Gallbladder symptoms, but diagnostics are normal. Please help!

[jgs81]

I am a 29 y/o female, pretty healthy, with a normal BMI. A little over a year ago, I had a sudden attack of debilitating, sharp pain in my right upper quadrant that radiated to my back after eating Japanese food. I went to the ED, they gave me a GI cocktail, diagnosed me with a stomach ulcer, and sent me home on Pepcid. I had a stomach ulcer once prior to this, and I knew it didn't feel like an ulcer. I suspected my gallbladder. Over the next year, I would occasionally get sharp, colicky pains in my RUQ, specifically after eating a meal that was fattier than what I normally eat (I generally steer away from unhealthy foods).

This past December, I developed SEVERE nausea, but no vomiting. So much so, I suspected pregnancy and took a home test, which came back negative. The nausea was not associated with eating, or a specific time of day per say, but seemed to be worse at night. I tried cutting out certain things in my diet---wheat, dairy---nothing worked. Then the colicky pains in my RUQ started to become more frequent, even after foods like graham crackers and lasted anywhere from seconds to minutes. I also developed increased gas/bloating and belching. No heartburn or reflux, but my MD put me on Zantac.One month later on the Zantac, no change in symptoms. Still no vomiting, but continued nausea, pain, and gas.

I was referred to a gastroenterologist who drew bloodwork, scheduled me for an abdominal ultrasound and HIDA scan with EF, and gave me a prescription for Zofran. White count, LFTs, Amylase and Lipase were all normal. Had the radiology tests done today---no stones were visualized on the u/s, HIDA scan showed no obstruction, and my ejection fraction was 88%. Since all tests were normal, my GI doctor wants to start me on Nexium tomorrow and follow up in 4 weeks.

My last "attack" was yesterday, while I was out for a run. Besides a Vitamin D deficiency and IBS, I have no diagnosed disorders/diseases. I just had my yearly exam two weeks ago in early Feb---I'm not pregnant. I'm extremely frustrated, as I seem to be having textbook gallbladder symtoms, but clinically, everything looks normal. I'm tired of feeling like crud, and I don't want to be on Nexium, Zofran, Simethicone, etc. for the rest of my life. Does anyone know what could be going on with me? Any suggestions would be appreciated. Thanks for listening.

[jgs81]

Thank you both very much for your comments. I'm sorry you went through what you did, and I'm glad you are doing much better now. It's nice to know I'm not alone. I'm currently seeking out another physician for a second opinion. Wish me luck :)

[Cdngal]

For me as well I had the same symptoms, except the pressure pain would cause me to vomit...this went on for 7 months for me and 44 lbs later... all my tests were normal my HIDA scan was 52% which is considered normal, but was very sluggish, was diagnosed with biliary dyskinesia, I had my gallbladder removed in January the symptoms are all gone, no pain, nausea or vomiting... my GI told me I had all the class gallbladder symptoms and with the biliary dyskinesia she thought would be best route for me.. she was right!  She said sometimes gallbladder can be very difficult to diagnose, my surgeon told me my gallbladder was full of scar tissue from all the attacks, so its still possible.

[michell221]

You have just described what I went through.  I had bad pains after eating and pain in the GB area. I also had nausea and a feeling like my food was not digesting properly.  I did not have an ulcer.  They did endoscopy colonoscopy etc.  Finally they did a hida scan.  It came back at 88%.  That is above the 35% cut off for a bad GB.  There has been some research stating that a high ejection fraction such as this is also a cause for biliary dyskinsea which we have.  They have done studies and GB removal has helped some of these people with the GB pain and high ejection fraction.  

I chose to wait and deal with pain.  I got it tested again about 1 1/2 yrs later.  It was then at 23%.  I got it removed.  I was still left in pain but a different kind.  I no longer had the constant pain but bad attacks that hurt like someone kicked me there and it would make me sick.  I was finally diagnosed with sphincter of oddi dysfunction. I will have this forever but mine is not too bad so I am able to lead a fairly normal life.  It is better than the constant gallbladder pain.  

That is probably what caused my GB to go bad. Sphincter of Oddi cause the bile ducts to spasm or narrow.    The initial pain and high ejection fraction was probably a manifestation of my disease . MY GB was very scarred and adhesions were everywhere according to my surgeon.