords: gall bladder, biliary colic
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