Gallbladder question.

[jfem4]

Hi,
I am a 41 yo female. No medical/surgical history. Exercise ( run-3-4 miles/3 times /week, plus weight train). 5 feet 8, about 155 pounds. Diet is low in fat, high in fiber etc...

Last year, ( dec 2005)I started having stomach issues, nausea, fullness, yellow stool.
I had stool cultures, endoscopy, colonoscopy ( found proctitis-treated with Canasa supp), abdominal US, pelvic US, blood work.
All were negative.

I started taking probiotics, vitamins etc...and all was well...excpet for the occasional yellow loose stool. ( not diarrhea, just loose). And the occasional bloating and gas.

About a month ago, I noticed a dull, achy, pressure.pain right below my Rt. rib. I also noticed that during this time, I had loose yellow stool, felt bloaty, and just not well.


THe pain lasted for about a day or so, on and off...Not excruciating, just annoying, and sometimes a little painful.

It went away, and was happening on and off for about an hour or so every couple of days.

Went to the GI, he ordered an upper GI with small bowel, and a HIDA scan.

THe GI series was normal.

THe Hida Scan :
Visualization of the gallbladder and bile duct @ 10 minutes, and flow into the duodenum @ 25 minutes.
After the injection of CCK, the parient experienced nausea.
THere was poor contractility of the gallbladder with ejection % of only 10 %.

Impression : no obstruction of the cystic or common ducts.
Abnormal response to CCK.


So my questions:

1. does my gallbladder have to be removed?

2. is there anything that I can do to increase/strengthen the contractility?

3. did I do anything to cause this?

4. if I don't have it removed, will it get worse? Can I die from this?

5. If I get it removed, will I get bad diarrhea? Everyone that I speak to has some sort of diarrhea issue after they had it removed. I don't know if they had this before it was removed, but I just know they have it now.

6. should I repeat the test? The nausea that I felt was slight, it did, however, produce the dull-like pain that I get.

7. if I did have it removed, could I do it via open abdominal instead of lap? Does it matter?

I don't really have any other issues except the knawing.dull pain at times.
No nausea/never vomited, no diarrhea.

Just bloaty once in a while, more gassy than usual...

thanks for reading this and answering all the questions.

One MD says it has to come out and the other says not unless I am in sever pain and it's interferring with my life ( which it is not,at leat now)

Jane

[Kevin Pho, MD]

To answer your questions:
1) A low gallbladder ejection fraction was found.  Smaller studies have suggested that removal of the gallbladder can help with the symptoms.

2) Normally removal of the gallbladder is done to treat this.  I am not aware of medications that can improve the contractions.

3) I am not aware of specific inciting events that can lead to a lower gallbladder ejection fraction.

4) It is unlikely that this condition is life threatening.  However, the pain and discomfort can continue if not appropriately treated.

5) There is a small proportion of patients who have diarrhea after removal of the gallbladder.

6) If the results are in doubt, repeating the test can be considered.

7) I would discuss the surgical approaches with your surgeon.  If possible, a laparoscopic approach would reduce recovery time.

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_

[Felix'sMum]

Hi, we're in  similar positions - I'm a little older at 46  but have the exact same symptoms. I think the short answer to whether you did anything to cause the gallbladder trouble is No. It used to be said that the typical profile for this complaint was someone Fat, Forty and Fertile. Nowadays, most doctors agree that ANYONE can suffer with it. The mechanism that causes gall stones and poor gallbladdder function is not perfectly understood yet but diet, for example, whilst it might play a part,is only part of the picture. As for the diarrhoea thing, I hear good and bad from different people...my own doctor says it's rare, but I read here it's quite common. It's possible that the dietary adjustments which need to be made post-gall bladder removal don't suit everyone and some people's alimentary system just doesn't adapt well to changes. As to whether we should have our gallbladders out, my friend, I don't know cos I am struggling with that one myself while awaiting a date for surgery. Like you, the pain is bothersome but liveable with. However, it is pretty much a given that while many, many people have gallstones and never have a single symptom, once you DO experience problems, they are not going to clear up and will get worse. Can you die from this? Not in the simple sense that gallstones/poor gall bladder function is fatal in and of itself - but poor function increases the risk of infection, particularly where gall stones are also involved, and worst case scenario, if left untreated, the infected gallbladder bursts and causes septicaemia/blood poisoning which most definitely can be fatal. Laparoscopic versus open surgery? Take the keyhole surgery every time. Bigger wound = more scarring and adhesions, longer recovery time and risk of post-op complications. Good luck with your decision as to which way to go on the operation.

[poolnoni]

I have been having low stomach (large colon area) distress for over a month. I get the feeling of wanting to have diarrhea, nausea, feel week, no appetite and low stomach discomfort. I am taking several different kinds of antibiotics long term but my doctor doesn't think it is medicine related. Please I need some answers.

[Felix'sMum]

Hi, sorry to hear about your symptoms. They are very different from gallbladder so maybe you could post a new thread so someone with more experience than me and jfem (the originator of this thread)might help you out. Good luck.

[jfem4]

Thanks for your input...

It seems that we are in the same boat, unfortunately...

Did you get a surgery date?
I'm glad to hear that your MD says that the diarrhea is rare, although it does seem like it's pretty common on the internet ?

I have to talk to my GI and find out some more answers to questions like that.

So you have stones??? Is it the same pain, rt, upper quadrant, nausea, ,etc???

I would do lap, but I read about some complication to the bile duct???

I agree, it seems like a faster and less comlicated surgery...

GOod luck to you too...

[Felix'sMum]

Hi, no date for surgery yet - quite happy about that cos it gives me more time to think!I live in the UK where healthcare is free but the downside is you have to wait(legal maximum 6 months, sooner for urgent cases of course).To answer your questions, yes, there is an increased risk of the surgeon nicking the bile duct during lap surgery and if it happens you need open surgery to repair it. The damage can also happen, however, during open surgery anyway so for me that isn't really a concern. Statistically, damage to the bile duct occurs in 3 per 1000 lap procedures so it's pretty rare. Yes, I have stones and they certainly interfere with the way the gallbladder works and yes, the pain is the same - right hand side pain, under the rib and shoulder blade, worse at night (for me and most others I believe), plus nausea, gas and diarrhoea etc. Did the scan you had show any stones? If you decide which way to jump on the surgery question, let me know - and I will too. Good luck!

[jfem4]

Healthcare is FREE??? Wow!! How much longer do you have to wait??
How long have you had this?
Well, those are pretty good odds for the lap...I can see why that may be the better option.

I'm waiting for the GI md to call me back regarding my options...

In repsonse to your question, I don't know if I have stones...would they see that on the HIDA scan? I haven't had an abdominal US in a year, and last year there were none, but I didn't have the rt upper quadrant pain then...so I guess I  really don't know the answer to that. I just assumed because it didn't say it,that they checked on the HIDA scan??

I'll talk to the MD today and let you know what he thinks...

Good luck to you,too...

J

[Felix'sMum]

Hi again J! No, the HIDA scan may not have showed stones necessarily, only the gallbladder function. You probably need another US to rule stones in or out, although the results of the HIDA test may have given the doc a clue. Broadly speaking when there is inflammation of the gall bladder, the radioactive dye used in the HIDA scan will appear in the bile ducts, but it will not enter the cystic duct or the gallbladder ~ that usually indicates obstruction. So a lot depends on whether the dye got as far as your gallbladder and whether any stones were suspected at that point. I think if they were, the doc would have suggested a further detailed US scan. he probably thinks you have ABP which is a type of biliary pain caused by either microscopic gallstones or an abnormality in the gallbladder muscle, both of which could be responsible for the pain. In any case, removal of the gallbladder is the only "cure". Hope the doc has some answers for you today!
C.

[Blondehaze99]

Im a 25 YO female, with some digestion issues that are being sorted out. 3 months ago I had AWFUL stomach pains, I was drinking at the time so I figued no more alchol tonight, a few weeks later I drank again, the same thing happened A sharp awful pain in my stomach. Then I started to get this same pain without alcohol, it was really bad so I went to the ER they did a gallbladder u/s which came back normal.they sent me home and said it was gastritis I went to my Doc and he put me on Protonix and sent me to the Gastroenterologist, the sent me for an endoscopy they said it was just mild gastritis( no suprise I have been on meds for this for almost 3 months now) Well on Thursday night I was in such awful pain, RUQ under my ribs I figured it was only gas or something so I went to bed, Friday was worse, it was a stabbing pain which was getting worse as I walked. It was fine if I was laying down. I went to the ER yet again. The DR would only do blood work and most of it was fine except one of the levels were a little high so he had me go for a CT scan for a pulmonay embolism which was negative. SO he came back and told me that he didn't know what was wrong with me he could admit me but he didnt know what was wrong. He told me to go somewhere else. So I left. Went to my family DR he gave me Vicodin and compazine.

When I eat I feel full for hours, like my food just sits in my stomach, I get nausea no vomitting. I have a gastirc emptying study next week. Is there a possibility it is my gall even though my liver enzymes are all good, pancreas is good. Im just so frustrated, I don't know what else to do, I feel like there is always something new going on.

[KAK87]

I'm a 19 year old, healthy female and I had that EXACT same problems! Extreme pain, bloating, nausea, miserable, and practically in pain 24/7, until my family doctor put me on Protnix, then that helped a little bit.  Then I was referred to a gastroentologist and he did a endoscopy and there was no ulcers, but the test results found mild gastritis.  He then upped my dose of Protonix to 2x a day, one in the morning and then one in the evening.  This did help some, but I could right away tell whenever the medicine was wearing off.  I was then given an ultrasound, but no stones were found.  Then I had to take a HIDA scan, and I was diagnosed with dyskinesia, so then I went to a sugeron and I had my gallbladder removed.  I've never felt better. No more pain, bloating, or anything! I'm so happy to be able to eat without being in pain afterwards for hours.  It's just nice to enjoy the day without worrying about if I eat this it will just kill me.  My life is pretty much 10x better after the surgery! No more Protinx or living off of Rolaids for the rest of my life!  After they removed my gallbladder, they could see that it was inflammed, scarred, and it was starting to crystalize into forming gallstones.  I had this surgery exactly a month ago, and I could already tell that it worked just a few days afterwards! If I were you I would get your gallbladder checked out.

[janeysuz]

fat, forty, fertile??  well I'm 5'2" 138lb, 47, no meno yet, but I've had these weird symptoms since age 16...I used to work at a restaurant and when leaning over the counter to take orders my right rib cage would feel sore, but the doctor just tole me "well then don't lean on the counter" (thanks, doc)

ever since then, I've felt symptoms such as tingling under my right rib cage which over many years progressed to tingling pressure slight pain just to the inside of my right scapula, as if a knitting needle were pushed through, and sometimes my esophagus would feel a little tight way down by my clavicle

so at age 32 I had all this work done, CXR, blood...they thought said there was nothing wrong...I was "relieved" but the symptoms continued intermittently (such that I could convince myself there was nothing wrong)

for some reason in the winter months it seems the worst, maybe it's after the fatty holidays, who knows?  but now for 3 weeks I feel it pretty bad, I wouldn't qualify it as outright pain but rather discomfort, distraction, annoyance and a cause for worry...I wish it would go away but it doesn't though it does go down sometimes, that knitting needle is always there, and I feel a bit nauseous over slight things (like my son's laundry!).  

what will they do to test me now?  have things improved insofar as diagnoses?

[TummyTroubles4Me]

I am also in the RUQ tugging sensation/occasional pain, yellow BMs, low HIDA Scan scores (11% first time, 20% second time), debating whether to have my gall bladder removed club.  

In addition, I have had sporadic diarrhea (lasted 3 wks w/onset)and constipation, plus have horrible gas pains followed by a large BM EVERY morning - this has been happening for almost a year now.

Question to the ladies on the board - do your issues correlate with your monthly cycle at all?

If I get my gallbladder removed, I want to be sure that's the issue and the consequences (is constant diarrhea) are not worse than my present symptoms.

Keep us updated!