Chronic nausea and gallbladder ejection fraction of 38%

I have read several posst and I've been able find other people with similar symptoms like mine.  I have had IBS type symptoms for about 11 years, but a few years ago I began having stomach issues that just didn't seem like the usual IBS stuff.  I started having severe abdominal bloating almost 3 years ago and began suffering from on and off constipation. I started to notice that I was feeling this terrible nauseous feeling in the center of my upper abdomen...it's so bad that I can't even stand to have my bra pressing on my ribs or have my shirt or a sheet touch my stomach.  In the beginning I was tested for colon cancer and celiac disease.  I had a colonoscopy done at the age of 29 in 2009 and also had an EGD to check for celiac - everything was negative.  The first GI specialist I saw (who did all of those tests) told me I probably had IBS. I wasn't happy with that general answer....it just didn't seem to really explain the symptoms that started in 2008.  All of my previous symptoms that started in my early 20s were very much like IBS: food would go right through me....no matter what I ate.  I learned to deal with that and just tried to follow a very healthy diet and stay active.  Everything changed when I started taking Yaz bcp in 2008.  I didn't put it all together until a family member mentioned my symptoms sounded like gallbladder issues.  I researched online and found the connection between gallbladder problems and Yaz.  I am not sure if that's my issue, but none of the symptoms I started having in 2008 began until AFTER I took Yaz.  I stopped it in Jan 2010 and felt a bit better, but have continued to have issues.  My GI doc said it probably isn't my gallbladder because I'm in good shape and I eat healthy....he said it's probably just IBS.

I stopped seeing the GI doc in April 2010 and I was just dealing with everything. I recently started seeing a new PCP and she sent me in for an abdominal ultrasound to rule out gallstones. Last week I had a PIPIDA scan and my ejection fraction was 38%. Ever since the test I have been having worse pain afer I eat...it's been pretty unbearable nausea and it last for several hours.  It's always in the center of my upper abdomen, though...I have never had that sharp right upper quandrant pain typically associated with gallbladder disease. I have been referred to a general surgeon to discuss options.  I don't know that taking out my gallbladder would help, but I can't live like this.  I was so sick when I ate after my scan last week and it just seems to be getting worse.  I don't know if it's damage done from the Yaz or if it's even my gallbladder.  I don't want to have unnecessary surgery nor do I want to be on any medication for the rest of my life.  I haven't had kids yet and I'm worried I will feel worse when I'm pregnant or worse after having kids if it really is related to my gallbladder.  

Has anyone been able to get a concrete diagnosis?

[Kaneda2112]

Sorry to hear you've had a hard time of it.

Did they rule out specific food tolerance issues, liver, badly bleeding ulcer and pancreatic disorders with any bloodwork? That sounds like a simple first step.

Best of luck!

[JamieLL]

I have tried eliminating certain foods and never really found any relief...I haven't been able to pin point a specific trigger.  I don't think it's an ulcer because I have never had any symptoms to make me think I had one.  What kind of pancreatic disorders are you referring to?  

[Cdngal]

Hey ya, I believe 38% is borderline for normal.  My Hida scan was a normal EF of 52% but my symptoms were all gallbladder related and mine was very sluggish, i was also very sick during the and after HIDA scan, they say if you have gallbladder issues the symtpoms will occur during that test.  I suffered from this for 7 momths lost 44 lbs which i couldnt afford to lose... I also am thin and and in good shape, doesnt mean you cant have gallbladder issues.  All my tests were normal except the HIDA scan and after the surgery the surgeon came to see me and told me how scarred and inflamed it was.... this did not show up any tests at all.  I had mine removed in january and all my symptoms disappeared.  Talk to your GI and see what he thinks or maybe get referred to a surgeon and see what they think, you dont want it out if you dont have to, but you also dont want to continue with this.

[JamieLL]

That's why I want to make sure that it really is my gallbladder...i don't want to have to take it out to be sure that's really what is causing the pain.  I have always wondered because I don't have the typical URQ pain people associate with gallbladder issues...just the constant nausea in the center of my upper abdomen.  I felt fine during my scan, but felt terrible when I ate after the test and I've continued to have worse than normal nausea when eating ever since.

[Cdngal]

Have you ever had an upper endoscopy? Or Barium swallow to check for ulcers, reflux, Gerd etc... you seem to be on the right path... I had alot of nausea with my gallbladder issues... and vomitted alot.  Hope you feel better, keep us posted after you see your doctor.

[Kaneda2112]

The only reason I mention pancreas is that my nieces bf (age 24!) had nausea and mild pain after every meal for 2 YEARS! He eventually had pains in the centre of his abdomen. They got so bad that he was eventually hospitalized a few weeks ago - they diagnosed that it was his pancreas causing the pain.

He was pumped full of antibiotics and pain meds and was out of the hospital a week later with the doctor's command not to drink alcohol for at least 6 months.

I was just throwing it out there because it seems to roughly correlate with what you're experiencing. Hope you get some answers - it would be great to hear more if you get a resolution or any further answers.

[JamieLL]

I have had an upper endoscopy (in Mar 2009 when I had my colonoscopy).  The doc was checking to rule out celiac disease.  I wonder if it's worth having again just to have a look.  

I had some type of barium swallow testing done back in 2000-2001, but I don't remember specifics...I do remember how horrible that stuff tasted and how uncomfortable I was having to roll over on a table while they took that scans.  The testing was done because of the IBS symptoms I began having.  This nausea/pain is totally different than that, so maybe the GS will want to do some of that type of testing before resorting to surgery.  I have an appt next week, so I'm praying the doc is not "cut happy".

Did you have URQ pain when you had gallbladder issues or the same center nausea pain as me?  I feel like that is a key thing for my doctors to keep in mind to really figure out what's wrong since I don't have classic URQ pain typically associated with gallbladder issues.  

[JamieLL]

Was there a specific name for the issue with your nephew's pancreas?  I've been trying to research any reference I can find to see if I can get something that really explains my symptoms.  

[Cdngal]

For me my pain was URQ into my back...so i did have the typical pain... plus severe nausea, i lived on anti nausea pills for 6 months...i vomited alot as well lost 44 lbs by the time i had my surgery and couldnt really afford that much brought me to 100 lbs at 5'4...my biggest complaint was the nausea and vomitting for sure, the pain almost felt like someone put an elastic around my upper body and squeezed it was terrible.  Let us know what the doctor says.. when do you go again?

[JamieLL]

My pain feels like someone constantly has their fist pushing into my upper abdomen (right at the bottom of my sternum all the way down to about 1 inch above my belly button).  Ever since I had my PIPIDA scan it has been worse, especially after I eat.  It feels almost like I need to throw up, but it has a distinctly different type of feeling.  I get a lot of bloating and I feel like one of those people that has had lap-band surgery and can only eat a very small amount of food at one time.  My stomach is extremely sensitive to the touch...I can't even have my shirt touching my belly lately.  It's so weird....

My appointment is on Tuesday, 26 July.  I'm praying that this doctor isn't completely clueless and will actually listen to what I have to say without just assuming I need my gb taken out.

[JamieLL]

Well, I went to the general surgeon on Tuesday and he is 90% confident that my gallbladder needs to come out. He seemed to be knowledgable and he listened to what I had to say. I'm still on the fence about surgery and I'm getting a second opinion.  I'm going to look at finding a doc in Kansas City just to see if I might have luck getting someone who is familiar with the Yaz BCP correlation.  One thing the GS I saw this week was able to shed some light on was the reason for my center abdomen pain: he said that only about 20% of the population has an anatomically correct gallbladder, so many people have no URQ pain but still suffer from gallbladder issues.

At this point, I just really want to confirm that it is my gallbladder, that it needs to come out, and hopefully be able to prove that it's all from being on Yaz.  I'm jumping on one of those lawsuits if that's the case!

[Cdngal]

Always good to get a second opinion before a surgery.  I feel much better now that mine is out...when will you go for another opinion?

[JamieLL]

I'm not sure when I'm going just yet...I have to wait on Tricare (military insurance) for the referral.  It takes some time, but at least it's free!

[turkee23]

i was having some pain in the center of my chest, felt almost like a heart attack, i couldnt keep anything down for 5 hours (cause i was eating the fatty foods and stuff) i ended up going to the ER and had an ultra sound and found i had gallstones.

had it out the next week (didnt let them do the emergency surgery cause it was 4 am and my mom didnt know i was there)

but for that week i had the pain in the center of my chest, i was freaked out about the surgery from reading all these crazy stories online about "dumping syndrome" after and people having the same pain after, but the surgery went great, in at 10 home by 3, dr went through my belly button and thats it!...not even a stitch!

had min eout 6/21/11 and im fine, eat what i want, and lost 22 lbs...

[JamieLL]

I have been having chest pains the past two weeks....like someone is sitting on my chest.  And, now the classic gallstone/gallbladder symptoms are starting.  I can barely eat and i've lost 9 pounds since my PIPIDA scan.  I was thinking the chest thing wasn't related, but it sounds like you may be on to something.

So, they can go through your belly button?  Tell me more!

[Cdngal]

The chest pains get definately be related to gallbladder issues... The Laproscopic Cholesectomy is pretty much the standard way they remove gallbladders now, they make 3 tiny incision and usually remove through belly button or higher in your chest (thats where mine was removed) the scarring is so minimal i had mine out in January 2011 and you can barely telll, healing is also much faster.

[cocobd]

I just had my gallbladder out last Friday---I don't have the intense nausea anymore but I don't feel perfect yet---I eat three times a day now; whereas, before the gallbladder was taken out, I barely ate for three weeks because of the severe nausea----did your nausea go away immediately----also, did you have terrible shoulder pains after the surgery because of the air pumped into your stomach? My gallbladder problem showed up with the HIDA scan too---no gallstones but a 30 ejection fraction---I am just hoping the gallbladder was the only problem---my gastro doctor did an endoscope, CAT scan of my abdomen and the ultrasound---all negative except my endoscope showed slight inflammation----I am on one other forum but found this one this evening--these forums are very helpful---

[avisg]

I would want more concrete tests that so its your gallbladder before its removed I had mine taken out in 2007 and ended up with a far bigger problem called the sphincter of odi dysfunction.So make sure they are sure. Your refraction rate is on the low but on the normal side .How are your enzyme and liver counts?. Have they done an mrcp yet ? Its basically and MRI of you digestive system .

[Cdngal]

I was same could barely eat anyting before my surgery, you are doing better then i was, for the first 10 days after surgery i was so sick I got dehydrated and ended up in emerge from all the vomting, once they gave me some IV fluid and some meds are started my road to recovery took about month before i didnt feel exhausted everyday, the nausea went away couple weeks after... both my surgeon and GI told me that will take my body a year to settle from the surgery... I guess makes sense since afterall they did remove an organ, so your system has to get used to it... You should take anti-acid pills for few weeks... thats what my surgeon gave me and really helped with the nausea.  Also they suggested to take 2 metemucil pills every morning, also will help you not get constipation or diarrhea.

[Reruho]

Jamie,
I only had the sharp pains a couple of times in the 23-24 years I suffered with this problem . I mainly suffered with a cramping like pain under my right breast and along my diaphragm for many years (20) before I had a Hida scan and it showed an ejection fraction of 15%. I had been going in for RUQ ultrasounds every 6 months for years, normal was always the results. Labs were always normal. I had intermittent referred back pain..I found out that this is normal for biliary dyskinesia.  I went to the ER and wound up being treated for back strain-pain medicine and muscle relaxers.

The last year the back pain became constant and I described it as having a knife stuck in my back. I had problems sleeping and wearing a bra. I already suffer with chronic pain. I had been taking daily pain medication, so my pain levels would probably rated higher. A nightly vicodin was the one thing that allowed me to sleep those last 6 months.

Food never really bothered me until the last couple of months before surgery. An anpple had me doubled over in pain. I later found out that the pectin in apples and oranges will stimulate the Gb to contract.

Surgery was a godsent. I felt better immediately. I went on a low fat diet and it gave me diarrhea. I made the mistake of eating some gas producing veggies (cabbage) and paid for that one. I used some digestive enzymes from the health food store for a month and that help settle things done. I found I need some fat or I get constipated, too much and I have diarrhea.

Reta

[JamieLL]

I have been reading about the sphincter of odi dysfunction and I was planning on asking about that when I go in for my second opinion at KU Med.  I REALLY want to be sure that it really is my gb and that taking it out will fix the problem.  So, the MCRP would be a way to diagnose that?  And, looking at my liver and enzyme counts?  How did you get diagnosed? And, what were your symptoms?

[JamieLL]

I can't even imagine living like that for all those years!  I am having such a hard time now (ESPECIALLY after my scan) that I am almost losing my mind!  I am really staring to have what I would consider classic gallbladder/gallstone symptoms every time I eat and it just last forever, so I really don't get relief.  I don't even know what to eat to keep from feeling bad.  I don't know how I can be having all of this pain when I was told I don't have stones.  I still have 3 weeks before my second opinion and I'm not too enthusiastic about getting my gb removed without being completely sure that is the cause of my problem and that it will get rid of my symptoms.  I have sharp pains under my right breast, the same continual center abdominal pain (which makes it VERY uncomfortable to wear a bra), some random back & shoulder pain, and even sharp pains down lower into my abdomen.  It's so frustrating not knowing if someone will be able to confirm a diagnosis before taking out an organ.  It sounds like you have had to adjust your diet....the doctor I saw said no dietary changes are needed and I knew that had to be wrong!  How can a digestive organ be taken out of someone's body and no dietary changes put into place?  I've talked to people who have no problems after surgery and talked to some who have tons.  

I have been looking on this website called *****************.com - has anyone been on there?

[Cdngal]

I had to change my diet before and after, I eat alot more low fat, i dont eat red meat  or pork, no fried foods (well once in awhile but pay for it) and when i have dairy i have skim and non fat... no pop, or caffeine either...I also take a fibre supplement every morning, 2 metemucil pills.  So I have done well... I know people that have it out and then go back to eating crap have issues... unfortunately without the gallbladder its alot harder to digest, so better just to make it easier on your body.  YOu will get used to the new diet, so worth not having the pain and vomiting.

[cocobd]

I don't think you got my message yesterday because I accidently had "blocked" checked in my profile---how long did it take for the nausea to go away after your gallbladder surgery? I am almost as nauseated as before the sugery and I am 10 days after surgery---this is miserable----did you take any meds after surgery? any info would be greatly appreciated...

[Cdngal]

Hey there,

I was nauseous and vomited green bile for about 7 days post surgery, I had to to go the ER to have IV fluids to get hydrated again, as with all the vomiting and not being able to eat a thing or drink as much as should have been i got dehydrated...after the IV fluids I started to feel alot better.  I was put on Zofran and a strong acid reducer (cant remember the name for one month) this seem to do the trick, 10 days post surgery i was finally able to eat and feel normal and then all the symptoms went away that I had prior to surgery and post.  Are you on any acid reducing meds?   As well with eating make sure you are eating a low fat diet for the first couple months and if you have any dairy make sure its non fat and skimmed.  My surgeon and GI also suggest fibre supplement everyday so i take 2 metemucil every morning... (this was a great suggestion as i did not get constipated or diarrhea)

[Cdngal]

Your nausea is most like still from the anesethtic, you should be seeing you surgeon for a follow up very soon?  If not you can always call their office?

[JamieLL]

Well, it looks like I am going to go ahead and have surgery.  I went in for my second opinion and the doc told me it was biliary dyskenesia.  My gb isn't fuctioning as it should be - I don't have stones, infection, inflammation, but there is no way to know if I will slowly decline or if my e.f. will just go down quickly.  The doctor said we had options and that we could see how things went after another HIDA scan. He didn't push surgery on me and his experience level is outstanding.  I asked tons of questions and after getting all of the information I felt I needed, I went ahead and decided to go for the surgery.  I am trying to have faith that I will feel better and can lead a better life.  I am schedule for Sept 26th at KU Med in Kansas City.  I have lost almost 12-pounds now, so it's definitely time.  I will keep everyone posted!

[Cdngal]

Thats exactly what I was diagnosed with but took them alot longer to figure mine out... and lost 44 lbs by the time surgery was done...none of my MRI or CT showed inflammation but after my surgery my surgeon came to see me and told me it was very scarred and inflamed... everyone is different, but i am very glad i had mine out... i feel way better then i did before.  Make sure to be patient after the surgery, you wont feel 100% for awhile its going to take time for your body to heal so be ready for a low fat diet for awhile and slow introduce your body to things... i had mine out in January and there is still sometihing I eat that i know my body isnt ready for yet.  My surgeon and GI both told me one year for the body to settle which makes sense as you are removing an organ.  Good luck with the surgery and keep us posted... feel free to message me if you have any questions.  Cheers!

[JamieLL]

Does anyone have any tips to share regarding how to handle things after surgery?  I know everyone is a bit different, but I'm so worried about how I will feel.  I have to go back to a very stressful job and, even though I sit at a computer most of the day, I know that will take its toll on me.  I am planning on taking 1-2 weeks of leave.  Everyone I have talked to seems to all be of the same thought: the surgery is no big deal and I will feel better quickly.  I don't want to be negative, but I don't want to be too idealistic either.

Also, has anyone out there dealt with pregnancy after surgery?  Or know anyone who has?  My husband and I want to start a family and we were planning on this fall, but obviously my surgery and all my issues have halted that.  I am wondering how long it will take me to feel better and know that it's safe to get pregnant.  I'm almost 32, so I hope I don't have to wait too long.

[JamieLL]

I had my surgery on Monday and I ended up not being released to go home the same day.  I was severely nauseous in recovery, so my doc admitted me. The pathology report won't be complete until next week, but my doctor said that he had to deal with a ton of adhesions when he got in there.  He was still able to keep it laproscopic, but I have 4 incisions instead of three.  He had to pry several of my surrounding organs off of my gb because I had apparently had so much inflammation for so many years that things started sticking together.  

I had serious issues with the gas in my body until last night...I was hurting so bad - the worst pain I have ever felt in my life.  It has been painful to laugh, cry, talk loudly...anything that requires me to use my ab muscles.  It's an interesting feeling to feel like you have zero muscle in your stomach when you are used to being able to do crunches like nothing.  I'm feeling better regarding the gas, but my epigastric incision is really bothering me.  I can feel my pulse in my aorta and that seems to be irritating it.  

I seem to be able to eat ok the past day or two, but my appetite was mostly non-existence while in the hospital.  I was forcing myself to eat, but it was only a few bites at a time.  I'm keeping my choices healthy, so I haven't felt too bad.  

I have a follow-up appointment on the 7th of October, so my doc will be able to give me more info regarding the pathology report then.  More to come!