Gallbladder seems fine but PCP recommends removal

[misha50]

Had a full GI work up: CT scan, Hida scab, ultrasound, endoscopy, blood and stool tests.  A few years ago I also had an endoscopy, colonoscopy, x-rays, and blood and stool tests.  Results of all the tests do not show any problems with my gallbladder, and also no gallstones.  There is some family history of gallbladder issues.

I have acid reflux for at least the past few years and, per my GI at the time, slow motility in my digestive tract.  Per my current GI I may have IBS also.  Most of my symptons were diarrhea, stomach aches/discomfort, and soft and black stools.  Prilosec has made these symptons bearable and has helped relieved them to some degree, however still have some of the above symptoms and gassiness.  In truth, I never really felt that I had classic traditional heartburn or had problems eating certain foods, such as I could eat spicy foods and not have much change in my symptoms.

However,  in the past year I have developed additional painful symptoms:
Alternating pain between my right chest muscle and right under my right rib, like a throbbing or someone grabbing me under the rib - this initially started off as pain in my right upper back, but now it's rare to have the pain in the back.  The pain definitely tends to happen after eating, but also when laying down to sleep and when waking up in the morning.  Pain killers, such as Advil and Vicodin do almost nothing to relieve the pain, however once I tried Vicoprofen and it helped a little, but this is a very potent drug and it felt very addictive as I enjoyed its effect on me, so this drug is out.  I also have nausea, a bitter bile taste in my mouth, a feeling of fullness due to the nausea, some heartburn.  Fatty/Oily foods tend to inflame the pain the worst, but eating in general tends to aggravate it.  The pain is debilitating as I can't concentrate, am ultra sensitive to any noise or stimuli, and in general am not able to function.

My PCP says I have classic gallbladder symptoms and wants to remove the gallbladder.  A GI and a surgeon that removes gallbladders will remove the gallbladder if I insist as I'm at my wit's end, but they think it could be musculo-skeletal, which my PCP says doesn't make sense as I get the pain after eating.  After discussing this with the GI and surgeon, they agree that musculo-skeletal doesn't appear to make sense either.

I will be seeing another GI for a second opinion, but at this point I'm ready/willing to have gallbladder removal surgery.  Thoughts or suggestions on this?  Thanks so much!

[JimK3145]

To answer your questions: yes, I'm still on PPI's (Prevacid, 1x daily 30 mg since last Aug. 07 because of the Barrett's). The Barrett's will be re-discussed after my upcoming follow up endoscopy in early Sept, 08. The first endoscopy was performed in Sept, 07. I gave up carbonated drinks and soda last Sept '07. Also gave up caffeine at that time. I don't smoke or drink either. Now I drink decaffeinated iced tea. Also raised my bed's headboard about 9 inches. Usually don't lie down for at least 2 hours after eating. I have an upcoming appt with a dietician/nutritionist at the urging of my new Gastro doc. He also told me to start taking probiotics. My quest is to find out what is causing my bloating/nausea besides just treating the symptoms.

Misha 50: About the lemon: I was told that lemon bitters sometimes helps.

[misha50]

Re PPI's: There are folks who have been on Prilosec for over a decade and report no problems,  There are no long-term studies that I'm aware of, so my info is from docs and other folks I know who take Prilosec.  In regards to your comment that one can't be on PPI's for the rest of their lives, while I agree with your sentiment, reality is sometimes different, so we all need to do what works for us.

[misha50]

I went off Prilosec for about 3 weeks and noticed that heartburn started bothering me, not killing me, but annoying enough.  I had no change in my RUQ symptoms.  I've been back on Prilosec for a couple of weeks and things are a little bit better.  Since I've taken Levsin, the RUQ pain seems to have dissipated a little bit so that it no longer really bothers me too much.  The biggest change is at night as it's not an overwhelming sensation.  There is still some RUQ discomfort that I notice, but so far seems manageable, not worthy of surgery as of this moment.  But the RUQ has dissipated in the past and came back with a sharp vengeance, so I'm hopeful that it really is going away.

The other products, such as pepogest and DGL so far have had no impact for me as I've tried them for a few weeks.  Not to say that they don't help others as I can only speak for my own experience.  I'm still taking my probiotics, which I find to help, even though all my docs seems to scoff at this motion.

JimK3145 - Water with a lemon always helps nausea.  You'll find it to be a natural wonder drug.  

[Tom7335]

read "alternatives to medications and surgery" in this Mayo Clinic link:
http://www.mayoclinic.com/health/barretts-esophagus/HQ00312/DSECTION=treatments%2Dand%2Ddrugs

Discuss w/Gastro Doc. You cant go on w/PPi`s the rest of your life.

Avoid all soda type drinks, Coke etc + coffee.

ARe you still on the PPI`s right now ??

Seek out a dietician or nutritionist w/certicifaction and Masters Degree.

EXplore the lef.org site.
from health concerns, drag cursor to disease prevention , then under gastrointestinal.
, click on Gerd. read about Baclofen.

dont lie down after eating. wait one hour, this causes reflux.

[JimK3145]

Thanks for the info on the DGL. Not sure if you read my post to Misha 50 on 30 July. That explains my current medical situation. My post about the PPI's is the reason I would like to get off of them for awhile to see if it makes any difference. The reason that I've been on PPI's since last August 07 is that I was diagnosed with Barrett's esophagus by my first Gastro doc. I'm now on my Gastro Doc No.2 and am scheduled for a follow up endoscopy for Sep 2. Now that I have my HIDA results back (36% EF), I need to discuss this result with him also since I get intermittent RUQ pain.
One last item: Do you have any recommendations for anything to treat low level nausea? Thanks!

[Tom7335]

Thanks for the info on PPI`s. If you read my earlier posts, I suggested that Misha
go off Prilosec. I still maintain a course of 6-8 weeks max is best . It is a
terrific drug, but in recent years has become overused. I believe the key is
weening off it very slowly. While on prilosec, I felt nauseated and weak. My
research led me to DGL. Once again, thanks for this important info.