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15 Year Old with Chronic Nausea
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The gallbladder is a pear-shaped organ underneath your liver that stores bile and most often gives you trouble when something, like a gallstone, blocks the flow of this bile. Discuss topics including gallbladder attacks, gallbladder removal, gallstones, and inflammation.

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15 Year Old with Chronic Nausea

I have a 15-year old daughter who has always been extremely healthy.  Although her diet has never been great, she was constantly eating, normally small meals throughout the day (we called her the "Grazer).  Right after school ended last year, she started complaining that "nothing tasted right" and that her appetite seemed "off", although I saw no change in her eating habits and she still participated in events and things with no problems.

The end of July, we went to an anime convention that she looks forward to every year (she is an anime artist).  On Friday, she got extremely overheated and then was vomiting/nauseous/bowel issues for the rest of the weekend.  The following week, she complained of nausea, and when she couldn't attend band camp the next week, I made an appointment with the doc (prior to that we blamed the overheating, a virus, etc).  The doc ordered blood tests and they came back "normal" although a few showed a little bit off when I read the results.  Unfortunately, another doc took my copy so I can't post the "questionable" levels.  Doc ordered light diet and Gatorade and she seemed to be improving.

Then, I was away one day and she spent the day eating junk food and drinking nothing but sodas (that is NOT unusual).  She was extremely sick the entire weekend and could not attend school the next week (NOT like her at all).  The doctor ordered a barium swallow and as an aside said "let's get an ultrasound of the gallbladder".  I thought he was nuts because she really wasn't complaining of pain and I thought gallbladder problems were very painful (although my mother had NO pain WITH stones when her gallbladder was removed years ago).  

That week, her pain increased and I began to worry about an intestinal blockage so we went to the ER.  They could not order the barium swallow, but did an ultrasound of her gallbladder and female organs (to rule out ovarian cysts).  There were NO ovarian cysts (this was Thursday) on the ultrasound, but they diagnosed her with "gallbladder sludge".  Her family doctor immediately made an appointment with a pediatric surgeon at a renowned Children's Hospital near us.  He instructed me that if her pain increased AT ALL to take her to the ER at the children's hospital immediately (it is an hour and a half from our home).  On Friday afternoon, after a shower, she came to me and said "Mom, the pain was just so bad I had to grab my dresser to keep from falling"  We loaded up and headed to the ER.  

We took the ultrasound data and other paperwork, but they were not convinced it was gallbladder because she is VERY skinny (always has been...no anorexia...she is built the same as me at that age) , very young and didn't have the "pain" associated with gallbladder.  They ordered a CAT Scan just to be sure of what was going on...the CAT Scan showed some constipation (which she was already complaining of), a hemorragic ovarian cyst (which did not appear on the ovary the day before) and everything else "normal".  Since she had the appointment on Monday with the surgeon, the sent her home with strong laxatives to fix the constipation and suggested a follow up for the cyst (that appeared to be related to her cycle as her period started on Monday).  She went through the Miralax treatment - which was TORTURE as the nausea kept her from being able to drink the mixture in the time she was supposed to.

The surgeon decided to order another test - a nuclear medicine x-ray (I guess the same as the HIDA test others on here have mentioned) - to determine if her gallbladder was working properly.  We also rescheduled the barium x-ray we had cancelled when we thought it was her gallbladder.  During the HIDA scan, she had no pain and no nausea, although she felt like something had "dumped out" in her tummy at one point.  The barium swallow was done the next day.  The HIDA test said her gallbladder was "working normally" and the barium swallow was also normal with no ulcers or acid reflux.  Yet she is still miserable.

She goes back and forth between diahreah and constipation (this is a child who was as regular as clockwork from the day she was born).  In the past month, she has had ONE normal bowel movement.  The nausea is constant and is worse in the mornings.  She eats next to nothing, and she really cannot afford to lose anymore weight (and does not want to).  She is 5'6" and weighs 109 lbs as of yesterday.

Yesterday, we saw a pediatric GI doctor at the Children's Hospital.  I gotta add that for a man who deals with children, he had VERY little personality.  She informed him that yesterday morning she could not keep her nausea meds down (a chronic complaint) and that they are no longer working.  She takes 15 mg of prescription Prevacid (even though she has no evidence of acid reflux), Zofran 4mg once a day, and 12.5 mg of promethzine every four hours as needed.  She also informed him that yesterday, for the first time, her vomit was "a funny color" and when he asked her the color, she said "lime green."  His comment was "That's bile" made a note in the computer and moved on to the next question.  Most of his questions focused on her pain levels, which have never been terrible...most of her problem is nausea.

After all the questions, he said "Well, she has had some pretty good tests so far, but there are a few I would like to see the results of" and proceeded to order lab work that was to be done the next day, and also told her she needed to get a stool sample test.  He said that he felt she needed an endoscopy and possibly a colonoscopy, but was only doing that to completely rule out IBS as he didn't feel her symptoms matched IBS.  I mentioned that it was the nausea that was the worst for her and his comment was "she is already on the best meds I can give her for that, so she may just have to deal with it until the tests come back"

We go for the blood work and pick up the specimen vial for the stool sample after being told the surgical department would call about her endoscopy.  They did...he wants it THREE WEEKS FROM NOW!  This poor child, who is not eating, who is so nauseous she can barely move, who has already missed so much school...and he wants her to "deal with it" for three more weeks....even after she tells him she is vomiting bile.  I have done research...vomiting bile is a SERIOUS symptom and should be dealt with immediately as it could mean an intestinal blockage (hello....constipation!).

After reading a lot of the information on here, I am convinced that her gallbladder IS working...it is just spitting sludge into her system causing her to be nauseous and causing the bowel issues.  Although I do not want my 15 year old to have surgery, I am sick and tired of doctors who ignore the ONE test that has come up abnormal (the fact that she doesn't fit the profile for gallbladder - fat, forty, female and flatulent - should REALLY be a red flag that there should NOT be sludge in her gallbladder) and keep ordering "more tests".

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6 Comments Post a Comment
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Avatar_f_tn
Sorry...I ran out of space...

Anyway, my question is this: has anyone ever had completely NORMAL tests other than the sludge, had their gallbladder removed who saw an elminiation of all symptoms?  I don't mean just pain...she really isn't in pain, but the nausea is unbelievable.  It is worse in the mornings.

Before anyone asks, the first tests run when we were in the two ER's were blood tests for pregnancy and they were negative, plus the fact that she has had a normal menstrual cycle in the past two weeks, so it is NOT morning sickness from pregnancy.  The nausea does last all day and is worse after she eats ANYTHING, not just fatty, greasy foods.  It is just debilitating in the morning.

She is NOT a nervous child and has never been one to stress easily.  She is beginning to get stressed about school because she has missed so much (she is in Honors classes) but is keeping up pretty well with her work as we have gotten it from her teachers when she has been out.  And the nausea happens even on weekend mornings so it isn't her trying not to go to school....she was excited about this year since it his her sophomore year and her first "real" year in HS.

Sorry for the length of this, but I am trying to eliminate red herrings such as pregnancy or stress.
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Avatar_f_tn
Hey i left you a message please read... ttys.
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Avatar_f_tn
UPDATE:

My father had surgery for a gastrinoma on Monday 10/3.  Before his surgery, they ruled out his gallbladder as a problem with a HIDA Scan, stating that his gallbladder was working normally.  During the surgery, they removed my dad's gallbladder because it had stones.  He had no symptoms and a normal HIDA scan just a few weeks before his surgery.

Yesterday, I called to see what prep work she needed for the endoscopy and colonoscopy scheduled for Tuesday 10/18.  Apparently, she does not need the colonoscopy because all the IBS tests she has had have come back negative so IBS has now officially been ruled out.  In addition, the barium swallow came back negative so she does not have GERD either.
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Avatar_f_tn
UPDATE:

We have a diagnosis!  She has post-infectious IBS...she apparently contracted a virus in July that damaged the nerves in her colon which caused it to slow down to the point stool could not get out.  She is now on a Miralax regimen every day to keep things moving but the doctor says that the problem should resolve itself, it will just take some time.

The gallbladder sludge indicates she may face gallbladder removal in the future but it is not her problem now.
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Avatar_f_tn
I too have a 15 year old daughter who has been sick with pain in her stomach and severe nausea especially in the mornings. She had a CT scan last May and they found a huge cyst growing on her left kidney. They took her to surgery to drain it and also did the scope down her throat to check for ulcers. She did have healing ulcers and treated her with the prilosec and she was ok for about 3 months when she began having the same symptoms again. Unfortunately I had lost my health insurance so she has been suffering for such a long time now. I finally got my insurance back and took her in last week in where my dr said she is very constipated and decided to do an ultrasound to check to see if the cyst had grown back. Sure enough she has another large cyst about the size of a 50 cent piece on her kidney and now they say theres sludge in her gallbladder too. She is little being almost 5'8 and only 111 pounds. She is so pale and just so sick with nausea and pain but not pain around the gallbladder. We are going to see the surgeon for her gallbladder in about a week and Im afraid hes going to brush it all off to anxiety like everyone else. I cant stand to watch.her suffer anymore. I have to homeschool her to hopefully get her caught up so she can pass 9th grade. Is the Hida Scan what I should make them do and any other tests you can advise?



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Avatar_n_tn
My daughter had a virus back in Feb, flu maybe. She had all symptoms but no fever. From that time till now, she has nausea so bad, she can't go to school. She has lost 10lbs. The Dr has her on Prilosec and an anti nausea drug. I am at my wits end as they seem to not have an answer. Has anyone gotten a solid answer or a positive change?
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