Gallbladder and nausea

I'm a 38y.o.WF with a fm. hx. of gallbladder problems. In 8/2005 I had chronic, mild RUQ that lasted for three months and was not associated with eating meals. Tests performed then were: RUQ ultrasound revealed no abnormalities/gallstones; my liver profile/CBC were normal; upper endoscopy was normal(except for a small hernia); my HIDA scan was essentially normal with an EF of 80% and I was diagnosed with biliary dyskinesia.  In 1/2007, my dull RUQ pain returned along with bouts of nausea/diaherra/constipation when I eat. The HIDA scan was repeated with CCK and the EF was 16%. I was referred to a surgeon who said I have an 80% chance of the pain getting better and have surgery scheduled in five days.  
Also, I do have mild multiple sclerosis with no disabilities but I am afraid to undergo general anethesia/surgery becuase it might bring on a MS attack.
I keep reading that GB sx. "may" be of benefit to those with biliary dyskinesia but could bring on problems with chronic diaherra (diarrhea) and the dull pain may not go away. My RUQ pain is not bad and I am really more bothered by intestinal problems when I eat. Questions:
1)If I do nothing about my gallbladder, will I eventually develop gallstones? 2)Will the GB eventually stop working altogether and die? 3)Could I develop a GB infection/gangerene by not having surgery? 4)Would it be wise to have the ultrasuond repeated to make sure there are still no abnromalities? Thanks!

[Kevin Pho, MD]

To answer your questions:
1) Gallstones are possible if the surgery is not performed.  It is difficult to predict if this would happen.

2) The gallbladder won't 'die' if nothing is done.  However if the ejection fraction continues worsen, it may be possible that the RUQ pain would increase in frequency.  

3) Cannot predict for sure.  If there is no current evidence of stones or biliary obstruction, or dilation of the bile ducts, then infection is less likely.

4) Repeating the ultrasound can be considered if the symptoms continue.  You can consider an MRCP to image the biliary ducts.

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

Kevin, M.D.
kevinmd_

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