N/V/D

in march 2006 i had my gallbladder removed due to multiple stones. my sx's were N/V/D. the episodes happened late in the evening lasting 3-4 hrs. they were spaced 3-4 months apart. we could never come up with any common culprit. it was never the same type of food i had eaten that day. the sx's continued 2 weeks after surgery. i have had  upper endoscopy. colonoscopy, MRCP, ultrasound, CT abd chest and pelvis, SBFT and multiple lab tests. results showed a non obstructing stone r kidney , uterine fibroid, diverticulosis, and a redundent colon. i am told none of these are causing my sx's. my last episode was oct. 18th while on vacation. my GI Dr. and surgeon want me to go to er with my next episode and get a CT abd with oral and IV contrast.i'm feeling as though i'm going to live with this the rest of my life. any ideas what's going on? my GI Dr. does not see a need for an ERCP since the MRCP was neg.  thanks for your help

[Kevin Pho, MD]

Difficult to say without evaluation.  

The workup that you had has been comprehensive, and would rule out many of the major causes.  

More specialized tests can be done to evaluate the upper digestive tract.  This can include a gastric emptying scan, 24-hr pH study and esophageal motility studies.  

Another consideration would be Sphincter of Oddi dysfunction.  This is a relatively rare disease that can lead to some of the symptoms.  If suspected, a Sphincter of Oddi manometry can be done in conjunction with an ERCP.

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.
www.kevinmd.com