Gallstones or No??

About 3 weeks ago I was seen in the ER with upper right quadrant pain. They ran blood tests and an ultrasound and everything came back normal. (blood labs were fine and ultrasound showed no abnormalities or stones). They sent me home with some pain medicine. I haven't had that excrutiating pain since, but I do have some cramping in the area that goes away. Could stones have developed over 3 weeks time?? I have had a CT scan of my abdominal area about 2 months ago and that was also normal, I just seem to get these on again off again cramps. I continue to take pain medicine as well as bentyl for possible IBS. But I still wonder if there could be gallstones or something else that's been overlooked. I am a 25 year old female with no major health problems, except this current situation.

[michell221]

Yes you could have small stones that did not show up.  You also could have a GB that does not function well.  A hida scan will test for that.  If your GB is functioning below 30% then a surgery consult is generally given so you can decide if you want it out.  They will not usually do the hida scan in er so try to ask your GI doc for this test.  

[Brooke20]

My GB test came back normal.

[michell221]

Did you have the hida scan where they inject the CCK?  If so did the CCK injection reproduce your symptoms?  

[Brooke20]

The symptoms were never reproduced no. I have no tenderness in the area now or anything. not nauseas, etc. It's just the come and go pain that is in that particular spot.

[michell221]

What was your ejection fraction for the hida scan?  ... This is important to know.

The right quadrant pain is suggestive of some sort of bilary issue.  There a quite a few things this could be such as   peptic ulcer disease diagnosed with EGD, choledocholithiasis ( small stones)  and microlithiasis ( sludge in GB) , pancreatobiliary neoplasia, irritable bowel syndrome, musculoskeletal pain or Type III sphincter of Oddi dysfunction (SOD) (if you have normal liver enzymes during pain attacks if abnormal liver levels then you would be type 1 or 2) .

Ultrasound and magnetic resonance cholangiopancreatography (MRCP) have relatively high sensitivity rates for the detection of common bile duct stones but small stones and microlithiasis might be missed. Endoscopic ultrasound ( EUS)  and microscopic bile examination for microlithiasis could also be done to help rule this out..

[Brooke20]

I have no idea about the scan other than that it was normal. Like I said the only symptom is the come and go pain. I have back problems so I was wondering if that sort of pain can be felt around my problem area too.

[michell221]

You can have musculoskeletal pain in that area .  It looks like you will have to get more testing to be certain since it could be so many things.  Since you do have back pain already maybe your dr can evaluate this area and recommend some things to see if gives relief.