Continued Upper Abdominal Pain

[Cher29]

My problem with my stomach has been ongoing for about15 years.  I have seen several doctors about the problem.  The pain in my upper abdomen comes on suddenly.  It can last continually anywhere from one week to 6 weeks, usually the latter.  Then it suddenly stops.  About a week before the pain starts, I seem to be a little constipated.  This happens about 4 months later.  The pain comes on suddenlty and is continuous cramping, gasey, gurgling feeling in my stomach. Not severe just annoying& worrysome.  I also have pain in my back.  Alot of the time, the pain is right in the pit of my stomach.  Sometimes on the left & right sidesalso.  I don't have any reaction to any types of food.  The pain doesn't really worsen.  Just stays continuous.  I have had a CT Scan, colonoscopies and an Endoscopy.  Gallstones have been found.  I have been diagnosed with IBS in previous years but now the doctors think it may be my gallbladder giving me the problem and want to remove it but do not guarantee the pain that I have that keeps coming back will not come back.  My question is whether it is definitely my gallbladder causing the problem or is it something else?  How come the pain comes on suddenly, stays for a number of weeks & then goes away like it never was.  I eat the same things all the time so I don't think it is the food I am eating.  What brings this pain on? The last time I had my problem it was August 2007 which was 8 months ago, which is unusual.  I have now had the pain since May 7, 2008 and sometimes I am now getting lower abdominal pain.  I have never heard of gallbladder pain that is continuous and it is usually affected by what you eat.  Am I mistaken?

[Kevin Pho, MD]

The workup you have had is comprehensive and would exclude many of the major GI disorders.

The gallbladder can possibly lead to the symptoms.  Obtaining a HIDA scan with CCK stimulation can evaluate the gallbladder ejection fraction.  A low number can lead to abdominal discomfort.  

Other tests to consider would be a 24-hr pH study to evaluate for GERD or a gastric emptying scan to exclude gastroparesis.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Cher29]

Thank you very much for your answer.  I will show your comments to my dr before having my gallbladder removed.  He had never mentioned any of the tests you mentioned above.  The problem has been so mysterious coming and going every 4 months.  I think my dr thought that taking out my gallbladder as a last resort would solve the problem.  I am hesitant to have surgery without substanial proof that my gallbladder is the problem.

[Hojo81]

I have had similar issues now for about a year.  I just had my gallbladder out, but unfortunately, it didn't cure the issue.  It still comes and goes colicky around my stomach.  Sorry you are feeling this way, I know it is very frustrating!  Good luck with the HIDA scan, it's a breeze, but very expensive if insurance doesn't cover  (near $3000).I hope all turns out well for you :)  

[409]

Check for h-pylori.

[Cher29]

Sorry you still aren't feeling better.  I went to a surgeon last year who thought it "may" be my gallbladder but wouldn't guarantee my pain wouldn't return.  It sounds like your same situation.  I will look into that HIDA scan.  I heard that it was painful.  Is it not?  Did you have pain all the time or did you just have pain when you ate something?  My pain is all the time so I can't really tell if it is from eating.

[Cher29]

Thanks.  I will see what h-pylori is.  Docs never metioned this.

[Hojo81]

The experience I had with the HIDA scan was not painful.  You basically just lay there and look at a machine for 30 minutes that appears to do nothing!  Then, when that part is over, they start the CCK injection.  You may feel warm, I did feel some of my pains being replicated (like I was used to feeling)  and I was a bit nauseated, but that only lasted as long as they were infusing the line ( about 2 minutes)  It is tolerable.  Then you lay there another 30-40 minutes.  It really takes about 2 hours.  It was not bad though.  It may give you some valuable info.  I wouldn't rush to take it out though unless your EF is < 20%.  Mine was around there, and looking back, I think i should have just left it in.  My pain now comes and goes.  I can have 2-3 good days (minimal discomfort) and then bam, it's back with boring stomach and back pain!  It seems to be ALL OVER, but i'm sure it's just radiating.  I didn't think meals made a difference, but the more I pay attention to mine, it seems to happen when I am hungry.   I have done some research (of course, as we all have) and think that mine may be a duodenal ulcer.......but still not certain.  I didn't initially correlate it with eating, because I am not a big meal eater, but more a snacker.  You might try to eat meals and just see if it starts hurting more several hours after eating.  Good luck!  I feel your pain.  Your definetly not alone!