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Gastroenterology  (Expert Forum)
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Constant pain and nausea
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Constant pain and nausea

by Zydo, May 25, 2003 12:00AM
For about 12 years now I've had constant pain and nausea in the gall bladder area.  I've had endoscopies, upper gi's with barium, lower gi's, ultrasounds, catscans, but all have turned up nothing but mild reflux, which I took Losec for 6 months but didn't do anything for the pain or nausea.  Blood tests show liver functions normal.  The pain and nausea doesn't vary when I eat, but will vary over a period of several days or weeks and then a little better, but never going away.  Feels like a stomach flu or an infection.  The pain isn't a stabbing pain like gall stones, but a constant uncomfortable prickly, burning, pressure pain. I have had mild indigestion, constipation, bloating and gas, but have modified my diet to eliminate these things, and have eliminated every food from my diet to be sure that it isn't an intolerance problem.  Doctors are stumped.  I am at a loss as of what to do next.
Doctor's Answer

by Kevin Pho, MD, May 27, 2003 12:00AM
Hello - thanks for asking your question.



One consideration for unexplained gall bladder pain would be acalculous biliary pain (ABP).  One test to evaluate for this would be a HIDA scan with CCK stimulation.  



In people with normal gallbladders, the ejection fraction ranges between 35-75 percent. Patients who suffer from bouts of biliary pain and have lower ejection fraction readings are assumed to have ABP. Studies have shown that surgical removal of the gallbladder (cholecystectomy) helps ABP patients more than 90 percent of the time.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (6)

by surgeon, May 25, 2003 12:00AM
If it's been 12 years, the good news is it can't be something dire. If you haven't had a HIDA scan with CCK injection, you could consider it: it's a test of the function of the gallbladder. Some people have dysfunction even though the gallbladder itself appears normal on ultrasound.

by paty91356, May 25, 2003 12:00AM
I had something very similar to what you describe about 25 years ago.  I was so sick, I complained, fussed and whined long enough that I got a surgeon to remove my gallbladder...it was pathologically "normal", no stones, but I haven't had a minutes trouble since it was removed.

by glengariff, May 27, 2003 12:00AM
My husband has been suffering from lower abdominal pain for about two weeks.  We spent about 5 hours in the emergency room yesterday because he had finally had enough.  The blood tests, x-ray and sonogram all came back normal.  He is not in constant pain, but the shortness of breath is real problem for him.  The doctors from ER suggested that the shortness of breath was from his diaphram?  He also had a slight bit of fluid in his lungs, but they said this shouldn't cause the shortness of breath.  In reference to the ABP, would shortness of breath also be a factor?

by 4gpact, May 29, 2003 12:00AM
If the gall bladder studies are normal, you should request a gastric emptying test. You may have a disorder called gastroparesis; delayed stomach emptying. Your symptoms are certainly consistent. It is a very easy test, and will give you the answer to that question at least.

by erinye37, Jun 27, 2003 12:00AM
...I have had a gallbladder ultrasound, came back normal........monday I get a hiata scan done..........3 weeks of misery; sharp upper stomach pain with nausea, sharp left side pain, pain in lower back radiating down legs (sometimes legs feel so weak i want to collaspe), when lieing down everything is worse.........can't even work (especially in some areas at work it is 110 degrees plus....makes me real sick then).......at times I feel so sick I just wish I was dead (pitiful, sorry)......I need help bad....I am so tired of all this......no work with no more sick leave, how am I suppose to pay my Rent, and all other bills, which makes my stress level worse, and usually when my stress level is worse I get sick anyways........Somebody Help Me!!!!!!!!!!!

by tobycat, Jul 04, 2003 12:00AM
I have had nausea, abdominal pain on right side and diarrhea for about 2 months.  I have had a gallbladder HIDA scan, abdominal ultrasound, upper GI, colonoscopy, endoscopy and blood work.  

My gallbladder HIDA scan with CCK revealed an ejection factor of 21%, my liver enzymes are slightly elevated, I have fatty liver, moderate hiatal hernia, and acid reflux.  My GI doctor recommends having gallbladder surgery to remove the gallbladder.  I have had abdominal ultrasound but do not have gallstones.  I also have irritable bowel disease with constant diarrhea, nausea and pain in the lower abdominal