Gallbladder/bile duct?

[yankeerose1970]

I'm a 38 year old female that was diagnosed with Left sided Ulcerative Colitis 16 years ago.  Lately I have bouts of upper right quandrant pain but it comes and goes and is not that frequent.  When I have these pains, later in the day when I go to the bathroom I have green/yellow bile liquid in with diarrhea.  I have brought this up to my GI a couple times but he doesn't seemed concerned.  I am on 6mp (mercaptopurine) and Colazal.  Does this sound like a possible gall bladder issue, blocked bile duct or fast transit problem?  Also when I have these "episodes" my stool is pale in color.  My Uc is mostly in remission with little blips here or there.  Should I persue the matter in depth more with my GI or does this sound like something that I shouldn't be too concerned about?

[yankeerose1970]

Thank you for your advice.  I have a call into my GI so I should hear back from him in the next day or so.

[CalGal]

Unfortunately, there's not a lot that can be done at this time because they don't know what causes it. Some docs will try anti-spasm meds, and in some they're effective. Other docs choose to try some very specific calcium channel blockers. Again, they work on some but not others.

Spasms of the duct and the sphincter of Oddi - the muscular opening to the duodenum - have come to the forefront lately because it appears that many who have their GBs removed due to pain (with just a lowered ejection fraction and no stones) may go on to develop continuing pain and discomfort. In looking at what was 'uncovered' following the removal of the GB, it appears that there may be an underlying problem and the pain could have actually be due to spasms in the first place. No one is sure how the whole thing ties together yet, but the problem seems to be large enough that many surgeons are choosing not to remove GBs in patients with 'just' a low ejection fraction (and no stones present).

[yankeerose1970]

Thanks for the response.  Yes, my stool is a bit on the pale side when these episodes happen.  I do not eat alot of fatty things because of my Uc.  I am on a highly restrictive diet - meaning that I can't eat fried foods, raw fruits and veggies, seeds, nuts, spicy things.  Basically anything that is tough to break down.  I wasn't aware that a bile duct can spasm.  What would they do for something like that if that was the case?

[CalGal]

If the color of your stool is on the 'whitish' side, then yes, you need to pursue this actively with your doctor. The lack of color could mean that your bile duct could be spasming and retarding the release of bile. At other times when a spasm releases, you'd end up 'dumping bile,' and getting cramping and diarrhea.

I'm not sure about your fat intake, but you may want to try staying on a low fat diet to see if it's of help.

Ask your doc to do a gallbladder ultrasound and HIDA scan with CCK injection.