Alternate Diseases with Gallbladder like symptoms

[geosci]

Hello,  I am a 35 year old male who has been having Gallstone like symptoms for the last 5 years.  Usually the attacks would last a day or so and only occurred about twice a year.  Since December 2007 I have been in nearly constant pain.  Average pain is 4/10 spiking to 8-9/10 after eating.  Sitting up really makes the symptoms worse.   I travel a lot and spending more than an hour sitting in a plane can bring me to tears it hurts so bad… Pain is localized at the bottom of the right front rib cage and under my right shoulder blade.  Walking around or laying down seems to help a bit. From these symptoms my doctor was sure I had gallstones… Starting late January I began the testing.  First test was an Ultrasound.  Test was normal.  Also had a blood test (CBC) which was normal.  The next week I had a HIDA scan with CCK.   The CCK replicated the symptoms. I actually was stuck in bed for two days with pain and nausea after the test.   The results were not what I expected.  I have a 60% ejection fraction… Nice and normal.   The next test was a Upper GI to see if I had a  hiatal hernia.  Test was normal.  

Week before last I had a abdominal CT with contrast.  Finally a non-normal test.  There were indications of thickening of the stomach wall.  I was started on Omeprazole.  The Omeprazole did nothing to help.  Today I had an Upper Endoscopy.   Everything looked great.  A biopsy was done to see if there is an underlying cause to the thickening.  The Doctor doing the endoscopy told me that even if he had found something he didn’t think it would have anything to do with my pain…

I am to a point where I feel like I am going insane.   I am totally miserable and haven’t had a decent night sleep in two months. The symptoms continue to worsen.  Is there something else this can be?  Thanks for your time!

[CalGal]

There is a condition called SOD, sphincter of Oddi dysfunction, that may be a cause of 'underlying' problems that seem to be gallbladder issues but are not. Evidently the biliary system, a portion of the common bile duct, or the muscular opening to the duodenum (the sphincter) could be spasming and that will cause a LOT of pain. Typically, SOD isn't found until after the gallbladder is removed, but it's possible it could be present if all the tests turn out normal. The only diagnostic test for this is ERCP and manometry. If elevated pressures are found in the duct, they typically perform a sphincterotomy (cutting the sphincter) to loosen the opening. But if the pressures aren't high that sphincter should NOT be cut - so the manometry is very necessary.

You might want to talk to the doc about the possibility and see if you could try some fairly high doses of specific anti-spasm meds (or calcium channel blockers) and see if they can help cut the pain. If they help, it might suggest that the problem is SOD - but the blockers/meds don't work for everyone so it's a bit hard to tell.

I hope you're also following a lot fat diet. It's of help to some.

A very 'indirect' indication is the pain seems to get worse if a person takes a narcotic-based pain reliever - they increase the ductal pressures.

And is the doc sure no sludge was present? They can do a 'capture' of release bile to check. Sludge can be a MAJOR problem in some people.

[geosci]

Thanks for the response!    I have SOD on my list of questions for the next time I talk to my DR.  I have been taking narcotic pain killers for this and they seem to cut the pain a bit.  My doc had me avoid them for a week to see if the condition improved (he never mentioned SOD). Unfortunately it didn't, but I will stop taking them again to see if it improves. Fortunately I am not taking very much as I can't work and take them at the same time.  I am also watching the fat content of my food much more closely.  Hasn't really helped, but it is still a good habit to get into!  Thanks again!

[infoseeker65]

I've sent you a PM.  I've got similar symptoms and was hoping to email you.

[penwill65]

I have had same symtoms for years, but recently found out the problems wa due to disc degeneration, i guess upper right ab pain is a symtom of it..... but now im thinking i also have  Gb probs , cause i cant drink without getting sick after one or 2 drinks , and i recently started smoking again and my pain has gotton worse, and now im starting to get sick after eating fatty foods so just thought i would let ya know about disc degeneration in case they cant find anything else wrong ya might want to check into it.. good luck