Next Step....Surgery?

Plesae give me your opinion for this next step.  Here is my situation:

Normal weight 135 lbs, , regularly exercise,  41 year old female.
SYMPTOMS:
RUQ pain radiated to back  for 1 year
excessive gas, diahhrea, and fullness feeling after eating.  

Tests done; ALL CAME BACK NORMAL!!!
*bLOOD TEST
*ultrasound upper abdominal
*HIDA scan  "had medium pain with cholecystokinin injection about 5/10) Initially showed slow      declining activity becoming fairly steep after 8 minutes plateauing at about 95% total ejection fraction" stated 1.normal hepatobiliary scan 2. Normal gallbladder ejection fraction
*upper endoscopy withy random biopsy done (no pilori)
*colonoscopy

All of these tests came back normal with NOTHING found.

My GI has said that if all these come back normal then it is most likely the muscle of my gallbladder that is not up to par.  This is causing the pain.  His suggestion is to remove it.

MY QUESTION:  Is this normal.  Can all tests come back normal and it still be your gallbladder? Is surgery really my only next option.  The pain can be quite bad at times.  They also told me not to eat lettuce or any high fat.  My diet is normal with no excessive high fat...  

[Kevin Pho, MD]

First off, the workup is comprehensive.  The fact that everything is negative suggests that no major disease is present.

You can consider more specialized tests at this time.  This can include an ERCP with Sphincter of Oddi manometry.  Sphincter of Oddi dysfunction can lead to upper quadrant pain in the face of negative testing.  

Before removing the gallbladder, I would obtain another opinion first.  The tests do not suggest a gallbladder disease.

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