Need a Diagnosos

My daughter is an 18 year old Type I Diabetic. She is otherwise healthy with no chronic illnesses. Her blood sugars are well controlled and she takes good care of herself physically & mentally. She is a sophomore in college and works part time as a receptionist for an auto repair shop.

She is extremely well liked and respected by hers peers and has won numerous athletic and sports related awards. She received several humanitarian scholarships in her senior year of high school. She volunteers with pre-school handicap children in our school district.

Approximately 4 months ago during summer break from school she began experiencing stomach pain and discomfort. At first she thought she was lactose intolerant because she felt milk products irritated the situation. She also began to have difficulty having a bowel movement and would feel extremely full after eating a small amount of food. Within a week she began vomiting immediately after eating. The vomiting became so severe to the point where she could not keep anything down, not even fluids. This was after she tried puree foods and nutrition drinks. She even tried eating baby food. She felt like the food was sitting in the bottom of her stomach and she could not tolerate any type of food at all, not even soup broth, jello, pudding, applesauce, nothing!

Her doctor sent her for an abdominal ultrasound which appeared to be negative. She continued to have pain & vomiting. She was then sent to a GI doctor who performed an endoscopy (with no biopsies) which showed that she had some debris in her stomach as well as a lot of fluid. He also ordered a 4 hour gastric emptying scan which came back normal. He diagnosed her as having gastroparisis. She was started on Domperidone 4 times a day.

Her condition continued to deteriorate and she was admitted into St. Peter's Hospital in New Brunswick, NJ. They did a CAT scan which was normal. They gave her a tremendous amount of pain medication and sent her home. She continued to deteriorate and was admitted again, only this time to another hospital, Robert Wood Johnson Children's Hospital in New Brunswick, NJ. There they did an MRI, MRA, Hyperscan of the Gallbladder, &  numerous blood test.

She was diagnosed with a bad case of constipation and sent home with a pain ratio of 2 and having eaten nothing for 24 hours. She was home for not even 24 hours and she was admitted back into the hospital again by the Pediatric GI department. They did an endoscopy & colonoscopy with biopsies. It showed she had microscopic colitis. They also performed a hyperscan on her gallbladder which showed decreased mobility. She was sent home on asacol. Within a week she was admitted again due to severe dehydration. Her pain escalated and she had an ultrasound that showed a dialated common bile duct. She also had an elevated GGT and some other blood work. Right now she is being treated for Visceral Hyperalgesia.

Do you think she has Acalcuous Cholecystopathy, or an abnormality with her Sphinctor of Odde?

Please give me any advice you can.
Thank you,
Debbie Cseh

[boron]

Debbie, it is not possible to give a diagnosis from here...

Beside stones and sphincter of Oddi. an inflammation of the bile duct would be possible, because she also has microscopic colitis (cause is not known, but infection is suspected to be a cause).