Gallbladder dysmotility

[fane]

Hi, I've just been diagnosed with gallbladder dysmotility after having performed a HIDA test with an ejection fraction of 12%. I am a 28 year old male and I've been having many symptoms for the last 15 years. It all started at the age of 13 when after a 3 weeks hospitalization due to hepatitis A. I started to have major gallbladder colics. The episodes of excruciating pain lasted for about a month after which they went away for good. However, since then my whole digestive health took a turn for the worst. Indigestion, jaundice, bloating and a feeling of continuous dull pain in the upper right side of the abdomen were my regular day to day symptoms. I also noticed that after a long period of very little physical activity my symptoms were ten times worse. My doctor told me that surgery is the standard in my situation. I'm considering having the surgery done, however, I have a very important question. Here goes: Can the gallbladder partially or fully block the flow of bile through the main bile duct which comes from the liver? I have this dilemma because on all the forums I've been, nobody seemed to know how the bile is actually sucked in by the gallbladder and if the remainder of bile which doesn't fit in the gallbladder can freely flow from the liver to the main bile duct and into the small intestine without being stopped in any way by a dysfunctional gallbladder. I ask this because all the time when I have major symptoms I feel like I'm actually being food poisoned even though I eat super healthy. Sometimes I can not even walk without shaking, not to mention that I'm all pale( jaundice) and the bilirubin levels are usually above 3. Could you also explain to me how is the gallbladder responsible for these symptoms? My assumption is that something is blocking the bile duct and the liver gets flooded in its own bile. I'm not a doctor, but from all of my symptoms this is the conclusion that I've reached. Please help me better understand my gallbladder. Thank you.

[ncmomma]

I had my gallbladder removed 15 years ago. Seemed to have more trouble now then before it was removed. I've been having discomfort in the right upper quadrant on and off over the years, I head you can get sludge in the cavity where the gallbladder was, is this true. I also found out by getting my transcripts to bring to another doctor and reading them that the surgeon while attempting to see if I had stones in my bile duct tore it and then withdrew due to it but he never told me this and I see nothing done about it in my transcripts. I've had CTs, MRIs etc. and they don't see anything. I also had alot of abdominal surgeries, appendix, hysterectomy, right ovary removed, gallbladder removed, and wonder if there could be scar tissue causing a problem. I want relief after all these years. I seem to be having some sort of attack (feels like gallbladder) they admit but don't know where it's coming from. Tired of feeling like this. Got any ideas?

[fane]

How do you feel after 10 days since the surgery? Do you see any improvement? I want to take mine out in june.

[justgotpaid]

Well I know what it means, low ejection fraction.  With this test it means the percent of radioactive substance released by your gal bladder is low.  Ideally your gallbladder should release about 50-75% of the radioactive substance within the time of the scan.  If it does not then that means it is not contracting properly.  My gastrointerologist told me this study is not 100% conclusive, but surgery solves the problem 90% of the time.  So there is no gaurantee with surgery, but like I said it is easy surgery.  I went into outpatient at 6am, and was home at 12:30pm.  Unbelievable what they can do with laporoscopic surgeries nowdays.  

[justgotpaid]

I just had my gall bladder removed due to a 5% ejection fraction.  I had billary pain and a mildly elevated billiruben.  Only been 3 days since surgery, so I dont know if my problem fixed but will keep u posted.  Easy surgery, I am already feeling better, only mild soreness at this point.  I have had problems with mine for about 5 years.  I think I had stones and they just didnt show up, cause my symptoms were like gal stones.  But, glad to have it out.

[fane]

I'm looking at the film of my HIDA test and I see that all the radioactive substance stops completly just below the gallbladder( at 20min). Then at 25 min the gallbladder starts to fill up with half of the fluid. At the same time the substance doesn't seam to flow past that point. At 45 minutes all of the substance is sucked in by the gallbladder. At this point the gallbladder is fully filled with the radioactive substance. However at 60 min I can see a small path of the fluid being drained through the main bile duct and into the small intestine. After careful analisys of the HIDA test my common sense is telling me that the gallbladder acts like a vacum and that it actually blocks the flow of bile from the liver by continuously sucking the bile. Only a small percentage of the bile excapes and flows down into the duodenum. I would like to send you the film of my HIDA, but it is difficult to scan it. You would see it for yourself. The other thing. I don't understand why doctors are not that knowledgeble when it comes to these issue. For instance, my gastroenterologist told me that he doesn't really know what a small ejection fraction means. I understand that this technology developed during recent years, but still. A doctor should be well informed about everything. I guess people are people and that incompetence is well spred even among high society.

[power548]

For the last two months many times i passed loose mucous stools an ulta scan report says i have slightly thickened gall bladder wall Iam really worried , adecade back I suffered from Jaundice .
My doctor have prescribed Metronidazole+diloxanide furoate I have completely the course I got symptomatic relief again I started passing loose stools.

[Kevin Pho, MD]

You are correct in that the normal approach to a low gallbladder ejection fraction would be surgery.

There are small studies that suggest that this may help with your symptoms.

The gallbladder may be responsible for blockages in the biliary duct, especially if there are stones present.  A low gallbladder ejection fraction may occasionally be responsible for this, however the exact pathophysiology isn't totally known.  

If there is concern about the biliary ducts, an MRCP or ERCP can be done to evaluate the biliary tree.  Obtaining a blood bilirubin level can help determine whether there is blockages of the biliary ducts as well.

These options can be discussed with your surgeon or personal physician.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[tsco]

Good Post.  I posted yesterday on the gallbladder.  My EF is not as low as yours but this weird (I explained it as a low blood sugar feeling) feeling of weakness, shakiness is crappy.  I also was wondering what the reason for that is, that's why I asked about nutrients being lost due to bad absorption. Additionally I have lately had pale stools, so where is the bile going? I don't have stones. Is my liver holding it and causing this sick feeling? Anyway I feel your pain.   I'm 46 male in good physical condition and also eat healthy.  I guess I'll have the removal this spring.  Been putting it off but I feel these sick feelings everyday are related. Good Luck.