differential on gallstones vs. gerd

[Brynda]

About a year ago, I suffered my first attack of very severe pain just beneath my breatbone. Hurt so much I thought I might be having a heart attack. It was just after a high fat, spicy meal. Another happened a few weeks later and my MD prescribed a trial of Nexium. 3 months later, I go off the nexium, and the attacks come back within a few days. Same thing--sudden severe pain just under my breatbone, deep inside. The pain generally goes away after an hour or so, during which time I am madly taking OTC antiacids. I go to a new MD, who suspects gallstones. Ultrasound reveals he is right--multiple small stones, none in the duct. I quit taking nexium again, and again I have an attack 3 days later, also after a fairly high fat meal, plus wearing a girdle. So, I go back on the nexium, but have another attack--my first while taking nexium--3 days later. Sheesh.

It seems important to me that the attacks almost invariably hit 3 to 4 hours after I eat. The pain is central, although last night, it was a bit lower--just above my navel, rather than centrally, but just below my breasts. It also lasted much longer last night--3 or 4 hours, rather than an hour.

Demographics: 42, white, female, lost 100 lbs a year ago, sister had gall bladder removed in her 30s.

So what is this? GERD? Gallstones? Both? I worry that the gallstones are an incidental finding, but if they aren't, I want the suckers out. What tests, etc, can help me decide what to do?
My MD suggested gall bladder laproscopic surgery, but that was before I quit the nexium and triggered the symtoms.

[5fan]

I would ask about a sonogram and a HIDA scan.  I had my gallbladder out in July.  I had a complicated case because I had pancreatitis also.  When I presented at the ER they did a set of abdominal x-rays and a sonogram.  I did not have any stones, but my gallbladder was "enlarged" and the wall was "thickened" along with being "inflammed".  I was admitted due to extremely high liver and pancreatic enzyme levels.

I had ignored my attacks for four months before I finally had to be taken to the ER.

I spend six days in the hospital and had my gallbladder removed.  The doctors never found any stones and cannot give me a solid explaination of why I had pancreatitis without a stone blocking the common bile duct but I am lucky I went to the hospital when I did.  I had one of the doctor's tell me if I was 50 years old and presented with  the same condition I would have had a 50/50 chance of survival.  Luckily I am only 31.

I wouldn't wait around.  I'd find a gastroenterologist who you are comfortable with and who is willing to do the tests you need to find out if your gallbladder needs to come out.

I am still having complications from my surgery.  The doctor now thinks that I may have another condition that caused my gallbladder problems, but I have a friend who had her gallbladder out and was back at work 5 days later with no problems at all.

The most important issue is to get a diagnosis.  From what I have read a HIDA scan is really the best test.

BEST OF LUCK.

[DI99]

my hubby too had his gall bladder out and is still having pain....they are running a lot more tests And are looking towards an immune disorder.

I had my gall bladder out after a massive attack (it was worse than giving birth.....I've had a C-section and a VBAC.  the gall bladder attack was worse....I felt great after the surgery.....keep up with finding out what is Wrong.....altho my hubby's idiot surgeon kept saying Well it takes a While after surgery to feel better....NOT  after having 3 laproscopic surgeries I can Say I only had discomfort....not pain....for a week.  so 6 weeks after my hubby's Surgery did the surgeon "release" him And now the other docs are Working on his case again./.....he has "lost" another 6 weeks.....he has been Sick for a year!

Dawn

[JackieG]

Hi Brynda:

I wouldn't have my gallbladder out unless tests proved that is the cause of your problem. Two tests can probably discover the root of your problems:

1) Sonogram:  will reveal gallstones, including number and approximate size, if you have them

2) Endoscopy:  Gives the gastroenterologist a clear view of your esophageal lining, which will show irritation if GERD is the problem and you've had it for awhile.

Good luck,
Chicken Soup

[Kim32]

Hi Brynda,
I had the same symptoms as you for 4 months. I went to the
ER. back in september and the doctor didn't even do any tests,
he just said "well it sounds like you have acid reflex" and then he gave me nexium to take, well i was taking that for about 2 months and my symptoms didn't improve (heartburn, nausea, severe upper stomach and backpain)  then i saw another doctor
(My 3rd) and he suggested to do an ultrasound (I hate it when doctor's just give you a pill to take without doing any tests)
well the ultrasound showed that i had gallstones,  so a few weeks later (this past November 19th) I had my gallbladder taken out.
Well now I'm still in pain (the other symptoms are gone,the severe upper abdominal pain, plus i can eat anything that i want now without any pain, not like before,i couldn't eat anything without me being in pain)
but now the doctor thinks that i may have a bile leak, so tomorrow i'm going to have a hida scan done, to check my bile ducts.
I have been in constant pain since september (my first symptoms of gallbladder trouble was back in July)
But since i have had my gallbladder taken out my symtoms have gotton worse by 100%! :-(
I have a co-worker who had her gallbladder taken out a month before i had mine and she says that she feels 110% better!
I guess it just depends on the doctor who does your surgery.
I'm hoping that this hida scan test will show that i have a bile leakage somewhere so i can get it fixed!  It just seems like it's one pain after another and frankly i'm really getting tired of it!
Since i have had my gallbladder taken out (2 weeks ago)
I have had numerous blood tests done, and urine tests, x-ray of the chest and stomach, an EKG, a scope, and a CT scan done.
All showed NOTHING!
I would say tho that your experiencing the pain that i had
from the gallstones, that  you should get it taken out, because the pain from gallstones will never go away once symptoms has started!  I wish you luck! Kim
P.S. wish me luck that they find out that it's a bile leakage that's causing me all of this pain, since the surgery, so i can get it fixed and not suffer anymore.