39 y/o male, 215lbs, Right upper quadrant abdominal pain, distinct pain in the exact same spot under the lower ribs, several times per day, comes and goes, often lasts for hours. Dull achy and burning with sometimes stabbing pain at peak, fatigue and infrequent waves of nausea. Pain is Exasperated by stress, fatty foods, alcohol, lack of sleep, started at Xmas 2018 and has been persistent ever since 4 consecutive months now) Worse between meals, eating, standing or taking a hot shower calms the pain. Sitting, laying, pressing aggravates the pain. Lost 25lbs trying various elimination diets with no success. Quality of life significantly reduced, losing interest in hobbies, depression starting to take over with no answers or solutions. No other health issues or significant history.
Blood work normal, abdominal ultrasound normal, HIDA scan 99% ejection fraction, upper endoscopy normal, CT scan unremarkable, colonoscopy normal, fecal labs normal.
Tried various OTC for acid reduction and acid blockers under original suspicion of ulcers (lansoprazole, mylanta,) these only caused further loose and irregular bowel symptoms. (Now discontinued). GI suggested IBgard after suggesting IBS, in which after finding out the daily cost I am using peppermint oil gel capsules. These calm my gut does not remove the pain. I have a Xanax prescription as needed for anxiety taken to help me sleep when the pain keeps me awake. I rarely take Xanax during the day. No other prescriptions or otc.
The diagnosis given:
Family doc: functional dyspepsia
GI doc day of colonoscopy: functional abdominal pain, something in the IBS realm
(Basically both see my anxiety medication and just point straight to nerves stating that nothing is anatomically wrong)
My own “doctor google” research out of desperation:
Found reports of similar biliary pain related to exceptionally high ejection fractions suggesting that anything over 85% could be an overactive gallbladder (hyperkinesia ) though my doctors all don’t buy into the theory that a gallbladder can function “too good”. I have no sludge, no stones, and my ejection fraction is 99%. I have a cousin in internal medicine and she is recent out of med school saying that my gallbladder needs removed that 99% is NOT normal. I’m at a loss for what else it could be. Cousin says possibly food intolerance but I’ve eaten literally anything in the last 39 years with no issues. Now it’s sudden onset that never given me a break. I’m not suicidal but I can relate to why people do it given that I’m just supposed to keep on in pain until whatever this is manifests itself into a more serious and visible test result. I don’t know what else to do other than go back and beg to have my gallbladder removed in which they have no clinical evidence to do so. Is it possible any of these tests could overlook something? GI doc said I’ve had a “significant work up of tests at this point”. What else is left for me?