unexplained abdominal pain

hi,
iam nineteenand  have been having for 2 months now unexplained pain in my right side of my stomach uner the rib cage. the pain is constant and all day. when the attacks come which i never know when to expect them they come with a vengence and go through to my back not around only through sometimes they hit into the middle of my stomach and then go through the back i have gotten a ct and endoscopy and blood work and every thing thank gd came out negative but the pain is endless and using all my energy. the docotor put me on prevacid thinking it was ulcears and lefsin for spasms the prevacid didnt do a thing the lefsin only help for 20ish min. along with the pain comes symptoms of naseau, car sickness which i never had before, loss of appetite and weight, extra saliva that i always have to spit out and not being able to anymore sleep through the night anymore. is there any advice from anyone of what this maybe?any help will be appreciated thank you in advance

[taliaes]

one more thing i got a pelvic and abdominal ultra sound and they came back clean. i really want to know what is causing the pain or at least a relief to stop the pain some days i cant move and others i can walk around and all but i get shooting pains and fall to the floor or if i am driving i would have to pull over etc.

[dsch2679]

You sound like me, only mine has been for 5 years or so. Mine started out exactly like that tho. They are working me up for my gallbladder now. Went through the whole gambit of GERD drugs, spasm drugs, you name it. Ask your doc to take a look at yours, see if that's it. Now keep in mind the last two abd ultrasounds I've had done were okay, but see if they'll do a HIDA scan, it's pretty definative.

[TwEeTyblrDle]

Hi,

I would definitely push a little harder about your gallbladder, your pains radiating upper right quadrant under the rib cage and shooting through to your back sounds pretty typical of that.  I had pains similar to yours before having my final attack that landed me in the ER throwing up, doubled over and crying.  I didn't have major stones but I had a couple small ones, enough to have my gallbladder removed.  You should never have to live with that type of pain, especially at your age.  Always remember if you don't feel satisfied with what your doctor's telling you, go for a second opinion.  Good luck!

[Sickboy61]

Other than you being 19, I have no idea why the docs haven't check you for gall bladder problems, you present all the classic symptoms.

Demand that they check it out, ultrasound to check for stones, HIDA scan for gall bladder function.

[taliaes]

according to the doctors on the cat scan my gaullbladder was not in any distress or inflamed so they did rule it out. in the beg, they thought it was my appendix cuz on they couldnt see it on the cat scan but now they are just stumped i went for a second opinion and i am much happier with the doctor. what is a HIDA scan? maybe i will ask for that. this week on friday i am getting a breathe test to see if i have an over produce of bacteria but both myself and my parents think its going to come back negative. i am at my witts end with this pain and just want it to go away i cant do anything normal anymore and that really bothers me.i am avoiding going to the hospital because i feel like they are going to do unnecessary tests and why waste their time and mine but when i am driving and feel terrible the thought of going to the hospital does pop up

[Sickboy61]

A HIDA scan measures how well  your GB is functioning.

http://www.medicinenet.com/cholescintigraphy/article.htm

http://www.mayoclinic.com/health/hida-scan/AN00424

http://yourtotalhealth.ivillage.com/hida-scan.html

[taliaes]

how do they do the test do they knock you out. sorry just a little curious!

[taliaes]

thank you to all who have responded any other responses would be greatly appreciated. is there any doctors on this site that can give some input?

[dsch2679]

They inject you with a small amount of some radio-isotope to "light" up your GB. If you are getting the CCK, or functional HIDA scan done, they inject something after that to make yor GB constrict to see how well it is working. It makes your GB think you just ate a really fatty meal.

[boron]

Would you say, your pain is related to meals? If yes, in what time after the meal the pain starts? Your bowel movements are regular, any diarrhea/constipation, change of stool color, bloating/gas?

CT and US can't rule out gallbladder disease for sure. There may be a functional disorder of GB (without any organic change), or there may be an obstruction in biliary tree (stenosis, stone...) HIDA scan should show all this.

[taliaes]

thank you for your response. my pain has no relivence to meals. it comes all the time i never know when to expect it. bowl movements are regular. whats a US? CT was suppose to rule out any problems with my gi system and so was the endoscopy.i will ask the doctor about the functions. would blood tests be able to show it. just curious maybe thats wht they ruled it out that it wasnt the gb

[boron]

US = Ultrasound. Bloodwork, in the case of gb disease, *may show elevated liver enzymes or bilirubin, but this don't tell anything about gb itself.

I want to remind you on other possible causes of your pain:

- hepatitis
- pancreatitis, or maybe only a pancreatic cyst
- aneurysm of abdominal aorta
- disease of the colon (Ulcerative colitis, Crohn's disease), obstruction in the colon

You've said you've had endoscopy - this was gastroscopy?

Liver, pancreas, and aorta may be checked with ultrasound; for the disease of the colon, colonoscopy would be needed.

It would help, if you can write down a history of your pain, eventual other symptoms, and their exact time course. You've mentioned extra saliva. Since when is this? You have also a heart-burn - burning in the throat? You have pains at night? Well, I was thinking on GERD - gastro-esophageal reflux disease. This would explain constant pain, which goes toward the back, salivation, and pretty much normal digestion. GERD comes from excessive secretion of acid in your stomach. It is not necessary that this is seen with endoscopy on the beginning, but with time, gastritis or ulcer usually develops.

[taliaes]

i have had an untra sound and they ruled out gaullbladder, appendix etc. i had a blood test and that ruled out crohn's diesease and IBD.again thank you for all the time you are taking to try to figure out what is wrong with my stomach. when i got my endoscopy they checked for ulcears they thought i had them and put me on prevacid but that didnt help at all.what is gastroscopy. sorry i didnt start doing my own research till this week bc i thought thats what i was paying the doctors to do. they said that if the breathe test and one other test i do not know what it is called doesnt work then i should get a colonoscopy but i would prefer to find the diagnosis before that happens. i do not have any heart burn and my throat doesnt burn either. the pain is in the same place 24/7. they thought in the beg i had gerd but it was ruled out. the extra saliva just began last week thats why this is worrying me bc as the weeks go by more and more symtoms (symptoms) crop up that i didnt have previously. i know the history of my pain and all that if you want i will post it all i am asking is for a diagonosis to make the pain go away thank you again

[boron]

Diagnosis is made from
1 history
2 body examination
3 investigations (tests)

1) It will help to any doctor, if you can tell, when did the pain start, is it related to meals, exercise, sleeping. Can you say exactly where your pain is? How many centimeters from the middle line? Is it sharp or dull pain, is it like a spasm?

Are you taking any medicines, do you drink alcohol?

2) Do you feel the pain, if someone presses over the affected area?

3) You have to have some investigation, only after that, diagnosis can be made. So after the colonoscopy, not before that. Gastroscopy is upper endoscopy, they look into your stomach. But, before go with all these investigations, try to collect your history of symptoms.

[dsch2679]

sometimes it just takes a LONG time to get a diagnosis. My primary doc has been trying to get to the bottom of mine for the past 5 years, with occasional visits to my GI doc. Trust me when I say I know that the symptoms are a pain the *** to deal with, but they can be from so many different things and it is in an area that is hard to visualize. It's hard not to, but don't get discouraged.

[Bonita_Linda]

I had all the test you have named and came back with all's well. Finely I ended up in the ER and they did the HIDA. My gall bladder had completely shut down. Before constantly I felt like somebody had punched me in the stomach. After they removed my gall bladder I feel so much better. Good Luck! Let us know how you do.

[Bonita_Linda]

I had all the test you have named and came back with all's well. Finely I ended up in the ER and they did the HIDA. My gall bladder had completely shut down. Before constantly I felt like somebody had punched me in the stomach. After they removed my gall bladder I feel so much better. Good Luck! Let us know how you do.

[taliaes]

thank you very much for responding with ideas of what this illness maybe. thank you to all of the people on this site for responding i really appreciate knowing i am not alone in this.
1.the history of my pain is that it started around 9 weeks ago out of the blue. the doctor has all this information he has been treating me since the beg. but the symptoms are illness is only getting worse. i never had this type of problem before my stomach was never one to cause issues out of the blue i had an attack which now comes daily. the symptoms are as follows a shooting pain in my stomach under the rib cage. it is in pain all day and then out of nowhere and with out warning there is a massive pain and this causes depending on how bad it is me to fall to the floor or if i am driving then to have to pull over. this pain also causes naseau loss of appetite and alittle bit loss of weight as well, its lately in the last 2 weeks caused me carsickness which i never in my life had before. i also have a loss of energry cuz this take up all of it.
2. i have had a ct scan on the abdomon and pelvis which came back negative, a sonogram on the abdomon and pelvis which came back negative thourough blood tests which all came back normal, and a upper endoscopy which they also took biopsys and all came back clear. the doctor that i am seeing was worried i had a treatable ulcear so he put me on prevacid twice a day but that didnt do anything so he took me off of it. then he thought that i might have stomach spasms so he put me on a med called lefsin i do not know the medical name for it and although it subsides the pain it never takes it away fully and makes me very drowsy. the doctor has a limited window because i do not take pills. when i get an examination from the doctor he presses down in the spot where it hurts and he hits the back where the pain comes though and if he pushes to hard then i do wince or scream with pain. I DO NOT DRINK OR SMOKE AT ALL AND HAVE NEVER IN MY LIFE I AM ALL OF NINETEEN. i do feel the pain sometimes when the doctor presses over it but not always. they said that if the breathe test which i am getting done to me tomorrow and one other test which i do not know the name of and nothing comes out of those they will do a colonoscopy but prefer to hold off since i am fairly young.thank you again for all the tome and help that you have given me and to everyone on this site who have responded. will let you know how the breathe test(checking for bacteria overgrowth) goes when i get back

[taliaes]

thank you so much for your encouragement i really appreciate it. its not that i want a diagnosis that i am in such a rush i just want something to take the pain away if they dont ever figure it out its ok with me as long as the take the pain away. i am going for more tests tomorrow and will follow up thank you again and have a good night

[Bonita_Linda]

get the HIDA my CT Scan showed nothing. And my gall bladder had shut down.

[taliaes]

hi just wanted to let you all know that i went for the breathe test today to see if i have overgrowth with bacteria and although i am still waiting for the answer and will not get one till tues it seems according to the tech who did the test that it is negative. i guess the next test will be the HIDA i will mention it to the doctor when he calls me with the results. by any chance is that the one where you swallow a pill thats a camera? cuz one of the issues the doctor is facing is that i can not swallow pills.
thank you

[boron]

in HIDA scan (radionuclide scan), they inject a contrast substance into your vein, and take images from the outside, there's nothing to swallow.
http://www.nlm.nih.gov/medlineplus/ency/article/003826.htm

Investigation with camera in the capsule is capsule endoscopy.

[taliaes]

that souds safe enough. on tuesday when the doctor gives me a call i am going to mention that thank you

[taliaes]

the pain is getting worse it started to subside in the begginning of last week and went through till yeasterday and then all of a sudden it came with a vengence and it hurts more than ever
the saliva situation is also getting worse and happening more frequently
i am at my witts end and do not know what to do????

[boron]

Is it anything strange with saliva (foamy, redish, black particles, mucous...). I mean, it could come from lungs. If you think, it's not from the stomach, it could also be just an overproduction, but why...?

You can ask the doctor for some painkiller (not aspirin or ibuprofen - they are bad for the stomach).

[taliaes]

no it just gets very thick and i need to constantly spit it out. i asked the doctor about the HIDA scan but they dont think i need that right now they also do not think that its my gaullbladder causing all the problems

[boron]

Do you think it's posible that the pain comes from the thorax, or you actaully feel it in abdomen. I mean - "under the rib cage" may have two explanations.

Saliva:
- do you know where parotid glands are? Are they swollen? Here is the image of three salivary glands:
http://www.bangkokhospital.com/ent/wp-content/uploads/2007/05/salivary2.gif

If you press on a parotid gland (just below the ear), some thick saliva comes into your mouth? And if you spit the saliva into a glass - is it totaly translucent?

[shell1925]

I agree with boron, you should definetly have a HIDA scan done.  I had 2 CT scans of my abdomen done (w and w/o contrast) and 2 abdominal ultrasounds.  My OLD primary care doc. kept telling me there is NO WAY it is your GB to give it up.  It is stress and anxiety.  Well, I got rid of her and my new one referred me to a gastro doc.  Well, after my 1st visit I had an appt. for an endoscopy and a HIDA scan.  My doc. called me the next day after the HIDA scan and said the GB HAS to come out.  When the surgeon removed it he asked me why I had waited so long to have it removed that it had been a long time since he had seen one in that bad of shape.  Go figure....

Oh and when you have the HIDA scan, if when they inject you, you start to feel nauseous with chest pain that is a pretty good indication that the GB is bad.  I felt horrible once they injected me and the tech told me that he can pretty much guarantee that it is bad because they inject with stuff to make your GB work.  Mine was only functioning at about 20% but it was extremely inflammed.  

My gastro doc and surgeon both said that an ultrasound and CT scan of the abdomen will not show inflammation, only whether or not you have stones.  I had no stones but my pain was on both the right and left sides of my abdomen when I would bend over or touch it.  I hope you can convince them to do a HIDA scan and figure out what is causing you all this pain.  Good luck.

[taliaes]

thank you so much for your encouragement. last night my symptoms got worse and i had the worst case of naseau and a severe pain in the area that hurt and then out of the blue i started to vomit. this really concerned me so i called the doctor this morning and he gave me two tests that i should go for the HIDA scan he said its not top on his list but when i have an attack i should get it done and an emptying of the stomach exam where i eat either an egg of oatmeal and they put chemicals and then take xrays to see how my stomach empties.

[shell1925]

I have never had the stomach emptying test so I don't really know what that is all about, but I feel with your symptoms that you are having that the HIDA scan should be at the top of your list.  Did he give the actual Rx's or he is calling the tests in himself?  If you physically have them I would schedule the HIDA scan 1st, but that is just me.  Are you seeing a gastro doc or your primary?  If you are not seeing a gastro yet I would make an appt. with them (if you don't need the referral of course).  I just switched insurances and I need referrals now...it sucks because I was so used to being able to go to whatever doc whenever I felt like it.

Good luck to you and I'm thinking of you.  You will get through this!!!

[taliaes]

hi, the doctor faxed over the perscriptions. i am seeing a GI, I was seeing my primary but he sent me to a GI telling me there isnt much he could do and I would be better seeing one. I dont need a refferal and my dad is also a doctor so he got me in to see a really good one bc in the beg i was seeing one locally but he wasnt doing anything for me.thank you soo much

[taliaes]

the pain is not getting any better this past week i had such an attack that i thought i was going to end up in the ER. on top of it all i think i might have the stomach virus and i am not sure if its from my pain or something else and i was vommiting and alot of diarrea (diarrhea).
I am litteraly at my witts end here. dont know where to turn anymore next week i am going to get the HIDA scan and the stomach emptying and maybe that will lead to something.
thank you to everyone who has been supporting me through this hard time-and all the pain that its causing me!!
have a great night

[taliaes]

hi, i know it's been awhile but i just wanted to add another point. i did a test today on myself to see the reaction. i have been off levsin now for a day cuz i am doing a gastric emptying scan and i can not be on any meds or the results wont come back accurate. so i had a chocolate milk this morning and that didnt affect me at all so i am not lactos intolerant. then later in the evening i did another test where i had a pizza with very little cheese but it was a bit oily and that was at 9:30 pm and at 9:54 i was doubled over in pain with another one of these attacks of mine. could this be related to the gallbladder?? after the gastric emptying scan i am getting a HIDA scan 2 days later and before i do i wanted to know if its related or is this another fact added to the already big mystery that i am going through???

[boron]

That oily pizza attack: it's not only related, it's typical for gallbladder disease.

Gastric emptying test shows if your stomach is emptying normally or slow or fast. So this is a test of a stomach.
With HIDA test they monitor the emptying of gallbladder.
These are two totaly different tests.

[taliaes]

thank you for answering i know that they are 2 diffrent tests but the doctor doesnt think its the gallbladder so he wants me to do the gastric emptying scan first. than within a few days if everything comes out clear they will do the HIDA exam i have been off levsin now since friday(being the last day i took it) and have not slept at all and i am in excruciating amount of pain which i am unhappy about no the medicine didnt work but it did relieve some of the pain so i wasnt doubled over 24 hrs a day 7 days a week.
the reason the doctor doesnt think its gallbladder is because i am all of nineteen and i am not over weight, not fat, not over 40, and dont have 4 kids, female(which i am)  the 4 reason a typical gallbladder has to come out and my parents made it clear that even id its my gallbladder unless the tests reveal that it needs emegency taking out than they will try to hold out cuz im pretty young to have that kind of surgery i would be more than happy to just get something to kill the pain and not let it come back more than surgery
thank you
have a great night

[boron]

Fat, fourty, four kids, female...this is a memo for students - it shows a typical case. But not all cases are typical....A young, single, slim man can have gallbladder disease.

[taliaes]

o ok

[taliaes]

i got the gastric emptying scan done yeasterday waiting for results. next week i am getting the HIDA scan done they wouldnt let me get it done befor ethe emptying scan cuz the doctor is semi-certain that i have some sort of problem like a blockage. im just nervous and waiting for the results

[boron]

Intestinal obstruction would also cause pains you have, that's possible, yes.

[taliaes]

i just got my results for the gastric scan and they came back negative. i am going for a HIDA this coming week but they keept telling me that it wont show anything unless its during the attack. they now want me to do a colonoscopy but my parents are alittle wary about it bc im all of nineteen and why should a 19 yr old have to get a colonoscopy. i dont know where to turn anymore!!
thank you for your resoinses though
have a good weekend

[taliaes]

i just got my results for the gastric scan and they came back negative. i am going for a HIDA this coming week but they keept telling me that it wont show anything unless its during the attack. they now want me to do a colonoscopy but my parents are alittle wary about it bc im all of nineteen and why should a 19 yr old have to get a colonoscopy. i dont know where to turn anymore!!
thank you for your resoinses though
have a good weekend

[boron]

Just go for that HIDA scan. Ask if they can do a "CCK HIDA SCAN". CCK is a hormone which normally cause contraction of your gb after the meal. During the CCK hida scan they inject some of this CCK into your vein, which induces gb contraction. HIDA scan shows procents of gallbladder functioning. If this % is low, there is probably a gallbladder disease. Scroll toward the top of this thread and find a post with some nice links, where HIDA scan is explained.

Beeing 19 is not young for the disease of the large intestine. Inflammatory bowel disease, (shortly IBD - there are two major types: Crohn's disease and ulcerative colitis) typically appear in young adults. It is not your age, which speaks against colonic disease, it is the fact that you have no diarrhea, mucus or blood in the stool, rised temperature, skin rash (at least you haven't mention them) or anything, except the pain, what would go with IBD.

[taliaes]

i went for the HIDA scan but the doc said specifically that i shouldnt be going for it unless i am having an attack but the office where i did it said that would be impossible cuz im not allowed to eat from midnight on and they dont always have appts avaliable and it takes to long from where i live to get in without the attack being over. they injected some sort of stuff into me including sailine but were having a hard time with my veins. it seems that the test will come back negagtive(whats new with that) but i will not know till the end of the week-into early next week. i was tested for Chrohns disease and it came back negagtive and i dont have IBD bc there is no diarrhea mucus blood or skin rash or temp. i dont know where to turn anymore i appreciate the support i am getting from this site from everyone who takes time to respond but if this test comes back negagtive than i am at a brick wall destined to be in pain for the rest of my life. it happened to be that when they injected it i was in alot of pain afterwards but they said that it should cause no pain while i am on the table or anything so maybe it was just a usual attack. now the attacks are coming also more frequent and they come if i eat or if i dont eat i dont know what to do anymore. i am ready to perform my own surgery and rip out everything in that area which will never happen bc i cant do surgery on myself and i am to scared. PLEASE someone help me

[taliaes]

also i am sick of this and just want my normal life back which at this point i dont think i will ever get back
thank you

[boron]

When you get results, ask the doctor for exact explanation about what those "% of functioning" mean in your case.

Until then, you have two choices: some painkiller (maybe Levsin again), or if you try something with food or something else.

Food:
a) drop ALL fats from the diet or maybe even
b) have a fasting session

Other:
If something stress you a lot, can you withdraw that, discontinue, get vaccations from that?

[taliaes]

thank you for your response.
the doctor never gets on the phone with me and they just keep sending me for more and more tests that basically is just costing alot of money. the pa gets on the phone gives me the results and hangs up.(not to personable if you ask my opinion) none of the pain killers im taking over the counter are working lefsin isnt working as much as its also something that makes me drowsy so that im not up a whole night. i dont eat much fats to begin with and ever since this unexplained pain i dont eat alot at all. i have fasting sessions when i get the tests done im still in pain and thats with no food in my stomach for at least 8hrs minimum

[boron]

There's another discussion here, maybe you'll get some idea:
http://www.medhelp.org/posts/show/434761

[taliaes]

thank you but i dont know what that means this website link that you attached is the disscussion that is going on me being the ne that started it but thank you

[boron]

This:
http://www.medhelp.org/posts/show/458213

[taliaes]

thank you for the link, but i do not have those types of symptoms that the person who started the forum has.

[boron]

So, this week you have HIDA scan? As I've said above, ask, if they want to do a CCK HIDA scan.

[taliaes]

i got my HIDA scan done already i do not know what they did they put some IV line into me. I am sitting on pins and needles waiting for the results i was suppose to get them last week but they didnt come in yet. lets hope its something within that!!

[boron]

Ask for exact results, and if possible for explanation. If you don't get results soon, you may phone into a hospital; if test was done, only report needs to be written.

[taliaes]

I still have not recieved the results from the doctor yet. it is going to be a week tomorrow, they will not give me the results until the doctor see it. they are very strict about it and there is nothing i can do but sit and wait and be in pain

[catjane]

I have read most of the comments and I really feel for you.  From what most people are saying here it does sound like your gall bladder.  You can't always rely on tests being right so should get a second opinion.  With so much leading to your gall bladder, try and focus on that one area.  I am so sorry you are going through this, but just keep at it and I will pray for you.  Good luck and keep us posted please!

[taliaes]

thank you so much for your thoughts they really mean alot to me. i have already seeked a second opinion and he is doing a full work up in order to figure out this mystery. thank you again and to everyone who has been part of trying to figure out whats wrong with me. i will keep you posted whenever i know something.

[Juliagulia87]

Your symptoms sound like what I've been going through for over a year now. Im scheduled to have my gall bladder out on April 1st even though all my tests have come back normal. They think it is worth a try. But seriously I know how frustrating it is. Don't let your doctors give up either. Also ask for a stronger pain medication. I have been taking Vicodin and Phenergan for nausea and they both work well.

[taliaes]

hi, what are they baseing it on that they decided to take it out or are they just giving it a shot and seeing if the pain will go away hopefully. i hope you feel well and that all should go smoothly and the pain should go away.my doctors are not yet giving up but they are doing a very expensive workup and alot of radiation and a colonoscopy and endoscopy and nothing is coming out in return (havent gotten the colonscopy yet-getting it next week) the doctors havent given me any pain medicine and part of the problem is because im only all of nineteen and because i can not take pills. they didnt even offer me pain meds. the naseau i can deal with its more the pain and the inability to do nothing for the past 4 months thats really bothered me. i just got a HIDA scan done and its been over a week and i havent gotten my results i am very worried of what they are and have not called the office fearing the worst(they check for % of functionality of the organs) i am hoping that they just were really jammed packed and didnt get the results yet or didnt review them yet.
thank you very much for responding  

[taliaes]

i dont know what to do i am scheduled for a colonsocopy for 11/2 weeks but i feel like the results will just come back negative again, why should i waste my time money and(its going to be painful) when they wont find anything and they are just going to be poking around.i dont know what to do anymore!!! anybody have any other suggestions i feel bad bothering everyone, i know you have lives and dont want to hear about my cosistant on going pain but i just need some insight if i should even bother with this. i never got my results back from my HIDA scan they said it would take 2 days its now been 2 weeks but no responses if it was negative or positive. thank you for listening to me

[Juliagulia87]

If they havent gotten back to you yet call them. A lot of times when everything on the test is normal they dont call back because its nothing to worry about. I had an endoscopy and colonoscopy done also and it is really not that bad. They give you meds to make you sleep so it really isnt a big deal. Ask them for pain meds in liquid form or ask if you can break them up and mix it in food so you wont know it is there. I have learned you have to ask for everything. They dont just offer. As for my surgery, they are taking it out based on that this has been going on more than a year and all my symptoms are gall bladder related. The doctor warned me that it might not fix things but honestly im up to try anything at this point. The surgery is April 1st...yikes!

[boron]

Results of HIDA are known when the test is over. There's no "after procedure", only doctor should write his opinion. So, go and bother them (daily if necessary) to get the results. Doctors are your servants, you paid them.

[taliaes]

hi, yes i know the results but i didnt get it done by the doctors office and i didnt call for results they were suppose to call me but most probably like everything else it came back negative which in a way is a good thing but in a way is the worse thing i wish one thing can result to what i have and make it go away i woke up this morning screaming in pain and there was nothhing to relieve it. lately i have been noticing a new symptom that hasnt occured in awhile. i have been having diareha everytime i have a BM i do not know what is causing this but it is worrying me somewhat. i dont even know if i should tell the doctor i feel like he cares but on the other hand im just another patient. but thank you for responding


Juliagulia87: i wish you good luck on your surgery and i hope this takes away any of the pain that you had. do they give pain meds for after the colonscopy that is what i am afraid of cuz i had a very bad experience with the endoscopy and i dont want to have the same for this i cant go through that type of pain again. i do ask but alot of the times they cannot provide what i ask for cuz they dont know what to do and end up doing nothing. every time i get a test done they have the pa from the office call and i feel like i know more than her she doesnt want to hear if there have been any changes just to give me the results schedule me for a bunch more tests and to be on her way, and i really dont like that for the amount of money that i am paying my insurace is not covering everything. i am putting out a couple of thousand and they cant even tell me what is wrong i feel like going to the closest emergency room in my area and demanding answers and not leaving till i get them, i hope the surgery goes well and that it ends any problems that you have and feel good
good night thank you all for responding  






,

[Juliagulia87]

It is very frustrating but you just have to be persistent. What happened during your endoscopy? I know I woke up in the middle of mine and freaked out cause I couldnt breathe but they gave me more sedation. If you were in any pain after it thats totally not normal and you should tell your doctor. When you go to have the colonoscopy done tell them what happened with the other test and maybe they can use another type of sedation. I wasnt in any pain after either procedure and everyone Ive talked to has been the same way. If you are still in a lot of pain ask for pain meds, or find a way to get them because seriously doctors dont usually refuse to give you them unless you are asking for a refill every couple of days. Just dont sit around and wait, thats pretty much the worst thing you can do. If you are in alot of pain then go to the ER I have several times just so I can get some relief from the pain. Thanks for wishing me good luck on the surgery by the way. Im getting a little nervous seeing as its the day after tomorrow.

Julie

[boron]

Call for results and, if possible, ask for doctor's comment on them.

How would you describe the color and consistency of diarrheal stool?

[taliaes]

ok, i think i will call today. its very loose and very discolored
i dont know how to explain any further than that. it looks like it forgot to be colored. and like im having a stomach virus which im not

[Tulipp27]

Im having the exact same syptoms (symptoms) except the saliva thing. This pain started in Oct. 07.  I was dianosed with gastroparesis Oct. 06. They have done 4 or 5 HIDA scans on me outpatient and ER everything came back normal. Ive had CT on abdomen,brain sinuses,small bowel, colonoscopy, endoscopy so much blood work I got sick. I cant have a MRI cause on 4-20-07 they put a gastric stimulator device in me and I cant go around large magnets. Be happy your gastric emptying study was normal. This implant they put in didnt work and it is now turned off but its big and cumbersome and hurts also. The last CT found free fluid around my pelvis so my gastro wants me to see a Gyn. Thats my next step I guess I know how frustrating it is waiting around in pain to get told everything is normal.Good luck please keep posting hopefully you will find something out.

[Tulipp27]

Hope you get relif from surgery. If you do it looks like it might be something I should consider.

[boron]

Loose and "very discolored" stool is from lack of bile acids. Bile acids are formed in the liver, stored in gallblader (gallbladder) and from there - after the FATTY MEAL - excreted into duodenum - the part of intestine just after the stomach. They are bile acids which give the stool its brown color.

It seems like you have some blockage of flow of the bile into duodenum. The common cause is a small gallstone (or stenosis, or tumor) which has lodged **in the biliary tract** - in the ducts between gallblader (gallbladder) and duodenum. This is painful. A stone could also come from the pancreas, or as said, it's not necesary a stone. Upper endoscopy, during which an ERCP (contrast investigation of biliary tree) is done, can show this. But first get that HIDA.

CONCLUSION:

No matter what HIDA will show, on the basis of your symptoms:

- right upper abdominal pain attacks
- loose colorless stools

you have OBVIOUS OBSTRUCTION of a bile flow from:

- gallstone or
- pancreatic stone or
- stenosis or tumor

in the BILIARY TRACT, meaning in bile ducts, but gallbladder may be stones free (or not).

WHAT TO DO:
Your situation is urgent. Leaving it as it is, may damage your liver or pancreas. Now take some man with you and go to the emergency. It's possible you'll need ERCP during which a stone - if it is a stone - can be removed, without operation.

[boron]

Image of blocked bile duct:
http://www.doereport.com/enlargeexhibit.php?ID=3915

ERCP nicely described:
http://www.medhelp.org/Medical-Dictionary/Terms/1/003893.htm

[Juliagulia87]

My surgery for tomorrow got canceled due to the fact that my insurance doesnt think I need the surgery and they cannot get a hold of my doctor. I am SO frustrated!! Does anyone know what I can do to make them approve it? I seriously cant catch a break.

[taliaes]

thank you so much for responding so quickly and for all the research that you are putting in to end my misery. just one question? didnt i get that ERCP done when i got the endoscopy? i dont want to have that again it was a really bad feeling and i woke up miserable and in pain, and was vommiting for the rest of the day a few times which is very unheard of according to the doctor. thanks also for the links they really make things easier for me. my parents said they are going to be taking action and calling the doctor i know im just another patient but its been 1/4 of a yr and i know thats a short amount of time but im really misearble.

Tulipp27: thank you very much for caring for me it is very very annoying and thankful that everything comes back normal and i would be fine with that if the pain would go away the pain has intensified over the last few days and im not sleeping anymore a whole night which is really needed in my case. i had the same issues as you regarding everything coming back normal and basically the same exams except i didnt bothering getting an MRI after the CAT SCAN, they thought they saw a cyst and sent me to the gynechologist but everything was normal. i am just going out of my mind right now. i will keep everyone posted thank you all for caring so much.
Juliagulia87: I was going to wish you good luck on your surgery tomorrow and i hope this brings you the relief you were looking for and no more pain but now i see your new post and this is not good. what insurance do you have. why did they do it so abruptly they knew you were getting surgery for sometime now i imagine call the doctor and if you cant get a hold of him let the answering service know that its sort of emergency. i feel for you.
thank you all who have been here supporting me and helping me through this rough mysterious patch in my life. i really do appreciate it. will let you know of any changes or results. also im getting a colonoscopy this coming monday i hope maybe this can help somewhat
thank you

[boron]

ERCP is done only when a blockage in the bile tract is suspected, so I doubt they did it on your previous endoscopy. ERCP is never done during a routine endoscopy.

If they "ruled out" the gallbladder, this does not include the bile tract. Ultrasound can't detect small stones or stenosis in bile ducts.

Where is your pain now, does the location change?

[taliaes]

i spoke wth my parents and they decided that they want me to go through with the colonoscopy bc maybe it could rule out some stuff. they never ruled out the gallbladder. the pain is in the same place but just lately more increasingly painful. i have no appetite and have had in exchange nothing to eat all day. i do not know what to do i am waiting(again) for the doctor to call me back so that i could let him know that i have a new symptom of discolored diarhea (diarrhea). thank you though for the advise i really appreciate it and take it all with me when i go to the checkups with my doctor. the pain is under my rib cage on the right side and it shoots sometimes through to the middle of the stomach and sometimes to the back where it literally jolts me in pain. i am trying my best to hold my own
thank you once again

[boron]

taliaes,
her is my opinion:

I don't see the reason why you'd need the colonoscopy at this moment. Not even one symptom goes with some colonic disease.

Discolored diarrhea is from BLOCKAGE IN THE BILIARY SYSTEM, it is definitely not from the colon.

Here are your symptoms:
thick saliva, car sickness, occasional vomiting, right upper abdominal pain and discolored diarrhea.

You have to finish the gallbladder part of investigation first. All symptoms and all your history speak for gallbladder. Again - gallblader (gallbladder) itself may be pretty intact, but the narrow bile ducts can be easily blocked with a small stone or fibrosis or tumor. This usually CAN'T be detected with ultrasound, CT, MRI, maybe not even with HIDA, but with ERCP.

Please, can you go and get that HIDA scan? Can you? Go personally there and demand it.

***YOU ARE IN URGENT SITUATION, you can't lose time now.*** Go to the hospital, go somewhere, where you will trust doctors.

[taliaes]

i got the HIDA scan already

[boron]

What was a result of HIDA scan?

[taliaes]

they never informed me

[taliaes]

hi whats going on with you did you end up getting your surgery how are you feeling??

[boron]

taliaes,

I know you had the HIDA scan, but what's the use if you don't know results. In your situation you can't afford to wait that they will call you. It's you who should call or visit them. Explain them your pain.

[taliaes]

i am calling this afternoon, although everytime i call they just send me for another few tests that all come out negative they dont care im basically another patient the doctor cares but he doesnt get on the phone the PA does and she really doesnt care

[boron]

Just insist. Threat them that you and all your family (say 20 people) will come there and make a scene. This usually helps. If it can't work by phone, go there personally and take your father or someone with you and don't leave without results in your hand. HIDA scan may show blockage in biliary tree.

[taliaes]

i called this afternoon to let them know of the new symptom and of constant pain that im having which is not getting any better. they told me if i want i can come in for a visit or i should go to the ER which i am trying to avoid so they made an appt for mon morn, where the doctor will give me his time and really re-evaluate the situation. thank you though for being so concerned though. i cant threaten they will tell me to go somewhere if i do i will let you know if anything changes and what happens on monday
when i asked what the results are for the HIDA scan they told me that when i come in they will discuss them with me

[taliaes]

hi, so i said i would update after monday and i was very out of it yeasterday from the anestisia. so i ended up having a colonoscopy because they wanted to rule out anything over there. he said he thought he saw some inflammation possibly so they took a biopsy i will get the results in a week or so. they put me on pain killers bc i was crying with how much pain i am suffering from. i will start them tonight so i will keep everyone informed if its working or not. he wanted to do another test about blockages but then decided that it would probably come out negative so decided not to put me through that torture again. i am going to see a nutritionist to see if my eating habits effect it in any way. i dont think so but if it will make the doctor and my parents happy and possibly the pain go away then im willing to give anything a shot!
juliagulia87: how are you doing? did you end up getting surgery? how are you feeling?
the doctor doesnt know what to think anymore he doesnt know if its the gallbladder or anything else ill just have to wait and see i have another appointment with him in 3 weeks to see if there were are any changes
thank you to anybody who is reading this/responding or taking an interest i really appreciate it!

[boron]

Even if there was inflammation in the colon, this does not explain colorless stools. Colorless stools are possible only if there is blockage of bile flow or if there is bacteria overgrowth (you've said you had breath test for this and it was negative).

right upper abdominal pain
colorless stools

Mention these two symptoms to anyone, there is a $16 to pay for doctors opinion on the expert part of this forum, or mention this to any other doctor. It's unbelievable how they all just skip what it should be checked: BILE DUCTS.

Ant taliaes - what was the result of HIDA?

Bile ducts can be also checked with MR (magnetic resonance) cholangiagraphy. This is done without endoscopy. Ask for this option, instead of ERCP.

[taliaes]

i got the results when i went for the colonoscopy he looked at them and told me they were normal. i told the doctor about the ERCP and he said he doesnt think thats what it is. he is taking alot into account he said he wants to see if this medecine will work if it does fine if it doesnt then he will do further tests when i come back to see him in 3 weeks. my breathe test was negative.i tried the other form where you pay and all i basically got was i am on the right track but should speak to the doctor cuz this doctor online didnt examine me even though i wrote out my while history. thank you again

[boron]

It is true, that doctor who examines you, has the last word.

If you by any chance develop skin itcing, jaundice or dark colored urine, please note that this is from blocked bile entering the blood and then skin and urine. This is possible only from blocked bile flow.

Negative HIDA scan doesn't mean, that bile ducts are OK. If ERCP is not accceptable for you, MRI of bile ducts can be an alternative.

[Tulipp27]

Glad to see your hanging in there.  I just wanted to tell you that my gastro. office called and got some more of my blood work back. The Dr. is seeing me on  the 15th of Apr. apparently something came up where he is sending me to a endocrinologist hope I spelled that right. And to California to get an EUS.  Im not sure which test it was since they did about 30 but I can tell you more next tues.  I dont know if we have the same thing but it sounds a lot a like. Good luck

[Juliagulia87]

hey

Sorry its taken me so long to reply, its been a long couple of weeks. My insurance denied my surgery because there is no evidence of gallstones. So i have to appeal it. Its pretty frustrating seeing as its been more than a year now and I still cant eat without feeling sick. Also my GI doctor has been out of town the entire time this has been going on so I havent even been able to ask him what to do. I started taking these new supplements called A F Beta food because it is supposed to get bile flowing and stuff. We'll see if that does anything. Other than that my primary doctor told me to ask the GI about a problem with the sphincter of oddi because that can cause the problems i am having. Hopefully everything is going better. You might need to start asking your dr. to check for rare things because your tests are all coming back normal.

[boron]

I'm glad you've reported your case here. No stones in gallbladder does not mean that everything is OK with the bile system.

gallbladder: stones, inflammation without stones, functional problems
bile ducts: stenosis, fibrosis, tumor...
spincter of Oddi dysfunction
derranged production of cholecystokinin (CKK)
increased symphatetic activity of gallbladder/bile ducts autonomic nerves

Any above - and possibly other - causes may result in "typical" gallbladder symptoms, which are not necessary from primary gallbladder disease, but from other parts of bile system or from hormonal or neural control of bile system. Totally different diagnostic is needed for each of them. So, ultrasound and HIDA negative do not rule gb disease out completely. Especially bile ducts are overlooked many times.

[Juliagulia87]

Hey,
I haven't heard from you in awhile so just wondering how its going. I'm seeing a new dr. tomorrow who specializes in ERCP's and endoscopic ultrasounds so we'll see how it goes. Give me an update on how youre doing.

Julie

[taliaes]

hey thank you so much i really appreciate it. what happen was that i posted a post early in april and they lost it and i never had time to sit down and write it all up again. basically my colonoscopy against my will of getting it done was normal. and the doc doesnt know whats causing this so he sent me to a nutritionist thinking its my eating and what i am lacking. they are trying all diffrent types of diets(i am not near over weight) but they are trying to cut out food to see if it will make me better. but nothing is working. i just tried 5 days of no dairy and no diet soda which the soda i only drink very little of and once a week and eating more often more-im a very picky eater and nothing seems to be working. i am going to see the doc on thur i dont know if he is going to. i feel like its a waste of time. he took me off pain medecine which he origanally put me on bc it made my toungue numb im at a loss right now. my parents are thinking of finding a second doc although this one is very good but he cant come up with anything and i want to get rid of this pain. thank you so much for asking though, good luck with your doc.

[boron]

Second doc is a good idea. On the first place, mention light colored stools (even if it gone away until now), that is by far the most informative symptom. Normal doctor will know what to do.

[taliaes]

why is that the most important symptom? isnt the pain and the area where it is the most important? i was in a load of pain this week and since i am off the meds i couldnt really do anything but it got to the point where i had to take the meds even though im not suppose to!!

[boron]

Yes, pain under the right rib cage is important information, it speaks for gallbladder or liver problem.

Hey, taliaes, can you write down somewhere this:
------------------------------------------------------------------------------------------------------------------------
Symptoms:
- pain under the right rib cage
- pale/yerllow diarrhea

Light colored (pale, yellow) stool means that there is not enough bile in the stool and there are only two possible reasons for this:
1. blockage of bile flow due to gallbladder/ bile ducts or liver disorder
2. overgrowth of bacteria in small inbtestine  

Since you've had right sided pain, option 1. (gallbladder/bile ducts) problem is much more possible than bacterial overgrowth. Unique test which shows bile flow is HIDA scan, which you've said you had it, but you've never posted about results.

YOUR PROBLEM IS LIKELY IN YOUR GALLBLADDER, or BILE DUCTS or maybe in tissues pressing from outside to BILE DUCT. Your problem is not likely in colon or small intestine, or stomach.
------------------------------------------------------------------------------------------------------------------------------

Find a reliable doctor, tell him your history with accent on what I have written above. Every decent doctor should know that pale stool + right sided upper abdominal pain goes with bile flow problem.

[dd90]

Girl, I've read your posts and i feel for you but take yourself to the emergency room. I was having severe pain just like that, but i wasnt about to wait for my Doc to get off his rear-end, and they gave me those same tests that you had and i got the results right then and there. There was no waiting. Of course my problem turned out to be gall stones. huge ones, but they yanked out the gall bladder i went home the next day, the majority of the pain was gone in a couple of days.

[taliaes]

sorry i thought i posted the hida scan came back lear

[taliaes]

the doctor is trying to do everything in his power 2 help me but cnt seem to figure out whats wrong

[taliaes]

i meant clear

[boron]

No, you haven't posted any results.

[taliaes]

sorry i thought i did i guess it didnt go through a couple of them didnt. the test came back negative

[boron]

Be sure that your (new) doctor will see the document with HIDA scan result.

[taliaes]

just out of curiosity cuz i am not understanding why would it matter if the doc sees me hida scan and not all the other tests that i took. if it came back negative/clear why would it matter?

[boron]

Because your current doctors made some weird decisions and it doesn't look they know what they are doing. Well, any new doctor will probably get all your documentation, I was only not sure, how this papers travel at your place from doctor to doctor.  

[taliaes]

ok thank you for the concern i really appreciate it. i am going to the doc tomorrow one last time to see if he can do anything for me and if not then between getting a new doc and trying my own experiments maybe something good will come out of it. i dont know if i wrote the earlier but i went off dairy thinking i might be lactose intolerant and it didnt work at all!!

[boron]

Look, taliaes, it won't help you to make diet trials for lactose intolerance and celiac and alergy (allergy) and so on.

You said you have
- pale diarrhea
- URQ pain
- thick saliva

Combination of these three symptoms goes ONLY with bile flow problem, which may arise from:
1- liver
2- gallbladder
3- bile duct
4- pancreas
5- tissue surrounding bile duct and pressing on it

All your three symptoms suggest ONLY to above causes, NOT to colon, small intestine, gaster disease, and NOT to lactose intolerance, celiac or allergy.

[Juliagulia87]

Hey so i saw the new doctor and he didnt really have a whole lot to say but on friday im having an endoscopic ultrasound. They put you completely out for it and its a good test to see how the actual organs are on an ultrasound. Ask your dr. about this or about Sphincter of Oddi dysfunction. The only problem is the testing for this causes pancreatitis a lot so they dont like doing it. Ask for different meds if youre in pain. Vicodin works wonders. You can hide it in food if you cant swallow the whole thing. Good luck with everything, i know its frustrating.

Julie

[taliaes]

hey i hope that this test finds whatever it needs to and doesnt cause any additional problems. I am going to see a doctor that my GI reccomended me to he specializes in unknown pain of my area or something to that extent. I dont think the doctor will give me that test cuz they feel like they gave me so many others that came out clear. they wanted to do the endoscopy where i swallow a pill and it has a camera inside or something but i cant swallow pills so thats out of the question. my doctor gave me a higher dosage of pain killers cuz i broke down crying to him telling him i cant take it and if it was up to me and i knew what i was doing i would take something and cut that area out. going to the ER is out of the question. they gave me the HIDA scan which also if i remember correctly check how the organs work so whats the diffrence. i'll let you know in a week from now when i go to this new doc how it went. thanks for updating me and good luck to you!!

[taliaes]

hi, sorry it took so long for me to get back to you. so basically i went back to the doc and he doesnt know what is causing the pain but doesnt think its anything dangerous so he put me on pain killers and up-ed the dosage and then in a couple of months he is going to slowy try to take me off of it basically if i dont take the med i cant live, sleep and i have absolutely no appetite i can have a cucumber for supper and be full for the night with alot of nasea and pain. he then went and sent me to another doc who he thinks can handle my situation better. i dont really like this new doc but i am still giving him a shot cuz its my last hope. and this doc doesnt think it has to do based on all the tests that have been done with my organs but he thinks it has to be with my nerves so he put me after examining me on meds called neurotin-which is what someone takes when you have shingles and he is also pushing acupuncture-thats his sell though. he thinks i should still stay on the pain medicine and on tiop this med. as well. i dont know what to do my parents are very very against me taking this new med. it has very scary side effects. also besides the fact that i hate needles i dont think accupuncture will help me any. just wanted to hear anyones opinion on this whole situation thanks for all listening to me!!!  

[boron]

100% against.

Talies, you have your intuition which works, you have smart parents (send them my congrats), and you stick with these lousy, greedy useless doctors!

[taliaes]

what did i do wrong i do not understand. my parents sent me to these doc i dont choose them

[boron]

You were asking for comments on suggested procedures.

I'm against proposed acupuncture, and pain killers will not solve a thing. This doctor obviously just want to earn from you. You said you had bad feeling about this doctor, this is your feeling, which you should consider and listen to it. I guess your parents want you the best and give you advices according to what comes in their mind. It is OK to listen all parties. I'm trying to help to understand you what is hapening with you.

Doctor you trust in, is a must.

[taliaes]

i just didnt trust him in the way he was telling me i should get accupuncture he didnt say it was a must but he was saying that it might alleviate the pain with the other meds he put me on. my original GI that i have been seeing for 6 months sent me to him and he knows that he is considered a well know doctor. the pain killers i have been on since mid april when i just couldnt take the extent of the pain and needed some relief. thank you so much for your opinion it really means alot i was just wondering if i should be taking this new med which is a cure for shingles and kills out my nerves in my stomach area where it hurts its called neurontin

[boron]

Taliaes, my personal opinion about taking this drug is - no. Not because of the drug itself, but because this may mask all your problems, and it just doesn't lead anywhere.

[Juliagulia87]

hey,

wow its been awhile! so pretty much i had that test and of course came back normal. Now i am seeing a specialist at USC medical center and they are giving me an ERCP to check for sphincter of oddi dysfunction. Ask your doc abiut that. I hope youre feeling better.

[taliaes]

hi i know its been awhile and i havent been on but here is the latest updat i think since i have been on of me. the doc thought that i had shingles and put me on neuronton which didnt alleviate the pain but made me loose alot and made me more nauseous than before so after a month of horror i went back and he took me off of it. then he wanted me to try accupunture and my parents at this point were willing to try anything to make me feel better so they gave it a shot and besides the fact that i got 30 needles all over my body and then heat for 1/2 hr it didnt do a thing for my pain. so the doctor sent me for an mri of my thorasic spine he thought that there might be something pushing on it and wanted to see so i went for the mri and the results for a change were there but it had nothing to do with my stomach i have a tumor and cyst both benine and no where near my pain on my spine is the cyst and very close to it is the benine tumor so they sent me for an asap neurologist appt and he thoruoghly checked me out and he said he wants to watch to see if the tumor is getting bigger but its not on the same nerve path as my stomach issue and he suggests that i go back to the doctor and see what he says and thats where i am standing right now cuz i havent gone back yet sorry its been so long since i updated i hope that all of you who are going through the same or similar pain get better soon and that you dont have the same issue as me where all the results thank G-d come back negative but still dont know why there is pain also i am still on a pain killer every night for my stomach thats the only way i alleviate some pain. im trying to cut it less and less but some days its terrible and i feel like i cnt live through that day!! thank you for listening to me and for all those who responded in the past or will respond thank you as well

[taliaes]

hi i was just wondering if anyone is still reading this and can give me some insight i know it has been a while but i was still hoping!! have a good night