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Severe Back pain...Gallbladder?
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Severe Back pain...Gallbladder?

I have been struggling with a nasty back pain between my shoulder blades.  It was the worst at night and was accompanied by gassiness and all sorts of noises in my stomach.  I assumed it was reflux and told the doctor so  (I had reflux about 20 years ago which I also felt in my back, not my chest).  Initially I was prescribed 40 mg of Prilosec and Malox after meals and given blood tests.  The blood tests all came out normal.  When the prilosec did not seem to help I was given an ultrasound.  That also came back normal except for a Kidney stone.  I know the pain I am feeling is not a Kidney stone because I have had one before and the pain is much lower.  I also had a normal chest x-ray and EKG.  I also have been struggling with Vertigo since last spring and my symptoms did get worse with this GI trouble.  Anyways, last week I took it on myself to go on a Low to No Fat regimen and the back pain got much better.  I could actually sleep at night!  I did however begin to get loose bowels of a light yellow color with specks in it.  

I went back to the doctor today and explained that I can now attribute the attacks to eating fat and she said since the ultrasound was negative she felt I was Lactose Intolerant and not having Gallbladder problems.  She suggested I add some  non-dairy fat back in to my diet.  Well I did.  I had beef for lunch and fried shrimp for dinner (no dairy at all) and my back pain is back in full force (pain started 1-2 hours after my meal, gassiness started immediately after meal).  I am not looking forward to the rest of the night.  Given my symptoms, I am convinced there is still something up with my gallbladder.  Am  I crazy???

I do not want to live with this pain forever.  Nor do I  want to live on chicken, rice, bread and apple juice (the only diet that seems to make the pain go away).  For me this one bout of pain is enough and I am  going back  on the fat-free diet regardless of what the doctor said.  Any suggestions on next steps?  The doc said I should'nt come back for 1 month, but I don't want to be in pain for that long.... I am a 41 year old female by the way.

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Surgeon has kindly answered your question in his comments below and I agree with his assessment.

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.
15 Comments
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Avatar_n_tn
the symptoms you describe are certainly consistent with gallbladder, although without stones it starts to get less certain. The main way to test for gallbladder being the source, in the absense of stones, is a test called HIDA scan (hida stands for the stuff that's injected). It can show if the gallbladder functions properly. To be meaningful, it also has to be ordered with a stimulation test, called CCK injection. CCK is a hormone that makes the gallbladder contract. If it shows the gallbladder doesn't function properly, and if the CCK reproduces your symptoms, it's a pretty good bet that it's indeed your gallbladder. Some people have a gallbladder that functions abnormally, even with normal anatomy. It's also possible to have small stones that don't show on the ultrasound. I'm no expert on lactose intolerance, but I don't associate it with nighttime pain between the shoulder blades.
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Avatar_n_tn
Thanks... Since I promised my little girl a trip to Disney next week, I will stick to the low, low fat diet and then request to see a specialist to talk about the CCK and HIDA when I return.  Taking out the fat seems to eliminate the symptoms totally on some days and greatly lessen them others.  I will also continue taking the Prilosec just in case it is just reflux (although it has provided no relief to date after 14 days).  I appreciate the advice.
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Avatar_n_tn
New Symptoms today:
I have now got nausea and explosive diarhea (diarrhea).  I feel extremely weak (light headed) and tired.  My stomach is extremely gassy and I still get off and on upper right back pain after meals but now it also radiates to the front, under my arms and right below my breastbone.  I also cannot even drink something without feeling it go down with some minor pain.  When I eat something it feels like it is stuck and I get major belching right away.

Could my last episode with the fried foods have damaged my esophagus?  The Prilosec I have been taking (40mg for 14 days now) has done nothing to relieve the symptoms.  Are these new symptoms something to be alarmed about?
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Avatar_n_tn
Go to the doctor and alleviate any fears.

Good luck!
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Avatar_n_tn
Although I greatly respect surgeon's replies, and 99% of the time, he sounds on the money, I have to disagree here.

I did not get this kind of pain UNTIL AFTER MY GALLBLADDER CAME OUT.

I am now lactose intolerant (milk will cause me this pain), and high fat foods. Also get it from too many tomato products. I have no idea what it is, no doctors can pin point it for me, and please, if you think removing gallbladder is a harmless operation, do a google search for gallbladder forums, you will see this is a needed organ. If you're gallbladder is in bad shape and you're very sick, then it should come out. But if you think your pain is caused by the gallbladder, wrong. I have no gallbladder, and the pain that you have.

I eat low fat, no dairy (or very little, spaced far apart), no acidic (tomatoes, orange juice, etc). I also take probiotics (Natren's Healthy Trinity). Following this, I rarely get this pain anymore.

But, sometimes I can't pass up the Dairy Queen and suffer for two days., LOL. Tylenol will help with the pain.

***@****

if I can do anything to help.
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Avatar_n_tn
Thanks..
Actually I now cannot even drink water without setting off these extremely painful back spasms.  The nurse sent me to ER yesterday and all they did was take a few x-rays and an EKG, perscribe some painkiller for nights and sent me home.  Of course I felt better in the ER because I was there so long I didn't have a bite or a drink for over 12 hours.  They did tell me to get a referral to a gastro specialist.  While I am relieved I don't have any aneurysms, tumors, pancreas or heart problems, the pain is still dibilitating.  For the past 3 days now I am on a diet of baby rice cereal, clear broth and popsicles and it still hurts everytime anything goes down.  At least the diarhea (diarrhea) stopped (now I think maybe the prilosec had something to do with the diarhea (diarrhea) and the antacids caused anemia - hence the iron fortified baby cereal has helped me keep food down).  I did talk them into prescribing Zantac as I remember Tagamet actually was able to control similar symptoms I had 20 years ago and the Prilosec clearly did nothing.  I am praying the Zantac works.  Meanwhile I called the doctor and am waiting for them to refer me to a Gastro specialist (although they say that can take weeks).

Note to the doctor:
Is it possible that I do have GERD and the prilosec just doesn't work on me for whatever reason?  I had similar symptoms 20 years ago and remembered a combination of prescription Tagamet and Gaviscon worked like a charm.  Nothing seems to give me relief this time and the pain is getting progressively worse.

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Avatar_n_tn
If you re-read my comment, I said the symptoms are consistent with gallbladder. I did not say it IS gallbladder. I also said how the possibility can be tested. I did not comment, in this case, on the possible after effects of having the gallbladder out. In other comments on other questions, I have said that for the vast majority of people, there are no or very minimal side effects of having it out, and that is a true statement. I have never said it is always free of side effects. And I have cautioned against gallbladder removal in several comments, when it sounded to me like the symptoms or the testing weren't convincing. Gallbladder removal is, I'm pretty sure, the most common operation in the US -- or among the most common. Around 250,000 per year. Nothing is 100%. If only 1% of people had problems, that would mean 2500 people with problems, which is more than enough to fill up lots of forums on the net. The 248,500 probably wouldn't be there. I think in my practice, I've been very careful in recommending surgery, and have recommended against it quite often. My gallbladder patients are among my most satisfied: when it's the right thing to do, it's the right thing to do.
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Avatar_n_tn
I dont understand how you avoid GB surgery if you are very symptomatic...Having mine out was possibly the best medical decision I ever made....When you are having middle of the night attacks that keep you vomitting and having dry heaves for hrs. you don't worry about what after effects might occur....Just "GET IT OUT OF ME", is the only thing I was thinking....I do wonder if having it out might have caused worsening reflux symptoms, but maybe not, it might have been a coincidence....
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Avatar_n_tn
Surgeon, I thank you for your advice.

I don't know you weren't trying to persuade me one way or the other just giving me good advice on the types of tests that might get to the bottom of this.

When I ever get in to see a specialist I will ask about the HIDA scan.  Earlier last week my symptoms were absolutely consistent with gallbladder, especially since Prilosec did nothing to help and any form of fat (fried or not) seemed to set set it off.  However, this week now any kind of solid food sends me into major back pain.  The only thing that seems to lessen the pain is eating liquids and in very small sips.  

Anyways, I am taking the Zantac in the hope that maybe it isn't my gallbladder and I just don't respond to prilosec for whatever reason.  I have promise my little girl a week at Disney and I refuse to miss it.  If I have to I'll stay on liquids until I get back and see a specialist and then we will take it from there.  Thanks... Everyone!
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Avatar_n_tn
OOPS...fixed  typo below

Surgeon, I thank you for your advice.


I know you weren't trying to persuade me one way or the other just giving me good advice on the types of tests that might get to the bottom of this.

When I ever get in to see a specialist I will ask about the HIDA scan.  Earlier last week my symptoms were absolutely consistent with gallbladder, especially since Prilosec did nothing to help and any form of fat (fried or not) seemed to set set it off.  However, this week now any kind of solid food sends me into major back pain.  The only thing that seems to lessen the pain is eating liquids and in very small sips.  

Anyways, I am taking the Zantac in the hope that maybe it isn't my gallbladder and I just don't respond to prilosec for whatever reason.  I have promise my little girl a week at Disney and I refuse to miss it.  If I have to I'll stay on liquids until I get back and see a specialist and then we will take it from there.  Thanks... Everyone!
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Avatar_n_tn
I have also gone through so many tests.  I was ready to give up
when i had an ultrasound done,they told me my liver was enlarged
i looked up on the internet "can pain be caused by liver"
guess what! the symtoms (symptoms) were exactly like the symptoms from
gallbladder. so maybe you should mention to your dr about this.
they usually don't believe it could be that unless your an alcoholic.
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Avatar_n_tn
just for the record, my second post here was in response to the comment by "MyBellyHurts," for whom gallbladder surgery evidently didn't turn out well, and who disagreed with my post -- for the wrong reasons, as I was trying to point out.
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Avatar_n_tn
Hello there.  I do hope by now you have been able to resolve your problems.  I just wanted to share with you my very similiar experience.  I started having great pain in my chest every evening accompanied by nausea and a few other strange symptoms.  The first time I went to the ER for it they told me I was having a panic attack.  Now, I am not the sort of person to have panic attacks, and I was certain they were wrong.  The symptoms kept reoccuring nightly so a few days later found me at my family doctor.  He said it was acid reflux, gave me some Nexium and sent me home.  The attacks continued, only they were worse.  So, back to the ER in the night I go.  This doctor told me it was the symptoms from the acid reflux, but did an EKG to make sure it wasn't heart related.  Gave me a Prevacid and sent me home.  About a month has gone by at this time and I am feeling pretty darn bad.  I had another really bad attack which sent me back to the ER.  This time I saw a PA and he asked, "Has anyone checked your gallbladder?"  Welll... No.  No one had even ASKED me about my gallbladder.  And if I hadn't been so sick for so long I might of thought of it, having had problems in the past with it, admittedly not these symptoms.  So, he gave me some Phenergan and scheduled a sonogram in the AM.  The sonogram showed that I had sludge in my gallbladder.  But, no stones so no one felt an urge to get it out, regardless of the fact that they symptoms were making me very ill.  By this time, I couldn't even drink water or eat rice without getting sick.  So, I called a doctor from back home and he got me in with a surgeon there.  I saw the surgeon and he decided to do the surgery based on the symptoms and the sludge shown on the sono.  The pathology of the gallbladder showed Cholesterolosis.  And the next day, after I had recovered from the initial effects of the surgery, all of the symptoms I had been having were gone.  It has been over a week since the surgery and I have returned to eating regular food (albeit fairly low fat) and I have not had ANY symptoms.  It is wonderful.  I am glad that he listened to me and got it out of there.  The 20 pounds I lost were great, but feeling that way wasn't.
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Avatar_n_tn
Thanks for you comment.  Now I know I am not the only one in the situation.  Status now is that I saw a Gastroentolgist and he told me without any tests that I surely had IBS.  So I started adding in Fiber per his request and got very ill (severe stomach cramping, naseau and diarhia.  He then decided to schedule me for a Endoscopy and Colonoscopy.  I had sever Polyps removed, including some in my stomach (fundic gland polyps?) and they are doing a biopsy.  Meantime I have been feeling somewhat better the past couple of weeks.  I am down  to about 3-4 bad days a week and the rest with minor discomfort, but tolerable.  The back pain is much less than before.  The doc still swears its IBS.  If I start to get more sever back pain again, I will remember your story.  Did you get any blood tests run and were they normal?
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Avatar_n_tn
Hello  > Went to E- room with ache in upper right stomach area. Dr. said it was gall b. spasmes. Prescribed Bellatol as needed. Said to stay away from fatty foods and oily foods, also spicy.I had these attacks about 4 times before and they puzzeled me as to what it was that caused this. I thought milk but Dr. said no that 1% milk was okay to drink.I may still see my family Dr. and mabey get boodwork done. Would like to try and keep my G bladder if at all possible but if the problem progresses may need removal. I am 59 yrs young with a triple bypass and an mechanical aortic valve. This happened 1 yr and 10 mos. ago.After I went back to work I lost 35 lbs.
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