Abdominal Pain

I have been experience abdominal pain under my right cage and on the right side of back.  It feels like the worst indigestion I've ever had.  I've received no relief from antacids or prescription Nexium.  The pain is worse when I eat and has been constant for 8 days.  Even though I'm loosing weight because I haven't been eating much my stomach is bloated (can't put jeans on).  I feel like I'm 8 months pregnant.   I went to doctor who said it's probably my gall bladder.  Had Ultrasound, told Gall Bladder is fine.  However, when I look at symptoms for gall bladder problems I can check off 99% of them.  What do I do next?

[Kevin Pho, MD]

I agree with the ultrasound.  If there is no dilation of the bile ducts, then blockage there is less likely.  If there continues to be suspicion, you can consider an MRCP or ERCP for further evaluation.

Other considerations would be various causes of dyspepsia - which can include GERD, an ulcer, or inflammation of the upper GI tract.  

Obtaining a HIDA scan with CCK stimulation can be considered as well to evaluate the gallbladder ejection fraction.  A low EF can mimic some of the symptoms you are describing.

These options can be discussed with your personal physician.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Jen700]

Can the gall bladder look okay on an ultrasound and still have a blocked duct?

[lizziecee]

Hi Jen, Dr. Pho doesn't answer supplementary questions - afraid you need to post again if you want his opinion. Otherwise go to the community gastroenterolgy section of this forum where someone may be able to help - not doctors though, just concerned patients who may have had a similar experience.
Liz.

[jep65]

please jen or any one out there considering gallblader (gallbladder) surgery insist that you get the old surgery.the new laparaspopic cholecestomy is too dangerous.they use titanum clips which migrate into your bile duct causing more severe pain than before.the clip that they use to clamp off the bile duct itself will build up an infection around it and up into bile duct tree.then they will perform an ercp where they put a camera down your throat to see what the problem may be.sometimes they will drop a stent inside of you causing even more pain.they don't tell you this because if you knew you would ask for the old procedure where they cut you open and leave a 6 inch scar.believe me if i knew now about the new laparascopic and ercp damages that take place i would not have elected to have the procedures.do yourself a favor cut back on saturated fat (meat) and look for milk thistle and or stone free these supplements will keep the liver and gallbladder flowing strong.i took 2 supplements (#1 ibs to help my digestion )and(#2stone free to my gi doctor)because he wanted to know what i was taking.he seemed more interested in the stone free than the ibs and shortened my visit and ran off with the supplement package.he performed my last ersp in feb of 2007and looked like he tried to remove some migrating clips from my bile duct.if you do the above supplements and diet (mostly vegetarian) and it does not work and you have to have your gallbladder removed YOU MUST INSIST  THAT  THE DOCTORS PERFORM THE OLD PROCEDURE!there are too many people being injured by the new laparascopic and ercp`s.if you don`t believe me just type up in your google search (clips migrating into bile duct or stents occluded after ercp).as for any doctors who read this(i hope you do)please stop hurting people just for the so called advancement in mediacal tecnology.if this was not causing a problem you would not be inventing and investing in disoveable clips to replace the metal titanium clips that migrate and block bile flow which leads to liver failure.because of this new so called technology i cannot work to get insurance to correct the problem that a simple old style gallbladder removal surgery could of prevented.so much for the new medical marvels.jen thank you for your comment space to vent my frustrations and best of luck to you.