RUQ pain, 95% ejection fraction

I'm 32/female/ 160 lbs./ mother of 2, no previous health issues.

For 4 weeks, I've had RUQ pain that is mostly located under my rib area to the far right side and sometimes it is felt wrapping around the side to the back. When the pain first was noticed, it was more of a discomfort. It would come and go, but became more noticeable after a week or two. I haven't been able to associate is much with meals, but it does seem to start up in the mornings as soon as I drink my coffee. The pain from there can last all day and doesn't seem to change whether I eat a fatty meal or not. The pain is usually a squeezing type pain on the side but yesterday it was more localized and sharp feeling rather than the usual squeezing. I have had some slight nausea on and off. I have visited a GI dr. who ordered an ultrasound, bloodwork, and HIDA scan. He seems to feel strongly that it is gallbladder related. The ultrasound showed no abnormalities, and the HIDA scan showed a 95% ejection fraction. I haven't been able to reach my dr. but have a follow up on Feb 20th.

My question is, do my symptoms sound gallbladder related, especially since it doesn't seem to be related to eateing? Also, everything I've read indicated that normal ejection fractions on HIDA scans are 35-75%, so does the 95% EF indicate a possible problem or does that just mean mine functions super-well?

[Kevin Pho, MD]

I agree with the testing done thus far.  The gallbladder is less likely to be the cause with the normal ultrasound and HIDA scan.  

Other possibilities can include Sphincter of Oddi dysfunction (which can be evaluated with a Sphincter of Oddi manometry) as well as biliary duct stones (which can be excluded after an MRCP).  

If these tests are negative, you can consider various causes of dyspepsia or upper GI disease.  An upper endoscopy can exclude these possibilities.

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

[shannonpancsod]

I have sphincter of oddi and it does sound a little bit like this, if you are interested in talking to me my email is women_2020@yahoo,com and I also have a support group for people who have this or pancreaitis or problems with there GBs,it took me foever to find someone to help me and I had to travel 24 hours finally to see a gi who know extactly what I was talking about/