Biliary dyskinesia and weight gain

[Mary1234]

I am a 45 year old healthy female.  I work out 5 times a week and am on the Eat-to-be-Lean program.  Two months ago a began looking and feeling VERY bloated.  I have heartburn issues for the past 4 years.  My doctor sent me for a HIDA scan and the ejection fraction was 20%.  (I had a HIDA scan four years ago and that ejection fraction was 40%).  A recent ultrasound showed no gallstones and an abdominal/pelvic ultrasound was normal.

In addition to feeling bloated I feel very full after only a few bites of food, my appetite has also descreased although I have not lost weight, I feel that I have gained.  I have a gnawing sensation that radiates from my RUQ to my RLQ and sometimes to my back. The surgeon that I saw is sending me for an upper GI endoscopy to look for a Helicobacter pylori infection and an isotope study to rule out Gastroparesis.  

Could Biliary dyskinesia , a Helicobacter pylori infection  or Gastroparesis casue me to gain weight?  

I also have hypothyroidism and my last TSH was 1.27.

[JimK3145]

It sounds as though you might have delayed gastric emptying (gastroparesis). When you mention "G" doctor , does that mean a general practice doctor or a gastroenterologist? I think it would be a good idea to see a gastroenterologist doctor since they specialize in the digestive system. You might also want to be tested for the H. Pylori bacteria. I must admit I don't know enough about complications after gallbladder removal to add anything more. You might want to read some of the other posts on this forum or go to the "general" gastroenterology forum and post your question there. You could also post a general question to Dr. Kevin Pho as a new post. I think that he only offers one answer per forum and I think that he has already posted his answer to the original person who posted here.

[Quiggley]

I had my GB removed January 20, 08.  It was infected, full of stones and non functioning.  Felt great for a couple of months, now by afternoon, I feel and look so swelled and blothed I look like i'm  expecting.  It huts my stomach to yake a deep breath and I have pain and renderness in my right side and my stomach feels sore to touch and hard.  My clothes do not fit and I have to unbutton my pants and skirt because I cannotr breath from the tightness.  I have not distinguished that any particular food hurts me and I have the same symptoms if I only eat a few bites.  Please help me with any info you might have.  Also, I went back to my G. doctor and he prescribed Protonix.  Helped a bit for awhile.  Thanks anyone.

[9ah]

Since I last posted response to Mary on Jun 17, I have had hospital stay for four days, two units of blood and much LRQ pain, through to the back. I had an ERCP in Indianapolis in late May. A stent was put in my bile duct due to narrowing. I felt absolutely WONDERFUL after the ERCP, then came home to south Alabama and had the bleed, pain and vomiting. My GI here says that's not that unsual after an ERCP. I have had several gasto surgeries, including a nissen fundiplication, bilroth I and then bilroth 2 with ruen-Y, gallbladder out, all pylorus area removed along with part of small bowel. My questions is this, I really feel like if the rest of my stomach is removed that I would feel much better, and maybe the pain and vomiting will cease completely? My GI says the gastroparesis can cause the vomiting, but not the pain. The GI in Indiana says that the only way I will stop growing ulcers (i have yet another one) is to remove the rest of my stomach. My GI down here says if I have the rest of my stomach removed, there would be  no way to do another ERCP if I needed one.  I think the stent fell out too soon, and that's why the symptoms are back. I will see my local GI Friday, July 18 and he will probably schedule another ERCP to see if I need another stent. If that's the case, and he puts another stent (any such thing as a permanent stent?) in my bile duct and it works this time, why would I ever need another ERCP, so what would it hurt to have the rest of my stomach out? Sorry to go on and on, it's been a battle that started back in  1982 with bleeding ulcers that caused pyloric stenosis. No pylori-several test, all negative. I have had iron infusions and blood transfusions, I inject B12 twice a month, I am jaundiced, not to mention the wieght I have gained!  I am a 58 yr old woman and am about to the end of my rope with this!  I think sometimes I should just not go to any doctor again, but then the pain comes back along with the vomiting! Thanks for your time. Sorry this is so long.
9ah

[JimK3145]

Thanks for the update. Let me know the outcome. Good luck!

[cadale]

As for the ultraound, no gallstones were mentioned, just a polyp inside the gallbladder, and a "puddle" of sludge under it, ducts appeared clear at that time, and hida scan tech said there wer no blockages he could see,every thing flowed thru. If the pinching feeling is mild, it feels as though I could itch it away, when its severe, heat/light pressure , like  my own palm over my side feels good.Weird I know, I have reactions to whatever I eat as my pain is from the gallbladder contracting for bile dispensing? so you think I wouldn't have gained weight. The chantix itself didn't put on the weight, it was a multistep process I think.Take chantix, stomach gets upset, lay down til it subsides, or eat a dairy fat food to coat stomach. By the time it sunk in to call Dr and report the stomach aches, it was too late. I was sedentary, and by coincidence, when I tried to walk/bike the weight off, the pain in my side began, thought it was an exercise stitch-in-the-side, but no, the gallbladder problems were becoming noticed..so the July 9th appt will tell what where,when and why, I hope. Details after that....

[JimK3145]

One last item. If you touch the area where you are experiencing the pain/discomfort, is it tender? When I get this pain, I can poke, press, or prod the area(s) and there is NO tenderness which makes it all the more confusing. My doctor has done this also (had me lay down on an exam table, pressed my whole abdominal area) and I don't get any areas of pain/tenderness to the touch. I was just wondering if you had the same experience? On last thing about your gallbladder, do you have any reactions if you eat fatty foods? One thing that my gastro doc told me was that if the gallbladder is acting up, then I would get s a short attack of discomfort for about a half hour after I eat and then it should go away.
As for the weight gain, I've heard that some people do gain weight after stopping smoking? Are you eating more now than before? exercising? Did your doctor mention that that might happen? Are there any side effects to Chantix that mention possible weight gain?

[JimK3145]

Thanks for the reply. I can't comment on the Chantix since I've never smoked. I have had my blood tested and my liver enzymes were normal I misread your earlier post. I thought that you said that you were having surgery on the 9th. I see that you will meet with a surgeon on the 9th. I am curious as to whether your ultrasound revealed any gallstones? I also get that stitch like feeling on my side occasionally. When it does it feels as though something is ripping (sort of like two pieces of velcro ripping apart). Sometimes my back feels like that also. I'm scheduled to see my gastro doc again on the 16th of July. I see that you mentioned sludge. Has your docs confirmed that you have "sludge" in the common bile duct? Let me know the outcome of your HIDA scan (the ejection fraction number if possible) and what the surgeon recommends on the 9th. Hopefully, things will get figured out out for the three of us.

[cadale]

I just had the hida scan last Wednesday, the 2nd, I will have follow up appt w/ Dr Wed the 9th, hopefully all the answers then. The RUQ pain is a constant pinch, like a stitch in the side while exercising/exertion..Its always there,sometimes sharper than other times.I have not been diagnosed with IBS, but all systems are a little out of whack with the rapid(6 wk) 20# weight gain after giving up smoking, and I was on Chantix for that...strange side effects, but it worked. I can't seem to get anyone to commit yet that Chantix played apart in it, since my liver enzymes have always been normal until 5 months after beginning the Chantix...now,hmm can't remember, but the Dr didn't like the numbers..they were slightly abnormal I remember him saying.It has been a nearly 5 week process so far, between primary care physcian, ultrasound, results(polyp and sludge), Hida scan, 7/2/08, and now to surgeon the 9th.. any advice welcome....

[JimK3145]

Hello Cadale,
Did your HIDA scan give you a gall bladder ejection fraction (usually a percentage number)? I'm curious since if it's between 40-70% , that usually means that the gallbladder is okay. Are they removing your entire gallbladder or just the polyp? What type of RUQ pain are you experiencing? Does it last long (if so, then how long?) or only right after you eat? Are you experiencing any stiffness? If so, in the lower right rib cage and/or right back rib area? Have you been diagnosed with Irritable bowel syndrome? Any info would be greatly appreciated. Good luck with your surgery!

[cadale]

Me too! I had a rapid weight gain/bloating and the RUQ pain, BUT had also quit smoking 1/08. After and ultrasound and a HIDA scan, I have a gallbladder polyp, surgery decision Wed 7/9/08....just coincidental in my case.....

[JimK3145]

Quick follow-up to my recent post. Are you just experiencing RUQ pain or do you also experience a general stiffness in the RUQ front and back area. Besides experiencing a short stabbing type pain, sometimes I also experience a stiffness similar to somebody placing a piece of cardboard around my right side. Just thought I'd add that info. Thanks again.

[JimK3145]

Hi Mary,
I read your post with interest. I'm am having similar symptoms although I have not experienced any weight gain. I'm able to eat without feeling full and my appetite has not decreased. I have had an endoscopy done and a biopsy taken during it indicated no H. Pylori bacteria. I was also given a breath test for bacteria overgrowth and the result was positive. I took antibiotics (Xifaxan) for 10 days and it seemed to relieve the abdonimal bloating but I am still experiencing stomach pain. I too have had a sonigram showing no gallstones and even had an MRI with contrast that indicated that my gallbladder was normal. I had a HIDA scan which indicated my gallbladder was functioning okay but since it was not done with CCK stimulation, I did not get a GB ejection fraction number. My new gastro doc says that redoing the HIDA scan with CCK stimulation might be an option. My main question is that since you have no gallstones and have a low GB ejection number (20%), what type of RUQ pain are you experiencing? Is it only when you eat or does it last for hours prior to and after eating? I am getting RUQ front and back pain that comes and goes during the day and night and sometimes lasts up to 8-10 hours. I have read that biliary dyskinesia can sometimes last that long! Any info that you could provide would be greatly appreciated. Good luck!

[9ah]

Hi Mary!
Wow! I thought I was the only person on earth that had biliary dyskinesia and gained weight instead of losing! I can almost watch my belly bloating.  I don't  understand the weight gain instead of losing, and frankly neither do my doctors.  I have NEVER been this heavy in my life! I gained almost 30 pounds in three months and I CAN NOT get it off no matter what I do.  I don't eat much because I can't. I have had a near total gastrectomy which left me with very little stomach and gastroparesis.  After nisen fundiplication surgery back in 2001 my gallbladder "died" 5 weeks post op.  Good luck to you.

9ah

[Kevin Pho, MD]

I am not aware of biliary dyskinesia, H Pylori or gastroparesis leading to significant weight gain.

There are studies that suggest removing the gallbladder can help with symptoms related to a low GB ejection fraction.  

I agree with the upper endoscopy and the isotope study (gastric emptying scan).  

If the symptoms continue, a referral to a surgeon can be done to see if removing the gallbladder can help.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com