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Gastroenterology (Expert Forum)
Thick Wall and Polyp - First Attack
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Thick Wall and Polyp - First Attack
by Vortex, Sep 02, 2006 12:00AM
Well I think I really overdid the fat. I had a 3 day weekend and purchased 3 large steaks, mashed potatos with lots of butter, and my favorite high fat ice cream. Anyway after my 3rd day last meal I said, wow cannot believe how good I feel, no stomach aches. But that night I woke up to a pain at 3 am that slowly grew to level 7 out of 10. Thought it was initially heartburn, but I take 15mg Prevacid for GERD with hiatel hernia, and the pain did not go past my midline below the ribcage. Took some antacid and waited, then with no relief I went to the ER.
Long story short, they did a EKG, then took some blood. Blood work came back with slightly higher than normal pancreatic enzyme. Pain slowly subsided after 4 hours to nothing. Then had a upper GI and sonogram 2 days later. The sonogram showed a thickened wall at 3.7mm vs. the norm of 2.9mm and a polyp at the top and a folded type gallbladder. Other tests unremarkable.
4 days later had a 2 minute level one pain at the same spot exact midline just below sternum for about 5 minutes just after eating, but no pain since (1 week).
About 5 months ago I woke up late at night with a nagging pain just below the shoulder blade and that lasted a few hours. Did not know what that was.
Anyway my Family Doc said I could wait, or just go ahead and get the gallbladder out, but if I wait I may have an emergency to deal with later.
Can the gallbladder become inflamed by a binge of high fat, then a week later look normal, or will the thick wall stay thick? Is the polyp near the entrance of the gallbladder something to worry about. No gall stones found, other than they think the polyp could be an encased gallstone. But should the gallbladder be that thick with no stones?
I have not had a gallbladder function test yet and normally do not have pain, have had some weight loss the last few months. I am age 50, play sports, and normal weight. Been on a low salt diet because of Meniere's in left ear.
Any opinion, or what next for tests. I am afraid if I see a surgeon, he would suggest surgery, so want some unbiased opinion.
Long story short, they did a EKG, then took some blood. Blood work came back with slightly higher than normal pancreatic enzyme. Pain slowly subsided after 4 hours to nothing. Then had a upper GI and sonogram 2 days later. The sonogram showed a thickened wall at 3.7mm vs. the norm of 2.9mm and a polyp at the top and a folded type gallbladder. Other tests unremarkable.
4 days later had a 2 minute level one pain at the same spot exact midline just below sternum for about 5 minutes just after eating, but no pain since (1 week).
About 5 months ago I woke up late at night with a nagging pain just below the shoulder blade and that lasted a few hours. Did not know what that was.
Anyway my Family Doc said I could wait, or just go ahead and get the gallbladder out, but if I wait I may have an emergency to deal with later.
Can the gallbladder become inflamed by a binge of high fat, then a week later look normal, or will the thick wall stay thick? Is the polyp near the entrance of the gallbladder something to worry about. No gall stones found, other than they think the polyp could be an encased gallstone. But should the gallbladder be that thick with no stones?
I have not had a gallbladder function test yet and normally do not have pain, have had some weight loss the last few months. I am age 50, play sports, and normal weight. Been on a low salt diet because of Meniere's in left ear.
Any opinion, or what next for tests. I am afraid if I see a surgeon, he would suggest surgery, so want some unbiased opinion.
Doctor's Answer
by Kevin Pho, MD, Sep 04, 2006 12:00AM
, Sep 04, 2006 12:00AM
A high-fat diet can exacerbate gallbladder attacks with the presence of gallstones. However, since no gallstones were found, an ejection fraction can be measured via a HIDA scan with CCK stimulation.
Further evaluation of the thickened gallbladder can be considered with an MRCP to evaluate the biliary ducts.
Regarding the polyp, followup would depend on the size and location. Treatment options can range from surveillence to removal of the gallbladder.
These optons can be discussed with your personal physician.
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_
Further evaluation of the thickened gallbladder can be considered with an MRCP to evaluate the biliary ducts.
Regarding the polyp, followup would depend on the size and location. Treatment options can range from surveillence to removal of the gallbladder.
These optons can be discussed with your personal physician.
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_
Member Comments
by Beachcombers, Mar 15, 2008 01:17PM
A related discussion, Vortex's gallbladder posting was started.
by Beachcombers, Mar 15, 2008 01:17PM
A related discussion, Vortex's gallbladder posting was started.
by Beachcombers, Mar 15, 2008 02:00PM
A related discussion, Layman's terms please... was started.
