Re: Gallstones vs Ulcer/H.pylori

Posted By Christine on February 16, 1999 at 21:30:09:

In Reply to: Gallstones vs Ulcer/H.pylori posted by HFHSM.D.-ym on February 14, 1999 at 21:46:31:





  
If I were you, I'd go see another doctor!  An ultrasound will show whetter or not you have gallstones.
: I am a 38 yo white female, 200lbs, of Polish/German ancestry. For
: about 2 months I have had pain in the upper right quad of my
: stomach, empty feeling in my stomach, pain in my back at times,
: pain in my right shoulder at times, pain between by shoulder
: blades at times,some foods create burning sensation in my gut
: about 20 minutes after eating but it gradually subsides and the
: same foods do not always cause this response,sometimes lower
: right back pain, burping, gas, and feeling bloated. The sx on and
: off. I recently spoke to a GP concerning this and he suggested
: I may have Gallstones (which is the same thing my mom suggested),
: he referred me to a GI specialist. When I had my appointment the
: GI doc asked me several questions concerning the pain (dull to
: burning), locations (upper right quad of stomach, etc.),when it
: occurs (whenever, somethimes after I've eaten certain foods
: (tomato sauce does not upset me),if it wakes me at night (no),
: is there a history of gallstones in my family (yes, my mother
: had her's out when she was 37), do I have kids(no), on birth
: control (no), do I have acid reflux (occasionaly,about three times
: in two months), have I lost weight (yes, about 5lbs since Dec.
: more than likely due to my not eating as much), he poked my
: stomach in the upper right area quite hard and asked if it hurt.
: Yes it did a little. It may have had more to do with his pressure
: than anything else. He suggested I had an ulcer and H.pylori.
: He emperically treated me with Prilosec and I had a blood test
: for H.pylori, results should be available next week.  When I
: mentioned the possibility of Gallstones he quickly remarked that
: he didn't want to "cloud" the issue and even if I did have
: gallstones he wouldn't do anything about them. I took the
: medication for three days and got headaches, constipated,
: and fatigued. I discontinued at the physicians recommendation
: and have not taken anything for two days.  My stomach feels
: alright. He wants to stick a scope down my throat to look in my
: stomach and I want him to do a non-invasive ultrasound to check
: for gallstones. 1) What do you think about the initial diagnosis?
: 2)How can I politely ask for an ultrasound? 3) Should I see a
: different GI specialist? I realize this is long. I greatly
: appreciate any response you can give me.  My next appointment is
: Feb. 25th.  Hope to hear from you by then. THANKS. I had no place
: else to turn.
Sincerely - Starr
Dear Starr,
It is sometimes difficult to distinguish symptoms secondary to gallstones and those secondary to peptic ulcer disease and Helicobacter pylori infection. To confuse the issue, even if gallstones are present on the ultrasound, they may not be responsible for the symptoms that you are experiencing. Unless there is blockage of the bile ducts,infection of the gallbladder (fever, pain, jaundice)or evidence of acute pancreatitis one cannot be absolutely sure that you are in fact experiencing biliary pain. Liver function test abnormalities may also be present. Furthermore, there are many cases where patients undergo an operation to remove their gallbladder only to find that several months later the pain returns. Therefore, it is important to try and exclude other causes prior to considering surgery.
Having said all that, it is not absolutely necessary to undergo endoscopy to make the diagnosis of peptic ulcer disease and Helicobacter pylori infection. You can have a barium x-ray test called an upper GI series and a blood test to look for the presence of the bacteria if you do not wish to take the risk of an endoscopy at this time. An ultrasound is a sensitive test to look for gallstones
and should certainly be performed as well. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: peptic ulcer disease, gallstones, Helicobacter pylori infection