Gallbladder ejection fraction

[homerroxy]

I had a HIDA scan because of severe abdominal pain, chest pain and back pain.  While I have had numerous partial bowel obstructions due to adhesions, this pain seems different. It felt like a heart attack.  My doctor wanted to make sure that the massive abdominal adhesions (I've had 3 surgeries to remove them) were not somehow now causing my gallbladder to malfunction.  The results came back with ejection fraction of 90%.  I know this is high.  Is this anything to worry about?  Obviously, if the number is low they remove the gallbladder, but what if it high?
Thank you

[Banned1]

So sorry to hear about the pain, nausea and vomiting.  It was my understanding that the magic number for a low ejection fraction (EF) rate is less than 35%.  Did you have an attack on the table?

As you probably know, almost everyone has stones.  Most stones do not cause ANY symptoms.  

Your primary care physician (PCP) will let you know pretty quickly if a low EF combined with the two stones indicate that you should have your gallbladder removed.  This procedure is called cholecystectomy and there are two types:  Open; and Laparoscopic.  

My EF was 81% but given my other symptoms and the presence of stones, I had my gallbladder removed.  At that time, I was told that there is no such thing as a EF rate that is too high.

You've asked, "Can anything else be causing the pain (no nausea or vomiting)" and you're looking for answers on this site.  There is a fantastic research resource that I've found very helpful called "The First Principles of Gastroenterology": http://gastroresource.com/GITextbook/en/Default.htm.   You can either search the whole book or select individual chapters on the left (i.e.: 13 - Biliary System).

It's exceptionally useful to keep a journal or a blog and your welcome to read mine if you want.  Everyone who is registered on medhelp has a journal on their home page.  It's a great way to review your situation objectively and identify patterns in your symptoms, medications and pain level.  Hindsight is 20/20 and keeping a log might help you look at things more objectively over the longer term.

It's really difficult to deal with pain especially when you don't have a diagnosis.  You are not alone!  Try to stay positive and reach out for support.  Talk to your Doctor, your family, friends, co-workers, church or social service volunteers or anyone you feel safe with.  Reach out to members of this forum who want to voice their opinions.  Remember though, that no one should be giving you instructions or advice on health-related matters except your health care team.  

Take care of yourself.  Good luck and Godspeed.

When you do find answers, I'd love to hear what the root cause is and how you got rid of your pain.  It gives people on this site hope to hear success stories.

All the best,

Sam

[KC411]

I had a HIDA scan today and they told me my gallbladder filled up fine but the EF was only 18%.  My US showed two 4 mm stones (or polyps)- does this mean I am a prime candidate for removal?  Can anything else be causing the pain (no nausea or vomiting) or is it likely to be my gallbladder?  I have almost constant discomfort on my right side, sometimes on my left and sometimes in the middle.  Thanks for your help-

[Kevin Pho, MD]

That value does not suggest that there is gallbladder dysfunction.  I am not aware that surgeons routinely remove the gallbladder due to a high value

I would look elsewhere, including an upper endoscopy to exclude various causes of dyspepsia - like ulcers or inflammation of the upper digestive tract.  

Cardiac causes can be initially evaluated with a stress echocardiogram.

These options can be discussed with your personal physician.

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.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[jnicka]

A related discussion, 2% excretion was started.

[Banned1]

Hi Kim:

I write too much so I'm glad my response didn't put you off.  Hang in there and let us know how you make out with your GI-Guy?  If you need to vent or chat, feel free.  I check in a few times a week.

All the best,

Sam

[KC411]

I just checked in here and thank you SO much for your thoughtful response.  It does help to know there are others out there searching (and finding) answers.  No, I didn't and have never had an attack, just severe lightheadedness with the CCK during the scan.
As a result, I am waiting on an appt. with a gastroenterologist to interprete my test results.  I have also been eating a low carb, high vegetable and fruit diet with good fats and some protein.  It does seem to be helping.  I am also trying to stay positive and think of some good outcomes as a result of this and that I believe has really helped too!

Thanks again for the information and resources and most of all the support!
Kim