sludge, stones and polyps

[ericasch]

In May of this year I began to have abdominal pain bloating and flatus after eating.  It also felt as if a belt was constricting my epigastric area after meals.  I had a pressure under my rib cage on the right side, esophageal pressure and difficulty swallowing and moderate pain between shoulder blades.  esophageal symptoms have improved but abdominal symptoms continue but more mild.  Gall bladder us showed sludge, two small stones, and two polyps. UGI normal and did not show reflux. Can two small stones and sludge be causing these symptoms and will a chole necessarily help.  The stones were small enough that the tech did not see them.  Can you have reflux with a normal UGI.  Should I push for any further testing?  Can you get rid of sludge and small stones without surgery.  Can Protonix be contributing to the symptoms.  Can gall baldder problems cause several months of discomfort without becoming acute and then resolve.  I have an appointment with a surgeon next week and I am afraid he will recommend surgery.  My mother has a history of colon polyps, could my colon cause the upper abdominal pressure after eating. I am 42, 5'6" and currently 118 pounds.  Weighed 123 prior to symptoms.  114 in late August. Most discomfort is between my umbilicus and rib cage.  Still have decreased appetite with a full feeling after small meals and vague queasiness, bloating and the belt sensation.  The pain between my shoulder blades is intermittent and mild.  My provider is  currently treating me with protonix for reflux and told me that reflux can be present but not show up on UGI.  I do feel worse if I forget to take the protonix

[Kevin Pho, MD]

A normal UGI makes reflux less likely.  The definitive test would be a 24-hr pH study.  

Small stones may be able to be treated with lithotripsy or medication.  However, surgery is the definitive and preferred treatment.

I am not aware of Protonix leading the the symptoms you describe.  

Gallbladder symptoms can indeed be intermittent.  Further testing can be considered with a CT scan and upper endoscopy.  A 24-hr pH study can be considered if GERD is still possible.

These options 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.
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