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chronic cholecystitis

I have pain in the area under and below my right rib cage. It also hurts in the back area under the sholder blade tips and radiates downward. I am nauseated and fatigued. This has been going on for approximately 2 months. The only meds I take is 12.5 mg. of Coumadin nightly for pulmonary emboli (no reason ever found for these after a slew of tests were done, but they happen out of the blue.) Pro-time is 2.3 with Coumadin. All regular bloodwork is normal.
   I recently had a HIDA scan with the following results: There was a somewhat delayed filling of the gallbladder with the radionuclide. At approximately 60 minutes there did appear to be a gallbladder that was visualized, however, it appeared to be somewhat smaller than normally expected.
   When injected with Sincalide, the ejection fraction was a negative percentage that suggested that the gallbladder filled somewhat more after the injection.
  The radiologist recommended a gall bladder ultrasound. My family doctor is ready to schedule surgery. My surgeon wants me to follow a "gallbladder diet" of no fats, etc. for a couple weeks. My diet is actually already high in grains, fruits and vegetables and low in fats.
   Is there a recommended course to follow?
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Avatar universal
Month ago my local doctor send for ultrasound for gallbladder
they check and told me wall thick so they arrange me to go to
hospital. Doctor in hospital  remove the gallbldder today
is the third day still I got pain inside everywhere when I moving
my body and pain when I breathing .They cut four places cut my
belly button too and all the way up between the ribs.So please let me is that normal or not?
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Avatar universal
A related discussion, what causes this pain was started.
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i hope that this message board is still read. I had a hidascan done July2001....and my GB function is only 22%...but what is weird is my pain is in the middle to left section...sometimes my right but mostly below the breat bone to the back.....I heard the a ERCP test can sometime locate the blockage and correct the problem. Has anyone had this procedure done and did it help?? Or does 22% functionings mean the GB need to be taken out...Thanks MaryC
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i hope that this message board is still read. I had a hidascan done July2001....and my GB function is only 22%...but what is weird is my pain is in the middle to left section...sometimes my right but mostly below the breat bone to the back.....I heard the a ERCP test can sometime locate the blockage and correct the problem. Has anyone had this procedure done and did it help?? Or does 22% functionings mean the GB need to be taken out...Thanks MaryC
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Avatar universal
I see that you posted awhile ago, so I hope you read this. I would love to cht with you, as I have had some of the very same problems. I am going in for my 6th ERCP (in 1 1/2 years) next week. It will be my 4th time for sphincterotomy/stint. The most recent one was in FEB. I guess I am looking at surgery if this doesn't work. What happened with you. Did you need the surgery? I have never talked with anyone who has had as many ERCPs. I would love to hear from you.
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Avatar universal
I think that you are so right...I believe that this is the reason that so many people have continued to have pain after having their gallbladders out. I'll try to keep this post short, but the story is long..hope to not bore you
I finally had the SOD (sphinc. of Oddi disease) diagnosed by a wonderful doctor who specializes in biliary tract disease. I know of 3 places that have special programs like these, Cleveland Clinic, University of Michigan and UCLA hospitals. MY doctor trained at U of M. I went to at least 6 doctors who couldn't find anything wrong and kept telling me I had irritable bowel disease and was just stressed. I kept saying that I wasn't any more stressed than any normal person would be after having pain for 2 years and not gettting a proper diagnosis. Like you I knew that there was something more. I also had several tests...EGDs, colonoscopies, MRIs, CTs, biopsies, barium swallows, etc.... and nothing wrong. I even had an ERCP with manometry ( where they measure the pressure in the bile ducts) at Uof M hospital and they couldn't help me either. I finally went to the doc I see now and he started tracking my liver and pancreatic blood values. After every episode of severe pain I would have blood drawn. These tests started showing a pattern of being elevated almost every time. THis means that there is a temporary blockage in the duct which causes backflow of bile into the liver and pancreas. Feels just like gallstones.
Anyway, I had/have the pain just like you. Pain in the upper right abdomen, chest, right shoulder and through the back. The back is there almost constantly. It also keeps me up at night, that's the worst. Right now it is 4;45am and I'm up because of the pain.
Told you this was long...
The treatment is with ERCP and sphincterotomy...where they cut the sphincter muscle so it stays open all of the time. I have had this done 4 times, because it keeps scarring over. I have also had a stint put in. DOn't worry though, this is not the norm, most people get relief after the first procedure. Only about 1% scar over. I had the last procedure Feb 28th and for the first time in 4 years I was pain free. It was great! Unfortunatley, my liver tests are up again and I have pain again so I go back in the hospital next Friday to have it done one last time. If this doesn't work there is a major surgery to fix it.
I don't want to sway you any way..but you might want to consider all of this before you have your gallbladder out. I really feel that I didn't need the surgery, as I was in the ER with the same pain 3 days after I had it. I have read alot about this (SOD) and am reading that there are lots of people who have their gallbladders out when they didn't need to.
One more thing...I know that sludge can cause problems in the duct, if SOD is present.
Please let me know if I can help any more. I'm on a misson to help people with similar problems, because so little is know about it and I know how hard it is when you don't feel well and know one can find anything wrong with you.
Hand in there...and good luck.
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Avatar universal
How did the doctor arrive at the Sphincter of Oddi Disease diagnosis, and how did he treat it? I've never heard of this before.  Also, this may account for the many many people who have had their gallbladders removed but still have symptoms months and years afterwards.  Also, did you have a lot of back pain/stiffness on the right side with this?  I'd be interested in your response.
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Avatar universal
Hi,
This is to everyone who is talking about undiagnosed right quadrent pain that seems like gallbladder. I have had many of the same problems for the past 4 years. 3 years ago I had my gallbladder out because of a low ejection fraction (11%). I ended up in the ER 3 days after the surgery with the same pain. After many, many, many tests and procedures I finally found a great doctor who diagnosed me with Sphincter of Oddi Disease. This is where the bile duct opening can spasm shut, which basically blocks the bile duct the same way that a gallstone does. You get the same symptoms. I have been treated through ERCPs where they can cut the muscle open. The first time I had it done I was so relieved with the relief of pain. I had been having pain for 2 1/2 years before I could get a proper diagnosis. I am now learning that the SOD can be present before a gallbladder is taken out or it can be caused by the removal of it. Please let me know if I can be of further help to anyone with similar problems or if anyone has experience the same things. It is terrible to not feel well and to now know why.
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Avatar universal
Glad to hear you're doing better.  I did have my ultrasound, and this time, in addition to the two small polyps it also showed some sludge or tiny stones.  Since my gallbladder is functioning at a normal level,my doctor has put me on Actigall - a drug that dissolves stones and sludge, instead of recommending surgery at this time. I've only been on it for a few days, so I really haven't noticed a big difference yet.  I haven't had any more attacks, but I'm still having the back/side pain (soreness and stiffness) at night, but I'm sure that if the medicine works, this should be relieved in time.  I've got to stay on the medicine for a while (1 to 3 months) so it evidently takes time to dissolve this stuff.  I'll keep you posted.  I hope you continue to improve!
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Avatar universal
Thanks so very much for taking the time to post a comment.  I had my gallbladder removed on 3-22-01.  To be honest, I felt different the moment that I woke up...I didn't have that intense pain between my breastbone.  It really amazed me.  It's been two days post-op and other than the usual, I feel great.  I am hoping that I NEVER have to experience that type of discomfort again.  

They also used some new type of anesthesia on me and I didn't have the typical reaction that I am used to.

Sorry to hear about your HMO.  I really dislike managed care.  Thank goodness for regular Blue Cross & Blue Shield.

I hope that you eventually have your cholecystectomy.  So far, I am pleased with my results.
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Avatar universal
Patti-Lynn:
Gallbladders are tricky to diagnose because they effect each person differently. As far as surgery goes, 85% of the people who have their's removed do fine.

Jimsel:
It's going to take some time to heal....regardless of the simplicity of the procedure, surgery is invasive. You just had an organ removed that was tied into you whole digestive system, and while you were in surgery (and for a while after)your whole system was completed sedated, that's a shock. Also, different people have different reactions to the anesthesia and the meds that they are given, so give it a little more time, and I believe things will level out for you. There are more people glad they had it done than not.

Patti-Lynn:
As far as the hida scan goes...the 7% means that you gallbladder is ejecting bile at only a 7% capacity. The lack of infusion (intake) means that nothing's going in it either.  Basically it's not working at all, so whatever's in there is kinda stagnant at this point, and there's a good chance it's diseased.

I'm going for my 3rd ultrasound in six months on Monday. My doctor thinks it is my gallbladder, but all the tests are within normal limits or "inconclusive", so if I'm going to get approval from insurance, I need more in their opinion than just an educated guess from my doctor.  Personally, I know it's my gallbladder, I just can't get the darned radiology department to get an accurate reading....these things do happen, though, so it pays to be persistant.

I wish you both well, and hope you are both feeling better soon.
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Avatar universal
Thanks for your comment.  Today is not good, I am very ill and contemplating having the surgery performed.  I too have difficulties with anesthesia and will probably react in the same manner.  Good luck and thanks again.  I appreciated it.
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Avatar universal
Your test results basically mean that your gallbladder is not working well.  I just had mine removed on May 8th (no stones) and I still don't feel well at all.  Of course, I got very ill several hours after the surgery and had to be hospitalized for several days.  I had a severe reaction to the anethesia and anti-nausea medication.  Plus, I was vomtining bile for a day.  However, these reactions are not common.  The air they pump up your abdomen with is a real pain.  It takes severals days for that to resolve itself.  For me, I just can't get my digestive system to kick in.  I am having a lot in belching and bloating.  I don't feel like the surgery was worth it at this point.  Although, for some people it can be along time for their body to adjust to not having a gallbladder any longer.  

If you do have the surgery, just be prepared for all the possiblities.
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Avatar universal
Thanks to all for posting comments.  It assisted me a little.  I have been sick for nearly three months with similar symptoms.  Epigastric pain with eating or without, stabbing pain in the middle of my back, nausea, violent vomiting, and a constant pressure in my chest.  I had two ultrasounds which were both normal.  No gallstones or blockages.  I finally had a HIDA scan performed which showed no intake and a something referred to as 7%.  The surgeon suggests a cholecystectomy.  Does anyone know what no intake is, and I am assuming that the 7% means that my gallbladder is functioning at 7%?  By the way, I personally thought that the second portion of the HIDA scan was horrible...made me very ill.  I cannot get in contact with my PCP or my surgeon.  I appreciate any answers.  Thanks.
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Avatar universal
It does sound like we are having similar symptoms....my biggest worry at this point is that having had the front right/back/side pain now since late August 2000 that whatever is going on will cause complications. What puzzles me is how can you be having gallbladder type symptoms without a gallbladder? I've read in a couple of medical books that in rare cases, gallbladder removal doesn't always clear up the cholesisitic pain. Sometimes it returns for whatever reason, without a gallbladder. I'd be very interested to hear what your doctor has to say.

As for my latest update...I'm a little tired. I haven't had a full night's rest since this began, and my wife is expecting any day now...so I guess sleep depravation will be a way of life for me for a while longer, but that's okay.

As far as the prednisone/prevacid treatments are going...  The 30mg per day of prevacid has completely taken care of the acid reflux/and the burning type indigestion pain I was having.  I'm due to move to a 15mg dose in about two weeks.  But the right side pain is still present (almost constantly now, and steadily increasing) I've taken predinsone before for sinus infection/inflammation and it doesn't take a whole lot of that cortecosteriod to get results if you have an inflammatory condition....as of today, I've had 120mg of the stuff in 4 days and I other than being a bit hyper, I could be taking sugar pills.  My sinuses clear and my joints feel great, however!  I really think my side pain is organ related, otherwise it would have noticed a difference with the prednisone by now.  I just need to ride this out a while longer until my wife delivers and things get a bit more settled.  I really don't think that the timing is good for us to both be in the hospital (if that's what it comes to).

I called my doctor again today and told him what was going on, and he wants me to come in again tomorrow.  I think he's as tired of seeing me as I am of seeing him (nothing personal either way) but it's definitely frustrating.

Keep me updated on what's going on with you, and I will let you know as well. Perhaps by sharing information we can both reach a cure soon.

Blessings.
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Avatar universal
My pain sounds just like yours. For months it was just an ache or heaviness. I would awaken at night and hold my side to turn over. I would notice it 24/7 but more at night. The last two weeks the pain is more pin like and has moved from the front right to the back right. I can put my hand on my lower waist about 3 inches below my waist band of my slacks, and it feel straight through.  I have no gall bladder. The doctors did a pelvic scan and an ultra sound...with all sorts of blood work. The one thing that is worrying me now is that I have been nausiated for 3 days. It stays with me daily and 3 nights ago I woke up and ran to the rest room to throw up.  Before, I would only feel nausiated occasionally and it would pass with a tums.
I know something is wrong and they will schedule a colon test.

The pain right now is in my lower right back and it feels pin like. I can live with it but I am just soooooo aware of it rking.

I hope you find out soon. Let me know how your medicine works. I am back on protonix for acid reflux. I will let you know how it works. My surgeon said that some people wiht pain like mine get better with  these meds.

God Bless you and hang in there.  I know how it feels to want to complain and everyone has heard it for over a year.
Lin
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Avatar universal
I was diagnosed with multiple stones in March.  I am trying to wait until July for surgery.  Does anyone out there have a good feeling for recovery time and also how long the actual surgery took.  I can't stand anesthesia and was trying to avoid surgery by low fat diet and herbs, but I still don't feel so great.  Also, at the time of my diagnosis a small hemangioma was found on my liver.  Does anyone know if that effects the surgery at all.

Thanks
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Avatar universal
No, I haven't been nauseated (as in throwing up) I have had severe bouts of stomach cramping and loose bowels after a high-fat meal from time to time. The pain in my side and back are still there. Like yours, it never truly goes away. The pain is more like a cramping pain. Remember when you were a kid and you'd get leg cramps or "growing pains" as they called them. They were sore, and almost had a sort of deep burning and stiffness accompanied with them in addition to just plain hurting? That's the kind of pain I'm having on the right side through to my back. The pain and stiffness are what wake me up every night. During the day, I go about my normal routine, but it's still sore. I really do think it's my gallbladder, but my doctor isn't convinced that's what it is.  I went ahead and started the prednisone in case it is some kind of inflammatory thing, but I'm not so sure....it's a 10 day regime where you take 4 the first day, 3 for 3 days after, then two, then one for a few days.  I figure it can't hurt to try it, since I'm running out of options here. I will say this....I took 40 mg (which I think is a lot of medicine) yesterday, and other than feeling somewhat hyper because of it, I still had the pain last night. Linda, what are they saying about your pain? What kind of tests did they run? I guess we are both learning why they call it "practicing" medicine. Because it's a process of elimination and second guessing. Let me know how you are doing. God Bless you too.
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Avatar universal
Good luck
I am so miserable with this! I now have a tearing type pain in my right side that goes through to my back. It woke me up last night and I was terribly nausiated. The doctors ran 700 dollars in tests and found nothing. I am still slighly nausiated today. I have noticed that when I eat the pain subsides a bit but gets full blown at night. I have no gall bladder. I feel bad most days now. I really do not know what to do anymore.
Rking, if it is your gallbladder....It will keep on bothering you until you will definitely know. Are you nausiated any. When my gall bladder had a stone in the duct..I would get really nausiated in the middle of the night and I could not get comfortable from the pain and bloating. Good luck with the paks and God Bless you
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If you read my previous post, then here's the latest. Talked with my doctor's nurse today...told her the symptoms were continuing, he said to tell me that the back pain, side pain, etc, was probably muscular-skeletal inflamation and ordered a steriod pack to see if that helps.  I really don't think this is what it is, but I think he has reviewed the tests and since they all come back "normal" then he thinks it's obviously not my gallbladder.  Guess I might need to get a second opinion.
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Avatar universal
Here's the latest installment in the "Right Quadrant Mystery Pain Series"....Since September I have had two abdominal ultrasounds (six months apart), two blood work ups (six months apart), Hida Scan, which brings us up to Monday, April 24th: I had an abdominal CT scan which covered the the entire abdominal area: stomach, colon, all organs. Results: Stone Cold Normal - no abnormalities present.  On Friday, April 27th, I had a sigmoidoscopy, and the results were also very good...no polyps, no bleeding, no inflamation, etc. Doctor was able to make the turn at the top of the left side and see along the transverse colon. It looked great as well. He said with everything looking as good as it did with what he could see, the likelyhood of anything being wrong in the ascending colon was extremely slim. I am still on 30mg of Prevacid which has eliminated the burning and acid reflux issues, but the pain in my side and back are still present, in fact I still wake up in the wee hours 4:00 to 5:00 am with right side and back pain. This is every morning, folks! I'm beginning to feel like I'm a 41 year old trapped in the body of an 85 year-old. I still believe it's my gallbladder, regardless of what the scans, ultrasounds, etc...say, and here's why: Yesterday, I ate lunch at my desk. (Hamburger and Fries from the cafeteria) Not real smart considering I had a sausage and egg biscuit for breakfast....but hey, I'm thin and my cholesterol is low, so what the heck I was working on a report....Two hours later I could actually feel spasms in my right side! Back pain, front pain, across to the chest pain...you name it! It wasn't burning like indigestion, it was like painful muscle spasms. I rode it out, and kept right on working. Felt kind of lousy and sore last night...so I went light on dinner. Again this morning at 4:00 I am waking up with a very sore right side/back, it never really goes away completely. I've also got these weird sore spots around the edges of my tongue that come and go. Maybe it's tied in to the gastro thing, or maybe it's just stress or lack of rest, I really don't know. I have heard and read that many times all the tests and scans come back normal but once they remove the gallbladder they find things or conditions the tests missed. This has been going on since the end of August of 2000, and it's not getting any better. My concern is, that if this isn't taken care of soon, then further complications or problems could arise that will only make matters worse. I'm still active, working out, and going about my normal routine, but this chronic pain is getting old. Anyone got any suggestions here? I'm running out of ideas (and tests).
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Avatar universal
Jennifer, I just wanted to tell you that Wendell is correct.  WE are only treated for symtoms, not causes.  While it may sound simplistic when you are suffering, when you know nothing other than what a Westerm practitioner tells you and when you think there is no where else to turn, many of our problems are caused by Candida.  I won't begin to describe this terrible epidemic on Western culture but so many suffer fro this fungus infection and simply are unaware that it exists.  Read Sherry Rogers, William Rae, Dr.Crook just to start your education.  It takes a while to cure but you don't get poisoned to survive.  And Candida is never your fault, just a result of the way we have begun to live.  Good luck.  Health is surely yours.
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Avatar universal
Just a quick update on my continuing quest for an answer. In my April 3rd post, I told you that they found polyps (2) in my gallbladder during an abdominal ultrasound, but no stones showed up. I read the radiologist's report and they are extremely small and not blocking any ducts etc. From what the doctors have said, and what I have read these are extremely common. All my bloodwork is normal. I had a HIDA scan on the 9th, and it showed that my gallbladder has an ejection factor of 63%, so it seems to be functioning well. The baseline is 35%, below this, surgery is often recommended. I have been on 30 mg prevacid for two weeks, and it has helped with the acid reflux tremendously.  However, I am still experiencing pain in the upper right side, and back. Primarily in the early am hours...like I said, it's the pain that usually wakes me up.  I'm not overweight, and if I tense the muscles in my back and push inward, I can sometimes feel the pain inside. A friend of mine said the same thing happened with her gallbladder-but it was full of stones. I did have an abdominal CT scan yesterday (4/23) and I have a sigmoidoscopy scheduled on Friday. As a side note to this, I'm also feeling some pain in my muscles and joints - neck, back, elbows, wrists...upper body mostly. Maybe it's all tied together. Maybe it's just a lack of rest and tension. Either way, I'm completely clueless as to what's going on here. It may be my colon, stomach, etc. Some people think it's all stress related and in my head. I do have stress in my life, and I'm not saying that this can't happen, but the primary stress I'm feeling right now is not knowing what's going on. I've discovered that medical science is not an exact science - it's a process of elimination, and even then, they sometimes overlook things. Based on what I know, I do think my doctor is being very thorough. I'm just going to hang in there a while longer and see what turns up.
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Avatar universal
rking.  It could still be your gallbladder.  Stones are often missed with ultrasounds.  Don't let any dr. tell you that they are overly accurate.  They are not.  One just has to read the many posts by people who had no stones and had the gallbladder taked out any way.  Upon examination, they very often have stones in them.  After they have done all the tests and ruled everything out, you might want to consider asking a surgeon to take it out based on your symptoms.  It's a tough call, but one worth at least considering.  Good luck and keep us posted.
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