chronic cholecystitis

[jenifer]

I have pain in the area under and below my right rib cage. It also hurts in the back area under the sholder blade tips and radiates downward. I am nauseated and fatigued. This has been going on for approximately 2 months. The only meds I take is 12.5 mg. of Coumadin nightly for pulmonary emboli (no reason ever found for these after a slew of tests were done, but they happen out of the blue.) Pro-time is 2.3 with Coumadin. All regular bloodwork is normal.
   I recently had a HIDA scan with the following results: There was a somewhat delayed filling of the gallbladder with the radionuclide. At approximately 60 minutes there did appear to be a gallbladder that was visualized, however, it appeared to be somewhat smaller than normally expected.
   When injected with Sincalide, the ejection fraction was a negative percentage that suggested that the gallbladder filled somewhat more after the injection.
  The radiologist recommended a gall bladder ultrasound. My family doctor is ready to schedule surgery. My surgeon wants me to follow a "gallbladder diet" of no fats, etc. for a couple weeks. My diet is actually already high in grains, fruits and vegetables and low in fats.
   Is there a recommended course to follow?

[rking]

How did the doctor arrive at the Sphincter of Oddi Disease diagnosis, and how did he treat it? I've never heard of this before.  Also, this may account for the many many people who have had their gallbladders removed but still have symptoms months and years afterwards.  Also, did you have a lot of back pain/stiffness on the right side with this?  I'd be interested in your response.

[Dani]

Hi,
This is to everyone who is talking about undiagnosed right quadrent pain that seems like gallbladder. I have had many of the same problems for the past 4 years. 3 years ago I had my gallbladder out because of a low ejection fraction (11%). I ended up in the ER 3 days after the surgery with the same pain. After many, many, many tests and procedures I finally found a great doctor who diagnosed me with Sphincter of Oddi Disease. This is where the bile duct opening can spasm shut, which basically blocks the bile duct the same way that a gallstone does. You get the same symptoms. I have been treated through ERCPs where they can cut the muscle open. The first time I had it done I was so relieved with the relief of pain. I had been having pain for 2 1/2 years before I could get a proper diagnosis. I am now learning that the SOD can be present before a gallbladder is taken out or it can be caused by the removal of it. Please let me know if I can be of further help to anyone with similar problems or if anyone has experience the same things. It is terrible to not feel well and to now know why.

[rking]

Glad to hear you're doing better.  I did have my ultrasound, and this time, in addition to the two small polyps it also showed some sludge or tiny stones.  Since my gallbladder is functioning at a normal level,my doctor has put me on Actigall - a drug that dissolves stones and sludge, instead of recommending surgery at this time. I've only been on it for a few days, so I really haven't noticed a big difference yet.  I haven't had any more attacks, but I'm still having the back/side pain (soreness and stiffness) at night, but I'm sure that if the medicine works, this should be relieved in time.  I've got to stay on the medicine for a while (1 to 3 months) so it evidently takes time to dissolve this stuff.  I'll keep you posted.  I hope you continue to improve!

[Patti-Lynn]

Thanks so very much for taking the time to post a comment.  I had my gallbladder removed on 3-22-01.  To be honest, I felt different the moment that I woke up...I didn't have that intense pain between my breastbone.  It really amazed me.  It's been two days post-op and other than the usual, I feel great.  I am hoping that I NEVER have to experience that type of discomfort again.  

They also used some new type of anesthesia on me and I didn't have the typical reaction that I am used to.

Sorry to hear about your HMO.  I really dislike managed care.  Thank goodness for regular Blue Cross & Blue Shield.

I hope that you eventually have your cholecystectomy.  So far, I am pleased with my results.

[rking]

Patti-Lynn:
Gallbladders are tricky to diagnose because they effect each person differently. As far as surgery goes, 85% of the people who have their's removed do fine.

Jimsel:
It's going to take some time to heal....regardless of the simplicity of the procedure, surgery is invasive. You just had an organ removed that was tied into you whole digestive system, and while you were in surgery (and for a while after)your whole system was completed sedated, that's a shock. Also, different people have different reactions to the anesthesia and the meds that they are given, so give it a little more time, and I believe things will level out for you. There are more people glad they had it done than not.

Patti-Lynn:
As far as the hida scan goes...the 7% means that you gallbladder is ejecting bile at only a 7% capacity. The lack of infusion (intake) means that nothing's going in it either.  Basically it's not working at all, so whatever's in there is kinda stagnant at this point, and there's a good chance it's diseased.

I'm going for my 3rd ultrasound in six months on Monday. My doctor thinks it is my gallbladder, but all the tests are within normal limits or "inconclusive", so if I'm going to get approval from insurance, I need more in their opinion than just an educated guess from my doctor.  Personally, I know it's my gallbladder, I just can't get the darned radiology department to get an accurate reading....these things do happen, though, so it pays to be persistant.

I wish you both well, and hope you are both feeling better soon.

[Patti-Lynn]

Thanks for your comment.  Today is not good, I am very ill and contemplating having the surgery performed.  I too have difficulties with anesthesia and will probably react in the same manner.  Good luck and thanks again.  I appreciated it.