To have surgery or NOT

[Dalhia]

I am a 47 year old female that has been having stomach problems for 8 months. The first symptoms were nausea, heartburn and a dull ache.  I was put on a PPI, the nausea and heartburn went away but only for a short time. I startd to get heartburn again so I was put on different PPI's that would only work for a short time. I was still experiencing the dull ache so the GI doctor suggested I take a few tests. I had an endoscopy everything looked good except I have a slight hiatal hernia, an ultrasound which came back negative, a hida scan and the ejection fraction came back 14%.  My symptoms now are a pressure in my upper right side, at times a dull ache in the upper middle and at times a sharp pain that would last a few seconds in my upper right side. A few times I did feel the pain radiate to my back that would last a few minutes. I haven't been experiencing heartburn like I was so I am not on a PPI.  I am taking enzymes at the moment. My GI doctor suggested for me to see a surgeon. The first surgeon  said if I am not experiencing any real pain he will not take the gallbladder out. He said "the ejection fraction is only a number,  come back in 3 months".  The second surgeon told me to "have it taken out, there is nothing you can do to improve it's function it will most likely get worse".  Who do I believe? I thank you in advance for your reply

[Kevin Pho, MD]

I can't make any concrete recommendations without personal evaluation.

Cases of low gallbladder ejection fraction are controversial.  There are some small studies suggesting benefit with cholecystectomy.  However, there is no guarantee that your symptoms will abate after surgery.  

That being said, I would consider surgery if all other diseases have been ruled out.  You can consider a 24-hr pH study to quantify the severity of the GERD as well as a gastric emptying scan to evaluate for gastroparesis.  

If the tests remain negative, surgery will remain a possible option to help alleviate your symptoms.

This approach 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_

[Crampster]

I guess this is a hard decision to make. I too am faced with a similar decision... however I experience pain when I eat anything with fat...
All I can tell you is that I have had 2 hida scans with a 67%, ultrasound and a CT scan all negative... but I am still having the gallbladder removed..
My biggest fear is getting stuck with Dump syndrome which is definately not what I need as I already have IBS-D.
To assist you in your decision the only thing I can tell you that I learned during all my oooh sooo fun testing is with a hida scan anything below 35% is not normal.  So at some point in time you may need to get the surgery.  However if you are not having major issues you could choose to wait.  
Best of luck.
Crampster

[Dalhia]

I am just afraid it is going to get worse and I don't want to deal with the pain. The question is when.  I have done a lot of research online and decided I am going to take it out.  If I  definitely knew the function will improve I would keep it but from what I have been reading it never improves it can only get worse. I am scheduled for surgery next Wednesday. I figured the sooner I take it out the sooner I can get on with my life and not worry about when I am going to get worse.I hope everything works out for you and good luck with your surgery.  Keep us posted and I will do the same.

[Crampster]

Have had the gallbladder surgery and was doing well.  Still have a burning pain around belly button.  Not sure how long that will last.  How have you been doing since your surgery
crampster

[Dalhia]

Hi I am glad you are doing well. I had surgery on August 8th and so far so good. It went well.  I was admitted to the maternity ward in a private room and felt like Queen for a day lol. I stayed overnight and released the next day. I was uncomfortable for the first week but once the doc took the staples out I felt better. I am able to eat whatever I like without having any major bowel movements lol.  I am experiencing the acid reflux again.  It began when I started taking pain killers for the first three days.  I am hoping I can get it under control again like I did before.  I have been off the reflux meds for about 4 months but I started to take pepcid ac again a couple of weeks ago.  When was your surgery? Are you able to eat what you like?

[DeHartN]

Hi,

I'm 31 years old female. Right after having my forth child, I started experiencing horrible stomach pain, right after meals (sometimes even before even finishing a meal), heartburn, gas, and frequent trips to the restroom. All these symptoms were intense for about a year after my last son was born, and they have been decresing in the last six month to the point that I only have, often times, pressure on the right side of my back, right below the shoulder blade. While being diagnosed, I have the ejection fraction test done three times. The first two showed 35%, and the last one two weeks ago showed 65%!!!! My doctor is puzzle. He said usually these readings don't improve. At this point I'm not going to have the surgery. Does anyone knows about gallbladder ejection fraction improvements? Could it be related to hormones?

Nat