Abdominal Pain mid right quadrant - update from medical test

[arsegja]

I am a 39 year old male. (5'10", 175 pounds) who has experienced dull low level pain in mid/upper right quadrant of abdomin.  Occasionally I have stomach problems such as bloating or indegestion, and I sometimes feel weak after these occurances.

First I'll describe my symptoms and history, and then I'll list my question.

History:  Pain in the abdomin originated 3 months ago and was quickly followed by a night of swelling in the abdomin, followed by dizzy spells the next morning. Symptoms that followed included weakness, and occasional light headedness. It took me a week to feel strong again.  Now I get occasional symptoms such as bloating, or minor indegestion after a meal.  I've gotten occustomed to the warning signs and I now know how to avoid these spells by controling my eating habbits.

My blood tests came back normal. I also have normal blood pressure and cholestoral. My upper GI showed reflux, and my ultrasound came out OK (no gall stones). I do not feel the typical symptomes of reflux. I do not experience problems in my esophogas, but the upper GI did show reflux. I will also occasionally experience tingling and numbness in the neck and left arm. But that is not a constant symptom. EKG showed no problems with my heart beat.

Yesterday I had a Hida-Scan to check my gall bladder, and I had a reaction to one of the injections.  The innitial injection was a radiological pharmicutical, that showed that the gallbladder was functioning normally.  That part went OK.  However when they injected me with the CCK, I felt nausiated and passed out.  They told me that they only injected about 25% of the CCK, and had never seen this kind of reaction before.  Unfortunately they were unable to acertain the ejection fraction because they couldn't administer the full dosage of CCK.  I was concerned that I passed out from the CCK.  The radiologist wasn't as concerned, but the other doctor was a little puzzled.

Hopefully I'm describing all these procedures correctly.  

Questions:  What would cause me to pass out from the CCK?  Could this be a clue that something may be wrong with my gall bladder?
Could this be a sign of problems with any other organs such as the liver?  What should my Gastroenterologist be looking at next?  My next scheduled test is an endoscopy.

Thank you for your help. I'd be interested in any advice that a medical professional can offer.

[hiyoyohi]

I am having this same problem. The pain is in the right upper quadrant, but more towards the middle. A gallbladder scan ruled stones out. My blood tests are normal. My urine normal. Let me know what it is. I'd be interested to know if it is endocrine related, because right now I am on bcps for an as-of-yet undiagnosed hormone imbalance.

[surgeon]

many people get a marked reaction from CCK, such as nausea, cramps, which is why the test can be confusing in some cases. In your case, the reaction was more than usual, but most likely means nothing specific in terms of clues to what's going on. It doesn't sound like gallbladder is the problem. Bloating doesn't usually accompany gallbladder problems. It might be that evaluation of the entire GI tract will be necessary, including a CT scan with contrast material in the gut, and colonoscopy. Given your dramatic symptoms, one might also consider looking for endocrine abnormalities; things which cause elevated levels of certain GI-active hormones, which often means collecting a 24-hour urine sample and testing for certain chemicals. A long shot.

[Kevin Pho, MD]

Hello - thanks for asking your question.

I am unaware of any disease that can cause you to pass out from the CCK.  It is possible that you may allergic to the CCK, or the CCK potentiated a vagal reaction, causing you to pass out (I am purely speculating on that last point).  

As for the next test, the endoscopy would be the most reasonable next step.  An endoscopy can evaluate for any masses or inflammation that may not be readily apparent on upper GI series.  If not already performed, I would also test for H Pylori, which is a treatable bacteria associated with inflammation and ulcers.  

Regarding the reflux, I would consider a 24-hr pH study to determine the severity of the reflux.

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.

FYI - I will be away from August 1-9th. I will look forward to answering your questions when I return.