Gallbladder or something else?

[jfem4]

I am 41 yo female.
Most recently developed RUQ pain, radiating to the back. Maybe 3 times/week, not associated w/eating etc...terrible nausea/bloating, early fullness. ( these symptoms started about a year ago...prior to that, I was perfectly fine)no diarrhea. It's getting worse and I am sick of feeling so badly.

Tests done:
11/20 -HIDA w/cck   1. ejection % is 10%
                    2.abnormal response to CCK
repeated test a month later-delayed visualization of the GB@ 2.5 hours, compatible w/chronic cholecystitis didn't do CCK

endo and US-WNL                    

1/16- colonoscopy     - chronic colitis, proctitis, IBD ( PRN Canasa)

Went to the surgeon who says the GB should come out-that there is a 90 % cure rate of my symptoms IF they are caused by GB.

I know there is a small study that suggests that removing of the GB w/ a low ejection fraction can be helpful, especially when reproduced w the CCK. ( I did get a little nauseous when they did the CCK ).


Questions:

1. How can I be sure symptoms are caused by GB?
2. what if any, other tests should I look in to -to r/o other cause?
3. can any of the other things : proctitis, chronic colitis, IBD etc... cause the symptoms? If so, in your opinion, is it enough to be the cause, or would you think to remove the GB.

4. if I remove the GB adn it's not the reason for the symptoms, what will happen? IS it bad?
5. Can I choose not to remove the GB?

ANy suggestions would be appreciated.
Thanks

[Kevin Pho, MD]

To answer your questions:
1) You can't be 100% sure.  The tests are suggestive that it MAY come from the gallbladder (with the low ejection fraction), but there is no way to be 100% sure.  I agree with the consideration of removing the gallbladder.

2) You can consider an upper endoscopy to determine if there are any upper GI disorders that may lead to your symptoms (i.e. an ulcer, GERD, or inflammation of the upper digestive tract).

3) If the gallbladder is removed and the symptoms continue, I would look for other potential causes of the symptoms.  

4) If the gallbladder is not removed, there is a possibility that the symptoms would continue if they are due to a low ejection fraction.

These questions can be discussed with your personal physician.

Followup with your personal physician is essential.

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

Kevin, M.D.
kevinmd_

[jonesy55]

I am sorry you are having such a hard time. I can definitely emphathize with you in this case. I too have been very sick and am tired of feeling that way. I really cannot answer too many of your questions because I am not a qualified medical professional. However, I think that it is a big deal that your gallbladder's ejection rate is only 10% as 35% is considered a working gallbladder. This simply means your gallbladder is not doing its job. However, I am not positive it is causing your symptoms as they are unrelated to eating food. Having a nonfunctioning GB can def. cause GI symptoms. I have a friend who was miserable for years with no answers and her GB ejection rate was 13%..she had it removed and feels better. I know my post probably does not help, but have you looked into gastroparesis(delayed gastric emptying)? This has similar symptoms. Overall, I think it is important that you push for answers and get a second oppinion before having surgery.

[jfem4]

Thanks for your input...

I did have an upper gi and an endoscopy...both were basically fine..

I'm leaning toward the removal...I actually have a date set for 3/26,,,

I just wanted to see your thoughts on this...

I want to feel better...I'm sick of feeling nauseous/bloated and just plain "sick"...


Thanks again...

[claudia2322]

I was having pain for a while it was so severe i thought i was having a kid. my doctor said it was my gallbladder so we did a cat scan and that showed stones. i dont know much about medicine but i know my body i told my doc the pain i was feeling was not from that i went ahead and had my gallbladder removed and still have the pain. my surgery was just a couple of days ago but what worrys me is that i spoke to someone that had the same surgery and she said that she had a drain after surgery i didnt know so i dont know if that is an issue or not. my doc said that i didnt need one that a lot of people dont use them. but i had the sever pain and diarrea (diarrhea) one day constipated the next and the pain i would get was with anything not food related. i could have water and get the pain. i just want to know if i did the wrong thing by having my gallbladder removed...what if that was not that was not the issue?????? mu doc did tell me before doing the surgery that he could not be 100% sure as to what was causing my pain. im just confused.

[cal11105]

I am also a 41 year old female.  For the past several years, I've been going to doctors for just about everything.  I've had all kinds of tests done with no results except for finding I had a trace of mitral valve regurgitation and GERD.  For the past three years, my symptoms of palpitations/several skipped beats, stomach upset, general joint/muscle pain, etc. have been getting worse.  Everyone kept telling me that it was stress - I've been going through extreme stress over family members being sick.  A few days ago, in the middle of the night I woke up with stomach cramps and had to go to the bathroom.  The stool was soft and black.  I developed very bad back pains and was in bed for most of the day.  After 10 hours I had the urge to go to the bathroom again and it was the same type of stools.  My pain got worse and my heartrate jumped up - even with my medication - I began having bad palpitations.  My husband took me to urgent care and they confirmed that it was not a virus or the flu.  He recommended I call my GI doc and have him do a HIDA scan which I did today.  I was told that my percentage was 25 instead of the normal which was 35 or higher.  I also had lab work done - amylase and lipase.  I am waiting for those results and also for the doctor to call me about the scan.  Could someone who may have gone through this please tell me what I may expect?  Could it be something other than gallbladder?  I've had bloodwork done for my organs several times and all have come back normal.  The recent was done at the beginning of January.  Thank you for any help you can give.

[kris1960]

I TOO HAVE HAD THE JOINT AND MUSCLE PAIN. TERRIBLE RUQ PAIN, AND THE DESIRE TO VOMIT. I WENT TODAY FOR A SONOGRM ON MY GALLBLADDER. IT IS MODERATLY DISTENDED. I AM WAITING FOR MY SURGEON TO CALL ME ON THIS. I OFTEN HAVE THE PALPITATIONS AND PAIN IN NECK. ALONG WITH GAS. DOES ANYONE HAVE ANY IDEAS ON THIS. IT IS STARTING TO SCARE ME.

[littlelady123454321]

i can sympathise with ur pain incredibly well.

a year ago in january, aged 18, i had the operation to remove my gallbladder, due attacks of excruciating pain. the abdominal ultrasound scan had showed up multiple large stones in the gallbladder, this was my only disgnostic test. the keyhole operation was relatively straightforward and i was released from hospital the folllowing day, albeit a little early it was later decided. the time after the operation was not particularly painful, altough in the weeks that followed i often found after a meal i had cramps and had to run for the bathroom, tho this soon settled.

i now find that i can be quite bloated, virtually pain free and have few if any restrictions on diet. however, i find it advantageous not to eat a fatty food, e.g. a scone or very much milk first in the morning or ill have stomach pain followed by a very quick trip to the bathroom.

i hope this might have helped and find i have relativly few regrets about my operation.

[lward]

After my gall bladder was removed I had problems with diariah Vit. E 400 IU daily helped. I took it for a while 6 months to a year I can't remember. I ran out of Vit E and things have been fine since. Vit E helps your body process fat. Hope it works for you