Time for a surgical consult?

I began having symptoms typically associated with gallbladder malfunction 6 months ago which have persisted. I have had one other bout with symptoms the year prior which lasted about two weeks.  Symptoms include intermittent upper right abdominal pain (stabbing) at the edge of the ribcage, pain at the right or in between shoulder blades, globus, pressure behind the sternum, and belching.  I have undergone ultrasound, a CT of the chest and abdomen, HIDA scan, EGD, esophogeal manometry, and a 24 hour pH study.  The CT report mentioned some fullness around the pancreas (nothing of note per the gastro doc), but otherwise all tests were normal per a gastroentrologist to whom I was referred. I have been a healthy 31yo female up to this point.  The symptoms have caused me loss of sleep as the symptoms seem most prevelant at night. I also have become less physically active since running creates more intense pain at that right edge of my ribcage. My mother underwent tests when she experienced similar symptoms that were all also considered normal.  It was not discovered until removal that her gallbladder had adhesions that were causing her trouble.  Should I ask for a surgical consult at this point?

[Kevin Pho, MD]

I agree with the testing this far, and it has been extensive.  Many of the major GI diseases would have been ruled out with the studies.

I agree that a surgery evaluation would be reasonable.  If the HIDA scan was done with CCK stimulation, it may show a low gallbladder ejection fraction.  That is a possible surgical indication.

If the surgical consult is non-revealing, you can look outside the GI system for musculoskeletal or pulmonary causes.

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

[Amy0131]

Thanks for your help.  I just needed some backup that I was heading in the right direction at this point.  

Great blog!

[tasia579]

Hi this is tasia579.
Girl i feel your pain! I went to the e.r. in July for severe pain on the right side and they diagnosed me with gallbladder problems. I had gallstones and sludge. I had my gallbladder removed in August and i was doing ok, watch out for fatty and fried foods if you go through with the surgery! I am doing better now it just takes a little while to heal and i have four children so i was not eating the healthiest before my surgery! I would check into all your options and then go from there! The surgery is easy for some people and harder on others!

[Amy0131]

Would it be strange at all that there has never been blood work ordered?  My mom, a nurse, was shocked to hear it has never been ordered.