Low HIDA, ovarian cyst, stomach spasms, WIFE IN HOSPITAL

[gd2475]

my wife is 29 years old, non smoker, non drinker, non contributing hx.  she has been feeling ill for 6 weeks.  she was diagnosed with gastro enteritis 6 weeks ago but it has not resolved.  she has cramping, bloating, major stomach gurgling, and generalized stomach and back aches (between the shoulder blades). she presented to the er yesterday morning with weakness, shivering, and severe stomach ache and cramping.  After many hours of workup, here is what i have compiled...

-labs are normal
-HIDA is low, 22%
-5x4 cm ovarian cyst same side, ruled out as cause of pain by -2 -ob/gyn consults, although it is displacing her uterus.
-upper scope negative for ulcer
-positive urine culture for e. coli (started levoquin today)
-gi doctor found some bile in the stomach and wants to investigate that (i dont know why or what that means)

my question, or rather my problem is that the md's in the hospital feel they have run all the tests necessary and are ready to send her home.  however, the only time my wife felt any relief of her symptoms over the past 6 weeks was today after she fasted yesterday in the hospital.  the minute they gave her a liquid dinner, she had all her symptoms come back.  her internist feels the gallbladder, although functioning at 22% is not contributing to her problem.  he says she can go another 15 years on her gallbladder.

As a health care practitioner myself (i am a dentist), i can certainly appreciate the diagnostic process, but i feel the answer is staring us in the face (removal of the gallbladder).  clearly my wife cannot eat without her stomach spasming, stomach pain and back pain.


i am at my wits end and considering bringing her to a "better" hospital but i am not sure what that will accomplish.

please help with any thoughts. am i barking up the wrong tree to want her gall bladder removed???

thanks in advance for the replies,


dr. d

[Kevin Pho, MD]

It is true that some studies have shown that those with a low gallbladder ejection fraction may have their symptoms relieved with removal of the gallbladder.  However, there is no guarantee of this.

Your wife has had a pretty comprehensive workup showing an absence of any other major disease.  At this time, I would consider removal of the gallbladder.

You can discuss this option with a GI physician or surgeon.  A second opinion can always be sought if the diagnosis is still in question.

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_b

[Canyon711]

It is possible that she has Irritable Bowel syndrome. When they can't find anything else that is usually what they diagnose. I assume she has had a upper and lower CT scan to rule out any other organ problem. When they did the upper endo I assume they checked for e.coli in stomach and all the other bacteria's that can cause these problems. That is usually done routinely as they should test for H. pylori, giardia, and assorted other things.

[Vijo]

In case you are still checking in this site: sure hope your wife has gotten help. My daughter suffered for months with pain attacks-horrid trips to the emergency rooms where they diagnosed her as just a 'druggie' looking for a fix because the tests were all "normal".  Anyway, long story short, finally a referral to a surgeon who did a new hida scan and said she was borderline ( I think it was 37 and we were told that 35 was the bottom normal number. I' thinking 22 is not nearly in the normal range.)  So he told her that there was a 70 to 80% chance that gallbladder removal would solve the problem.  He said it was like the gallbladder trying to punch through a partially closed door causing spasms. Surgery (last October) went well though much pain after, and we were told that the gallbladder looked normal which scared us that maybe it wouldn't solve her problem.  Recovery was a little hard but as of now she has not had any more of these types of attacks. (although other health issues)  Also, my elderly mother had pain between her should blades for years and they always checked out her heart.  Then finally, when her gall bladder quit functioning entirely and was gangrenous, we found out that that is a symptom of gall bladder trouble.  Again, hope your wife has already been helped!

[Jackeline]

I'm going through a similiar medical situation; I've always suffered with stomach spasms as a very young child, the doctors would give my mother medication to treat my spasms (Donatal).  For the past two years I've spoken to my doctor about this severe stomach pain, he referred me to a Gastro Doctor who ordered a thousand tests which included checking my gallbladder, for ulcers, etc. but everything was normal.  He diagnosed my pain as stomach spasm, I was given Amitriptyline, I continued to explain about the frequent bowel movements and vomitting. I was then told to take Imoduim AD daily.  The Amitriptyline began helping with the spasms, but then they worsen causing visits to the emergency room where I would be given shots Morphine for the spasm, now this should have taken all the pain away but it didn't it only subsided the pain by 40%.  Then the amitriptyline was increase to 20mgs daily and 1 Levbid 0.375mg daily.

My primary physican did blood work, where it showed I couldn't eat anything  containing wheat or flour.  He submitted this to the Gastro Doctor he then admitted me for a biopsy of the small intestine.  When I returned to him a week later the Gastro Dr stated everything once again it was normal.

I'm at my last wit.  I'm constantly fatigue and tired with this battle my stomach spasms have intensified where I have to sit because I get dizzy or I feel I'm going to pass out.

I've been dealing with this stomach problem for the past 25 years.  Any suggestions or ideas to what my stomach problem is that the doctor can't seem to diagnose or find a solution.

[tundra2]

I too suffer with stomache spasms. They are really severe. From talking with a few people who have had heart attacks, the stomache spasms hurt as bad as a heart attack does. I know that as freaquent as mine have gotten I have got to find a solution to the problem! Daily attacks! I take HYOSCYAMINE 0.125 MG TABS (brand name is LEVSIN) for them. They relax the stomache muscle for releif. I take mine as holding it under the tongue for quicker relief. Most of the time it works. When it doesnt, the only thing that does is to empty stomache and then pray I aint dieing!

[Juls8080]

I have been dealing with stomach spasms for several years now, and only recently did I receive medical attention when I was in the hospital this past November for food poisoning.  I am a 22 year old college student, and these spasms are increasingly starting to interfere with my schoolwork, and internship.  I have been given nearly every test imaginable and many different medication and nothing seems to completely work.  The medications are fine in some instances, however they sedate me and I am normally either at school, work or doing homework.  Yesterday I had another "espidode" at work and ended up on the floor in my boss' office (she was out of town) crying from the pain.  I called my doctor and he wanted me to go to the hospital for some scans.  After contemplating for two hours, I decided not to go because I didn't want to throw anymore money away for someone to tell me the results were normal.  I went home, instead, and slept the rest of the night.  How productive with finals coming up, no?  Today, I no longer have the pain, however my entire stomach is sore and I don[t feel like myself.  I am completely worn out from these spasms and tired of people asking me if I need to go to the bathroom.  Unlike most of the cases I've read about, my spasms are not associated with bowel movements, although occasionally I will get sick.  Does anyone think these spasms my be related to a food allergy??