gallstones and chest pain

[kimtch]

hi, i'm a 21 year old male.  6'0'' and 150 pounds.  i have a couple of questions regarding chest pain and gallstones.  a couple of months ago i began to have some nausea.  at the time, my primary care physican told me that i had reflux and put me on prilosec.  for the next couple of months, i was on prilosec or prevacid, which helped the nausea go away; however, i began to develop bad heartburn and upper left chest pain, around the nipple area of my left chest.  as a result, i went in for a upper gi series which was negative and ultrasound which showed gallstones. i then saw a GI doc who did an endoscopy on me and told me i didnt have refulx and only mild gastritis.  after this, i quit all the PPIs that i was taking and actually began to feel better.  the GI doc told me to take carafate for a month and i've been taking that now.  anyway here are my questions:

1) Is it possible that the PPIs were the cause of my heartburn and chest pain? i've read that too little stomach acid can cause these symptoms

2) are there any other GI tests i should have done to help determine if my upper left chest pain is GI Related?

3) given my young age, should i bother to check whether or not the chest pain might be due to something heart related?  

4) most importantly right now, should i have my gallbladder removed? the ultrasound showed stones, but i have no gallbladder related symptoms. no pain at all on my right side.  my GI doc says i dont need to get it removed, but the PCP and surgeon tell me i should.

thanks a lot!

[Kevin Pho, MD]

Hello - thanks for asking your questions.

1) Angina and chest pain are side effects in less than 1% of cases.  I am unaware of cases where PPIs cause heartburn.  

2) You have had an upper GI series, ultrasound, and endoscopy.  To be complete, a CT scan can be performed to evaluate for pancreatitis on any splenic abnormality.  An amylase and lipase also can be done to evaluate the pancreas.

3) It is unlikely that coronary artery disease is causing your discomfort with you being 21.  However, conditions such as hypertrophic cardiomyopathy can present as chest pain.  An echocardiogram can be performed to evaluate for this.  Without examining you, it is impossible to say for sure - I would discuss these options with your personal physician.

4) I cannot comment online whether you should have it removed or not.  It is possible that the left sided pain is coming from the gall bladder, but without examining you or your studies, I cannot suggest a treatment.  

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.

Thanks,
Kevin, M.D.

[surgeon]

It's not easy nor accurate to diagnose and recommend strictly online. But it's very possible your pains are related to your gallbladder: it's not all that rare to have the pain present on the left. Many people have been admitted to coronary care units with presumed heart attack, only to find out it's the gallbladder. At your age, it's even more likely, since heart disease -- particularly the kind that causes pain -- is pretty rare. But the only people who can accurately advise you are your own doctors.