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Doctor unsure(?!)

by Lisa90274, Oct 13, 2009 11:57AM
Hi, I've been sick since last Feb. although I had symptoms before that. I have a very limited diet. Absolutely no fat or I become violently ill. Very bad upper stomach pain between the ribs. Severe nausea lasting for 2 days and vomiting. Burning pain in my stomach.Once I threw up for an entire day. I have some pain in my upper right side below the ribcage that comes and goes. The nausea is what I can't live with. It's very very mild most of the time but I never know what will set it off. If I stick to my diet it's much better but sometimes some kind of chemical I think (like in sweetened cereals) will make me sick.
I had bloodwork that is mostly normal. I had a CT scan, MRI (slightly enlarged duct I think?) ultrasound of the gallbladder which showed sludge and an ERCP which was normal but took 1.5 hours to show my gallbladder (does that mean anything?) I went to 3 doctors (hence all the tests) who told me there was nothing wrong (I've lost 25lbs. which is not normal) and finally was referred to another doctor who said he's unsure. He said he thinks it could be either the gallbladder or the common bile duct. He said he's 50-50. But if he removes my gallbladder that could make things worse. I didn't understand why. He doesn't want to do the MRCP because he said he's sure I'll get pancreatitis and one of his patients was hospitalized for 2 months with it. I'm afraid of the MRCP because I've read that it can make symptoms worse (is this true?) I'm very confused and so tired of being sick. Anyway, thanks for reading this if you've gotten to the bottom. Any ideas appreciated.
Member Comments (1)

by CalGal, Oct 13, 2009 05:57PM
Lisa, sludge is never a good thing and it could be the thing that's causing your problem. Did the doc suggest any meds to try to 'dissolve' the sludge? Some people are candidates, others aren't. But sludge can cause problems because it can 'scratch' or irritate the cystic and common bile duct and result in spasms within the biliary system.

I'm a bit confusted, because typically they'd do an MCRP first, and then if stones were present within the duct, they'd do an ERCP to try to remove them. And the ERCP is the test in which there can be problems with pancreatitis. The MRCP doesn't have that possibility and is typically a very safe test.

A slightly enlarged bile duct can result from stones in the common bile duct, so if that's what might be going on, an MRCP should be done to further investigate what's going on. If sludge has entered the duct then something may have to be done.

The typical pattern is, if someone has no stones/sludge but a low ejection fraction, that's when people typically have post-surgery problems. But when stones or sludge are found and the ejection fraction with the HIDA scan is low, the chance of post surgery problems is much less.
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