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Gall Bladder Symptoms???
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Gall Bladder Symptoms???

Has anyone that has had gallbladder problems experienced anything similiar to what I am going thru? (or does this problem sound like something else?)

For the past 2 yrs I have had pain in the upper rt abd area that has varied from severe to mild.  When the pain is severe I would definately describe it as "an attack".  When the pain is bad I sometimes get pain under the right shoulder blade also and have a general feeling of not being well.  

Two key things I would like to have answered are (in relation to it being a gallbladder problem):
  1.  Whenever I am in the sitting position the pain causes the most discomfort.  Anyone else experience this?
  2.  Any use of alcohol causes the greatest attack.  Has anyone ever had a gallbladder attack due to the use of alcohol?

Other things that cause problems are fatty/fried foods and recently, the use of Vicodin for the pain makes it worse.

I have had 4 ultrasounds, 3 CT scans, HIDA scan, Barium enema, x-rays, endoscopy, numerous blood tests, Barium swallow, and stool analysis.  All have been normal with the exception of the first ultrasound that was done in Oct 2000 - it showed "mild gallbladder wall thickening could represent mild acalculus cholecystitis - correlate with symptoms".  The doctor did not think it was a gallbladder problem and the 3 ultrasounds I have had since have not showed anything abnormal (no stones, no wall thickening).  Any ideas?  Thanks for taking the time to answer.





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28 Comments
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I can relate to your symptoms.  I have have had similiar problems, fo the last 4 yrs or so.  It started out with mild like runners cramp in the RUQ.  They would come and go, and would have attacks of such bad pain that i have gone to the emergency room twice now.  I find when the pain goes from mild irritation to the constant crampy achy burning pain i would have to pace, sitting made it worse, laying down does not help either.  To the severe pain that bending over and pacing was all i could do.  I have not found alcohol to make it worse, vicodin only helps if i can take one when the pain is mild.  When the pain comes on hard vicoden does not help at all.
i have had an ultra sound, an endoscope, ct scan with contrast of abdoman and pelvic, hida scan with no cck, and a colonoscopy.  Found a small heital hernia, nothing to worry about.  A small hernia below my naval, nothing to worry about, and a polyp (removed during the colonoscopy), not cause of the pain.  Still no answers, One Dr. suggested my weight was the problem, another Dr. suggested it was still my gall bladder, or IBS.  I have no problems with having a BM, sometimes constipation.  I go back to the Dr. on the 2nd for a follow up of the colonscopy.  Good Luck with your health, i hope you find answers faster than i have had.
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It sounds like your gallbladder, you should have another Hida scan with the CCK.
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Tasha31

Thanks for responding.  Sorry to hear you have been dealing with this twice as long as I have.  You mentioned that you had a HIDA scan w/out CCK.  I understand that CCK is no longer on the market at this time.  From my understanding CCK is used during a HIDA scan to check for proper gall bladder contraction.  If your gall bladder has not been checked for proper contraction it may be something to explore.  I have been told that they can use milk (or someother fatty dairy product) during your HIDA scan to mimic the action of the CCK to check for proper g/b contraction.  Discuss w/ your doctor.  

I had a HIDA w/ CCK two yrs ago and everything checked out ok.  I am having another at the end of January and have been told they will use milk to check for proper contraction.  I'll let you know how it checks out.  Keep us posted of your progress.  Good luck and keep searching for the answers.
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Thanks for responding.

I have been told they no longer use CCK at this time anymore.    The procedures unit where I am getting a HIDA scan done at the end of January have told me they will use milk to check for proper contraction.  Does this jive with what you have heard?
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I live in Canada and as far as I know the substance they use while performing the procedure is an organic compound which comes under the heading of nuclear medicine.  I was assured that there is no harmful effects from using this substance.  I assumed it was called CCK.
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CCK is the hormone your body secretes when you eat something fatty that tells your Gallbladder to contract & squeeze out some extra bile to help digestion. It also tells the sphincter of oddi to open up.

During a HIDA scan, you are given the radiotracer first, they wait to see if everything is showing up, the they will give you either CCK or something else to make the GB contact so they can measure how well it is working.

My daughter has had 2. At the first one, they gave her Ensure to drink..they did not inject CCK..her ejection fraction was 32%. The surgeon was not convinced it was her GB, so he ordered another HIDA, at a different place. At the 2nd one, they actually gave her CCK into her IV. that test came back at 8%. she had her gallbladder removed yesterday.

I was not aware that they were using a substitute for CCK, if they were, they did not say so...we live in the U.S.

My daughter is 19..had no stones..nothing showed up on any other tests. Hopefully this will take care of her problems.
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I had a HIDA scan with CCK about 6 weeks ago in Memphis.  I haven't heard that CCK was no longer being used.
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This is probably a dumb question, but have you had your amylase and lipase levels checked (pancreatic enzymes).

Your attacks sound soooo familiar to me.  The major difference is that I only had them for 5 months before I ended up having to go to the ER because my abdomen went rigid and I was having a hard time breathing.  

At the ER I was told that no stones showed on x-ray and that the sonogram showed my gallbladder was inflammed, the wall was thickened and it was enlarged overall.  They went ahead and admitted me because my lipase level was 1919 and my amylase level was 658 (both of these number are way above normal).  I also had elevated liver enzymes.  I was told that I had acute pancreatitis.

I spent five days in the hospital without anything to eat or drink while they waited for my enzyme levels to return to normal range (or close to normal) so they could remove my gallbladder.  

While in the hospital I underwent a HIDA scan; liver scan; pancreas scan; CT of the abdomen and more blood work than I care to remember.

The reasons I bring up pancreatitis is that it is common to have pain that radiates up under the shoulder blade and alcohol is the worst thing you can do for your pancreas.  I've been told it is worse for your pancreas than it is for your liver.  

You may just want to check to see what blood work has been done and whether or not your pancreatic levels have been tested, if so what the results were.  I will also let you know that it is possible to have pancreatitis without elevated enzymes so you may want to follow-up with your doctor and ask questions.  


BEST OF LUCK

5fan
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I live in the US (Michigan) and have had two different hopitals tell me CCK is no longer available.  I shall check again, thanks.
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Thanks for the good info on CCK.  I live in the US (Michigan) and have been told they are not using CCK anymore.  I shall get a clarification on this.

I have been following your progress with your daughter and hope the removal of the g/b did the trick.  Please let us know how it turned out.
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Thanks for the info. Zoie.  It seems I am the only one that has been told CCK is no longer being used.  I shall check into this again.  Did your HIDA scan show g/b problems?  What were your symptoms?
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Thanks for answering!  I have been asking all my doctors the same thing about pancreatitis - they all say no.  I have yet to hear anyone with gallbladder problems say they are bothered by alcohol (if anyone out there is please let me know!).  Everything I read about pancretitis seems to be right on.  

I have had many blood tests done (including repeated amylase/lipase levels, liver function tests, etc) and all have been normal.  The amylase and lipase levels are actually BELOW the normal ranges given.  I have brought this up to my doctors and they say they are only concerned  if the levels are RAISED ABOVE the normal limits.  Why do they have a lower limit then???  They can't answer that for me.  I ask them what would cause such a violent reaction to any alcohol at all  - they all say they can't answer that question.  I believe the answer to my problem lies in determining what is being affected by that.

You mentioned that it is possible to have pancreatitis without elevated enzymes - I have read this also - I believe at this stage it is considered chronic if you do not have elevated enzyme levels.  I have mentioned this to numerous doctors and they say if I had chronic pancreatitis it would show up on one of the 3 CT scans I have had.  After reading some of the other forum comments I am not convinced of that.  

Is your pain in the upper right hand abd. quadrant like mine?  The doctors tell me that the pain from pancreatitis would most likely be on the left side of the abdomen.

It seems both pancreatic and gallbladder problems can be hard to diagnose sometimes.  My efforts continue to center on these two areas as possible causes.  Thanks for your comments.

Also, recently I have started having more nausea with the pain.  I don't know whether this would be g/b related or pancreas related or both.
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I am not sure if this helps...I had my gallbladder removed Friday 12/27 because of stones.  My GB was inflamed because of this, which was causing shoulder pain, etc.  I went to a wedding in September, before I realized I had a GB problem.  I had a little too much to drink, and was extremely sick a few hrs later.  Now I was not drunk, just a few glasses of wine.  I very rarely drink.  My doctor told me alcohol, stress, etc. can make the GB act up.  Hope this helps.
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Thanks for the info.  That helps alot!!!  The four people that I had personally talked to that had had their gallbladders removed were not bothered by alcohol so I wasn't sure if it could be my g/b.  Thanks so much for sharing your experience!  This may be another piece to the puzzle.

How did you feel after the surgery?  Did it make an immediate improvement?

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First the CCK issue:

My daughter's first HIDA scan was done at Spectrum Health North (formerly Butterworth Hospital) in Grand Rapids. It was October 22. At that time, they did NOT give her CCK, they had her drink Ensure & took photos for an hour after giving her the Ensure. The tech said they had been doing that for about 2 weeks..they felt it was more "natural" & that studies showed the accuracy to be comparable to giving CCK. I was a little leery of this test being done a "new" way..but what can you do? She also had to be given morphine to make the GB visualize. The radiologist said that that alone was consistent with a diagnosis of cholecystitis. the emptying percentage was 32%, with a foot note that the accuracy of this number might be off due to having the morphine. The surgeon we saw said 32% was "on the fence" & with no stones, etc...he wanted to rule out everything else, so he ordered a small bowel follow thru & a 2nd HIDA.

the second test was 6 weeks later, Dec 2, at St Mary's in Grand Rapids. This time the GB filled like clockwork. Then they gave her the CCK, in an IV, & took photos for 30 minutes, while constantly being given the CCK slowly.  she did not have any reactions to either the radiotracer or the CCK other than slight nausea..no GB attack...we pretty much figured that she was better...that the number would be higher...it came back at 8%!!!

Alcohol...yes...alcohol bothered her...(yeah..i know...she is 19 & all that...but she is a college sophomore...do you think I live under a rock??)  Anyway.....yes..a beer , a wine cooler...she felt it....but by this time ....EVERYTHING she injested bothered her...

It has been 4 days since her surgery. so far, so good. She has not eaten anything greasy or much different than before the surgery..the docs & nurses said...take it really easy!!! so, she has had rice, oatmeal, chicken (plain), cooked veggies, bread...one positive sign...the constant nausea is gone.

During the surgery, they also did a Cholangiogram...injected dye into the bile ducts, etc to check for blockage..that was all ok....the surgeon did not see any scar tissue or outward signs of why her GB stopped working...he said that actually he had hope to see something...she goes for her post op checkup on the 9th of Jan...He gave her about 60-70% odds that it would "fix" her....when you don't have stones....something caused your GB to fail...but what??? so..with an 8% ejection fraction..he said it was worth a try...we are hoping and praying for that...

So..sorry this is so long winded...but hope it helps you...

P.S...her blood levels were all normal...
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Thanks for all the outstanding information!!  I have gotten more useful information in the last week I have been on this forum vs the last two yrs in dealing with the doctors.  It helps to know their are others out there battling too.  Let your daughter know she has a crowd out here pulling for her!

I am scheduled for a HIDA scan w/ ejection fraction at the end of January.  Hoping it will show something.

Thanks again for taking the time to respond - I know you have had a busy week.  The information you provided was very helpful.
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Well, let's see, I had my gall bladder out the day after Thanksgiving after being in the ER the weekend prior and released with a diagnosis of Hiatal Hernia.. no diagnostics were done (Seeking something be done for that).  When by monday I was still in extreme pain I saw my reg dr, she looked at my blood which showed liver functions were off, and WBC was elevated (and I was on augmentin for a sinus infection).  Anyway, she sent me immediately to have an ultra sound and found several stones... needless to say, I was checked back into the ER and met with a surgeon.  He sent me for a HIDA scan.  I was not given CCK or a substitute, guess b/c of the visual stones the gb was coming out anyway.  I had complete blockage of the gb.

I checked in Tuesday before thanksgiving and was given Keflex to control the infection until they could get ER time after thanksgiving.  Surgery went off without a hitch done laproscopically.  He found I had a large stone impacted in the duct.

Since surgery I have had little or no pain.  Took only tylenol once out of the hospital.  I do find that dairy products still bother my stomach, but my understanding is that it could be totally unrelated as my father has lactose intollerance.  I find avoiding dairy products (even non-fat ones) work the best for me.

Before this attack, I had had several smaller attacks that I shrugged off as indigestion or dairy cramps.  My dr said that I was probally passing stones with each "attack".  I found that alcohol didn't really affect me, but I am not a big drinker.  I am now on a regular diet, and just avoid dairy foods.

Hope that helps at all, any post surg questions you may have feel free to ask.

:)
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I have only had my gallbladder out 4 days so far and I have seen a big difference.  Lately I was pretty miserable, so anything was an improvement.  I used to belch non-stop after every meal.  Now I hardly ever.  My constant shoulder pain...I am still feeling the effects the surgical pain so that will be a few more days until that is gone.  I can already tell a difference that it is gone.  I had indigestion all the time...dry heaves, gaging, vomiting.  Rich foods, fatty foods, garlic, and chocolate did it for me.  I have to be on a low fat diet for about 6 weeks while my system adjusts.  I can't wait to eat my favorite foods again!   Be persistant with the doctors that you want an answer.  I am a 25 year old that is pretty healty otherwise...not overweight.  I would have never suspected gallbladder disease.  There is no need to suffer.  If it is your GB, than more things other than alcohol would bother it.  Does food?
Anne
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Thanks for responding!  

When they did your ultrasound did it show the large stone that was impacted in the duct or did it just show the stones in the gall bladder? (in other words, did they only discover the stone in your duct while doing surgery?)  I have read that ultrasound can sometimes miss stones in the duct.  This could be very useful info.  

I also don't handle dairy very well - as well as, alcohol, fatty/fried food, garlic, and chocolate.  Along with the rt sided pain, I have pain under rt shoulder blade at times, nausea, excessive belching at times, some bloating.  

Things seem to point to the gallbladder area.  From what I have read there are 3 areas that could possibly be causing the problem.  The gallbladder, the common bile duct, and the Sphincter of Oddi (the muscle opening that controls the flow of bile and pancreatic enzymes into the small intestine).  I am hoping for the gallbladder as the other two can be more troublesome to treat.  I do not have stones so the decision to remove the gallbladder is not quite an easy one yet.  I am having a second HIDA scan done at the end of January and am hoping it shows a problem with the gallbladder.

Thanks again so much for taking the time to respond.  The information I have been getting from everyone has been outstanding!!
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Hi Anne,

Wow!  I thought I was reading a list of my symptoms!  Along with the alcohol, any amount of rich/fatty/fried foods, chocolate, and garlic give me problems also.  Onions as well.  I also seem to belch non-stop after meals- the larger the meal the more belching it seems.  I have constant, varied intensity pain on rt upper abd (during one of the ultrasounds I had the technician put the wand directly over the most painful area - it was the gallbladder!), pain under rt shoulder blade at times, indigestion, nausea (have not vomited yet, but close at times) and some bloating at times in the past (especially if I eat problamatic foods which I do not do anymore).  The one food that I handle the best is oatmeal.

I also am not overweight and have had extremely good health until this began 2 yrs ago.  Everything seems to point to the gallbladder area.  Possibly one of three things in the g/b area:  a malfunctioning g/b, bile duct problem, or a Sphincter of Oddi problem (the muscle opening that controls the flow of bile and pancreatic enzymes into the small intestine).  I wish there were stones as it would make the diagnosis a little more easier.  I am going for a second HIDA scan at the end of January.  The first was done in Oct 2000 and showed no problems w/ an ejection fraction of 68% which I am told is normal (I was also not in any pain when this first HIDA scan was done - I am in pain now so hopefully it will show something!)

I cannot thank you enough for responding!!  The info you and others have provided is so helpful!  Glad to hear the surgery has helped - wish you well during your recovery.
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Hi again!
Your symptoms really do sound like your gallbladder.  Believe it or not, I was misdiagnosed at first.  I went to my regular doctor.  I go to a team of docs here at the Cleveland Clinic, so which ever one is available will see me.  It figures that I had to see a brand new young doctor.  Even though my symptoms were classic GB, he told me I had gastritis, and it can last for a few weeks.  He did order an ultrasound, though.  A younger technician did it, and she said "everything looks good" (even though she is not permitted by law to diagnose). A week later I got a note saying no stones.  I was a bit confused...went to as gastroenterologist.  He said my symptoms are classic GB.  I told him I have had an ultrasound that saw nothing.  He said that is pretty common...many of his GB patients have had an u/s and stones were missed.  So I had one with the doctor and his tech.  Right away he saw the stones...was even able to measure them.  I do not think there were any in my ducts.  Have you been to a gastro.?  It is worth looking into, because you sure have all the GB symptoms.
Anne
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went to see my Dr. Today, had the results of the colonoscopy, polyp was negative thank god!  I had a really good week this week with very little symptoms, but that is how my pain is, really bad for a few months than subsides.  i talked to him about the 2nd hida scan with the cck, and he didnt feel it was necessary at this time, since i had a good week.  He said to call him when the pain came back.  He also is sending me to a Surgeon who does the gastric bypass.  I feel like i have been shrugged off.  Could not find the problem, send her somewhere else.  The last thing i want is that severe pain that sends you to the hospital.  It is so scarey, and hurts so bad.
I will be seeing my pcp in a few weeks, see what he thinks and what i should do now.  Good Luck to all of you.  Happy New Year!
Tasha
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Hello Anne,
Hope the recovery is still progressing in the right direction!  I agree my symptoms seem to match classic gallbladder symptoms.  Especially after talking w/ you - my symptoms seem to mirror yours.  I have seen 3 different GI specialists - this last one was the only one who seemed to seriously think it was the gallbladder and she has ordered another HIDA scan near the end of January (another ultrasound might be a thing to do also).  I live in Michigan and am familiar w/ the Cleveland Clinic (impressive facility).  If I don't have any luck up here I would be interested in driving down and talking w/ the gatroenterologist that stated your symptoms sounded like "classic GB".  If you are ok with doing that leave his/her initials on a post and I will call down there and see about an appt.  Thanks again for the info and continued wishes for a positive recovery.
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Hi Tasha,
Glad to hear the polyp was negative!  Your symptoms of pain varying from a mild irritation to a severe attack at different times is definately how I would describe mine.  One thing I have learned over the last two yrs in dealing with all these doctors is that if they are telling you something that you know doesn't jive with what your feeling/you've read - then its time to try a different doctor.  If you feel shrugged off then definately try a new one.  I have had the gammet - the first GI specialist I saw handed me one page sheet on IBS and "kicked me out" after a 5 min visit; or the doctor I see now, who spent 2hrs on my first visit and took the time to go through every test that I have had done and is willing to listen to what I have to say.  He was the one who put me in touch w/ the GI specialist I am seeing now.  She seems to suspect the gallbladder and has ordered another HIDA scan w/ ejection fraction.

On the issue of your second HIDA scan (and maybe someone else out there can back me up on this), I believe you stated your first HIDA scan was w/out CCK.  Did they check your gallbladder for proper contraction using Ensure/milk /some other substitute?  It would be given in a percentage.  The reason I ask is the HIDA scan w/out checking for proper contraction will just tell you if there is blockage or not.  You can have a gallbladder w/ no blockage/no stones and it can still be the problem because it does not contract properly.  If your familiar w/ gardenmaniac's daughters problem  - she had no stones, but her 2nd HIDA scan ejection fraction was 8% - below 30-35% the gallbladder becomes highly suspect.  If you haven't had it checked you may want to look into it a little further.

I also had 3 pain free months following a strict diet of no alcohol, no caffeine, no sugar, and no fatty/fried foods.  I was feeling so good that I started drinking coffee again, and shortly after that had a chocolate bar for the first time in a long while and that set it off.  That was back in July 2002 and I have been in pain since at differnt levels of intensity.  

I agree with you - when these attacks happen they are so painful and scary you literally think you could die.  I have never experienced anything closely resembling this.  I know how frustrating it is being in the doctor's office and the pain is at a mild level and your trying to describe to him/her how intense these attacks can get.  Keep searching and I wish you well.
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Hi again!
I actually did not have the surgery at the Cleveland Clinic...that is where I was misdiagnosed!  Go figure!  My gastro. is at Akron General, and so was the surgeon.  I was pretty impressed with both.  My surgeon is highly thought of in the area...did a wonderful job on me.  I just got my stiches out today...so glad they are out!  I am feeling pretty good, just a little sore.  I have to wait a few more weeks before I can resume my normal diet.  I guess the body needs time to adjust.  I guess there are several things a doctor can do to test the effectiveness of a gallbladder.  The nurse at the doc's office today said her gallbladder is not functioning like it should, and her insurance will only cover surgery if it is functioning below a certain number.  Some people have gallbladders that do not function, which causes the sludge.  If there are truly no stones or sludge, you may have just a poorly functioning gb.  In that case, your insurance may fight you on getting it taken out.  Just a thought...Make sure that it really is your GB, even though it sure sounds like it could me.  My cousin had hers removed, and learned later on she had colitis.  She probably did not need to go through the surgery.  Have a full workup before going for surgery.  Best of luck, and I would be glad to give you the name of my doc here in The Akron/Cleveland area.  Email me at Sheltie3x@hotmail if that is easier for your.  I only check this forum a few times a week, but check my email several times a day.
Anne
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I have not had a 2nd hida scan as of yet.  My GS is waiting till i have another attack i guess, he told me to call him when my pain comes back.  When i went to see him on Thursday we talked about the cck and they still use it here also.  He said that if when the pain comes back he will most likely take my gall bladder out.  It is so frustrating, not knowing what the pain is from, and not finding a cure for it.  I have changed my eating habits, and am trying my best.  The pain has subsided for now, but i know the pains pattern, it goes away for awhile, then comes back even worse than before.  My GS said to call him when the pain comes back, i wonder if he means for me to call him at 2 am, when it generally blows me out of bed.

:+)

I wish you all well!

Tasha
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just because you are not in intense pain..it does NOT mean that your GB is functioning better or is healed up. I could not find ANY info on a gallbladder getting better after it had failed..i tried searching the net with evey possible word combo I could on that & found nothing.

If you have been following my daughter's story, her first HIDA came back at 32%. She had no stones, no crystals when they took a bile sample during an EGD (the surgeon said that would indicate the formation of stones, maybe too tiny to show up on an ultrasound) 6 weeks after the first HIDA, she had a 2nd. she was actually feeling not too awful at the time...just nauseaus..she did not react the the CCK, other than mild nausea & her GB fillled with the radiotracer just like it should have. The first time it did not (indicates inflammation) We really expected the number to be higher than 32%..it came back at 8%. That was Dec 2. By mid Dec she was experiencing more pain again..but the surgeon couldn't get her in until Dec 27. I suppose if it got really bad we could have taken her to ER, but we live an hour and a half from the hospital, so she stuck it out.

She goes back to the surgeon on the 9th of Jan...maybe we will know what the lab had to say about her GB....

I guess my point is this...her condition didn't appear to be deteriorating, but it was.

My daughter only had night pain a few times...way back in september, but I'm told it is characteristic for GB problems.

Without stones ,no visible sludge or GB wall thickening...we were happy to have the 2nd HIDA scan to make the decision to have the GB removed. 8% is a pretty clear number to me.

Now we just wait to see if her GB was indeed the problem. From all I have read & even the surgeon himself...it may not fix the problem. she was able to eat a Wendy's burger today without any ill effects...( nine days post surgery).something that would have sent her into extreme pain before. She was on an almost NO fat diet, no raw fruit or veggies, very bland...

I would want a 2nd HIDA before I let them take the GB out.

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Hi,

I have a quick question and comment. Should your daughter eat such high fatty junk food? I have heard about people doing this, and after a few weeks, they begin to get sick again. Hope it won't be the case for her though. I met a lady in the mall who told me it took her about 2 years to completely recover in the sense of being able to eat out. She did say however, that if foods are very fatty, it sends her immediately to the bathroom!
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