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Re: Gallstones vs Ulcer/H.pylori

Posted By HFHSM.D.-ym on February 14, 1999 at 21:46:31:

In Reply to: Re: Gallstones vs Ulcer/H.pylori posted by Diane on February 10, 1999 at 17:08:47:

If I were you, I'd go see another doctor!  An ultrasound will show whetter or not you have gallstones.
I am a 38 yo white female, 200lbs, of Polish/German ancestry. For
about 2 months I have had pain in the upper right quad of my
stomach, empty feeling in my stomach, pain in my back at times,
pain in my right shoulder at times, pain between by shoulder
blades at times,some foods create burning sensation in my gut
about 20 minutes after eating but it gradually subsides and the
same foods do not always cause this response,sometimes lower
right back pain, burping, gas, and feeling bloated. The sx on and
off. I recently spoke to a GP concerning this and he suggested
I may have Gallstones (which is the same thing my mom suggested),
he referred me to a GI specialist. When I had my appointment the
GI doc asked me several questions concerning the pain (dull to
burning), locations (upper right quad of stomach, etc.),when it
occurs (whenever, somethimes after I've eaten certain foods
(tomato sauce does not upset me),if it wakes me at night (no),
is there a history of gallstones in my family (yes, my mother
had her's out when she was 37), do I have kids(no), on birth
control (no), do I have acid reflux (occasionaly,about three times
in two months), have I lost weight (yes, about 5lbs since Dec.
more than likely due to my not eating as much), he poked my
stomach in the upper right area quite hard and asked if it hurt.
Yes it did a little. It may have had more to do with his pressure
than anything else. He suggested I had an ulcer and H.pylori.
He emperically treated me with Prilosec and I had a blood test
for H.pylori, results should be available next week.  When I
mentioned the possibility of Gallstones he quickly remarked that
he didn't want to "cloud" the issue and even if I did have
gallstones he wouldn't do anything about them. I took the
medication for three days and got headaches, constipated,
and fatigued. I discontinued at the physicians recommendation
and have not taken anything for two days.  My stomach feels
alright. He wants to stick a scope down my throat to look in my
stomach and I want him to do a non-invasive ultrasound to check
for gallstones. 1) What do you think about the initial diagnosis?
2)How can I politely ask for an ultrasound? 3) Should I see a
different GI specialist? I realize this is long. I greatly
appreciate any response you can give me.  My next appointment is
Feb. 25th.  Hope to hear from you by then. THANKS. I had no place
else to turn.
Sincerely - Starr
Dear Starr,
It is sometimes difficult to distinguish symptoms secondary to gallstones and those secondary to peptic ulcer disease and Helicobacter pylori infection. To confuse the issue, even if gallstones are present on the ultrasound, they may not be responsible for the symptoms that you are experiencing. Unless there is blockage of the bile ducts,infection of the gallbladder (fever, pain, jaundice)or evidence of acute pancreatitis one cannot be absolutely sure that you are in fact experiencing biliary pain. Liver function test abnormalities may also be present. Furthermore, there are many cases where patients undergo an operation to remove their gallbladder only to find that several months later the pain returns. Therefore, it is important to try and exclude other causes prior to considering surgery.
Having said all that, it is not absolutely necessary to undergo endoscopy to make the diagnosis of peptic ulcer disease and Helicobacter pylori infection. You can have a barium x-ray test called an upper GI series and a blood test to look for the presence of the bacteria if you do not wish to take the risk of an endoscopy at this time. An ultrasound is a sensitive test to look for gallstones
and should certainly be performed as well. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
*Keywords: peptic ulcer disease, gallstones, Helicobacter pylori infection

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