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Biliary Sludge Symptoms?
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Biliary Sludge Symptoms?

Hello.  I've been having digestive symptoms of increasing severity for about two years, now.  At first, I thought it was due to my chronic sinusitis.  Basically, I have incessant postnasal drip -- Probably related to laryngeal reflux -- and I was thinking it was THAT causing me to vomit.  To be sure, it plays a part, but over the past month or two it's become QUITE obvious that the GI symptoms are independent from (Or at least only exacerbated by) the sinus/lung/LPRD issues.  I had been told in the past that the dull pains I'd been having just at the bottom border of my ribcage was variously costochronditis, muscle strain from coughing, intercostal pain from breathing/coughing issues, etc.

So, after another day of abrupt onset nausea and vomiting after eating I went to my own ER (I work in respiratory med).  All of my blood work was normal.  Nausea, vomiting, epigastric pain radiating toward the right side.  Ultrasound of my gallbladder revealed 'biliary sludge', and the ER doc told me it would have to come out.

I'm in the process of trying to find a GI doc; My insurance changed at the beginning of the year and my regular doctor is not available on that plan, so I'm having to go through the whole research/track down a doc taking patients/etc. thing.  I work at our pediatric hospital, so I don't really KNOW any of the adult doctors.

In any event, a lot of my reading is providing mixed results.  At present, my pain is mild to moderate, and almost -precisely- on the gallbladder.  It's my understanding that biliary sludge tends to be either asymptomatic, or with intermittent symptoms.  Why would the pain be constant?

I'm also experiencing a batch of GI symptoms, and just wanting to confirm they're more evidence of needing surgery (I like to be sure before I go getting parts removed, heh).  Nausea, vomiting, completely irregular bowel movements -- From constipation to diarrhea, more frequently steatorrhea, more frequently pale to bright green and burning steatorrhea, specifically.  At present, it's gone from frequent diarrhea to -infrequent- steatorrhea.  (Partially because I'm not eating much.  Even -thinking- about eating can occasionally get a spastic twinge out of my right side.)

Can just 'sludge' cause THAT dramatic of gallstone-like symptoms?  Is there anything I can do other than surgery, at least until I can GET surgery?  I don't want to keep missing work -- More importantly, I don't want to have to keep leaving work in the middle of a shift because of the abrupt nature of the exacerbations.  (Staffing does NOT like it when you have to leave a couple hours after showing up, with little warning.)

Thanks.

T
Tags: diarrhea
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Avatar_m_tn
Your problems very probably arise from gallbladder.

Pale stools mean, not enough bile is coming into your intestine, so fats are not absorbed and are excreted.

Green diarrhea, especially burning one, is quite characteristic for excess of bile excreting with the stool.

Now, this means, you once have reduced, and once excessive bile excretion. It is possible that "sludge" is releasing from your gallbladder in big portions: some times nothing, then in bulk...

Biliary sludge can cause colic pain, but maybe a constant pain, this is really a question for a specialist.

Diagnostic will be (or it already was):
-ultrasound of gb
-HIDA scan to determine gb function, which is the basis for decision for gallbladder removal.

Two years of symptoms speaks against that a sludge "would have to come out" just like that.

Try to ask on a "ask a specialist" part of this forum.
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Avatar_n_tn
I don't if you've already had your surgery or how things are going but your posting grabbed my interest. Your story sounds very much like mine. Read on if you care to, but be encouraged that life does improve after surgery for most people. I am a living testimony to that.  

I am currently 2 weeks post op from having my Gallbladder removed. I had a large range of symptoms which started in July of 2007 and would affect me at various times up till 2 weeks ago. The images and scans all showed that I had a "normal" gallbladder. It wasn't until the most recent episode with it that a HIDA Scan was ordered to test function level. The one thing about a HIDA scan is that if your gallbladder is not functioning correctly, you have a great possibility of leaving the test with more intense pain than you went in with, so take someone along that can drive just in case.

At that point I had consistant pain from late December to the day of the surgery (Feb. 14th). I never had a traditional gallbladder attack for which I am thankful for, however I think it may have speeded things up with the diagnosis had there been an attack.

When I had the surgery, the doc said that my gallbladder appeared normal but upon further inspection (after being taken out) it was full of sludge. So the long and short of it in my expierence is that yes you can have constant pain with a gallbladder full of sludge.

Until you can get that taken care of, heating pads and ibuprofen help. If necessary, ask your doctor, when you find one, about getting a stonger pain med to take the edge off and get some relief. Also, I was taking Nexium 40 mg as prescribed by my doc to help with any acid production and what not. I don't know that it made a big difference, but I could tell the days I ran out and had to refill.

The good news in this is that not even 2 days post op, I felt like my life had been returned to me. I was able to eat regular meals the next day (In small portions), and I have not had any of the scary story issues that you may read on the net.

The main thing is to keep moving on, and remember that better days are ahead. I wish you luck with your doctor search and surgery if you've not already had it.
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Avatar_n_tn
I'm wondering if I'm in the same boat.  I've felt lousy since Aug. 07.  I have almost constant nausea, burping,  no appetite, occasional pressure and discomfort in the middle of my chest, once in awhile going the the right front/back lower ribline region.  I can't stand to wear a bra - too uncomfortable.  I've had a slew of tests.  Only thing that showed up was GERD.  I've taking PPI's 2x's/day for 2.5 months and not getting much relief.  Ultrasound of gall bladder showed no stones, 2 small polyps.  HIDA scan EF was 32% - borderline.  I haven't had any full blown "attacks" - sharp pain, vomiting.  My bowel habits have changed - 3-4 times in the morning - very loose, occasional diarrhea.  Not sure what to do.
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Avatar_n_tn
There are many references on the web and anecdotally that gall bladder / liver flushes can be effective at reducing or removing early stones and sludge.  Have you tried it?  I've had chronic pain/discomfort for 3 weeks - most noticeably in the evening after being horizontal for a few hours - and a succession of imaging and blood tests with nothing terribly "sinister" surfacing.  I'm about to give the flush a go to see the result.  
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