Acalculus Gallbladder

I have always had on and off stomach problems which I suspected were brought on by use of NSAIDs for endometriosis.  Over three years ago, I started having pain in URQ which wrapped around to back.  I was getting referred pain in my quadratus laborum and after massaging the area, I experienced extreme rebound tenderness. I had so much bloating that I looked (and still do) pregnant after eating, my stomach gets hard under the sternum and I get woken up at night with palpitations which is relieved after burping.  

I had endoscopy, colonoscopy, abdominal US, abdominal CAT scan w/o contrast, abdominal MRI with contrast, and a HIDA scan in 2007, all normal.  

Now I am experiencing these symptoms all the time with no breaks in between and additionally I feel faint from the pressure in my abdomen. When I bend over and stand up or have a bowel movement - any pressure on my abdomen - I feel like my head is being squeezed and starting to faint. This happens fairly often in the past two weeks.  I had a cardiac workup last year and was declared healthy (holter monitor, stress test).  I also have trouble swallowing things - but again my endoscopy was normal except for some gastritis (biopsied).

I should also mention that in the past my WBC frequently fell below 4000 and I attributed this my body working overtime to rid itself of sinus infections (I can't take antibiotics because of my stomach!) Oh, and I didn't get attacks from eating greasy food - just from medication (ie claritin, etc).

So I go to a different GI and get a small bowel series and another HIDA scan.  Last week I failed the scan with a 4% ejection fraction.  So I know that my gallbladder is not working.  But if I have no stones, what triggered it?

My questions:  Can antibiotics or drugs cause or irritate GB disease as I notice taking any meds now irritates it.  Can GB disease cause enough problems to irritate the vagal nerve?  Or palpitations at night?  Can I expect this to not get better on its own and be facing a surgery?  Should I get another cardiac or neurology workup before surgery? I am so uncomfortable.

[CalGal]

No one really knows what triggers gallbaldder malfunction. In some cases the wall can become thickened resulting from some kind of infection problems and cause a lowered EF. But in other cases the true cause is not known. With a 4% EF, there is a good possibility that you may have to have surgery. It's something you need to discuss with your doc.

[michell221]

Can GB disease cause enough problems to irritate the vagal nerve?   I do not know the answer to this but I did get heart palpitations when my gallbladder started going bad.  I had the surgery and now am left with sphincter of oddi dysfuntion and still have the palpitations.  I have had a negative cardiac workup as well.  I do agree you will probably have to get it out to avoid your pain.  

[michell221]

Also most of my attacks come from medicine also instead of food.  I know that sphincter of oddi causes . spasms in the sphincter when taking narcotics in almost all that have this syndrome but mine is also affected by antibiotics, ibuprofen and a few other drugs in addition to this.

[Jennyct10]

Thank you.  It is very obvious that the meds made this worse.  I was getting the back pain all the time with movement, but now getting spams in the abdomen all day long.  The meds make it worse!  I am so afraid of surgery, but I don't see any way out...

[michell221]

I am afraid that you may have sphincter of oddi and it has taken its toll on your gallbladder.  I say this because of your reaction to meds and attacks of pain.   If  you do have this  your pains will most likely continue after the GB is removed but then you will need to see a specialist for SOD.  Your GB will have to come out though since you it is barely working and you do not want to get an infection.    If you do have  the surgery and they give you morphine in recovery or narcotics then your pain may be really bad.  If this happens get them to stop the narcotics and try to get by on just phenegran or something similar.  

I thought I just had a GB problem and in recovery I was in excruitating pain from the morphine.  We all thought it was just just gas or the surgery pains.  When they stopped the morphine I felt 100 times better.  It was causing horrible pain in my stomach and back from the spasms it causes in the sphincter of oddi.   I later found out when I was diagnosed that I can no longer have any narcotics because of this syndrome.

[alexjg]

my situation *****, i had a cck scan and my gallbladder was only working at 15%, i'm pretty much nausious 24/7. im having it removed the 20th.