Gallbladder symptoms

[rozie70]

I've been dealing with all symptoms of gallstones the past 4 days.  I ended up in the ER yesterday due to pain that was unbearable. Had US, Xray, blood work, everything came back normal. Sent me home with a pain med and instructed to see my PCP.  I don't have any answers to my intense pain/discomfort.  Would sludge show up on and US?  What test would show sludge ? How come I wasn't informed of sludge?  I have been reading through these forums and have read a few things about biliary sludge.  Can anyone give me suggestions to get to the bottom of this? In a way I felt pushed away with no direction.  Currently I am experiencing a constant pain in my upper r abdomen, right under my ribcage. When I take breaths in, the pain increases. I feel very bloated and haven't had a BM in 5 days.
Thanks in advance for any information.

[rozie70]

I appreciate your advice!  Can you tell me what is a HIDA scan ?   Is the "sludge from fatty foods ? I am wondering why the HIDA scan was never mentioned to me.  Anyhow, I will definately talk to my Doc about this.  
Thanks again!

[CalGal]

Most of the tests for gallbladder issues aren't definitive although they're the best medical science has to offer. The only test the docs didn't do for you was the HIDA scan with CCK injection with would show whether or not you have a decreased ejection fraction.

There is no 'perfect' test for sludge. Many, many times unless the image is perfect and you've got an excellent radiologist, the best that can be said is 'you may have sludge.' However, if no stones are seen and your ejection fraction is decent although you may still be having pain, you'd have to make a decision about surgery based on 'it could be.'

There is a test that can be done - but I don't believe it's used often - in which an EGD is done and during the test the GB is stimulated to release bile and the bile can be captured. That sample can be examined for the presence of crystals.

If no crystals are present then the problem could be something other than the GB. It could be spasms of the sphincter of Oddi - the muscular opening to the duodenum from the common bile duct. If that needs to be evaluated, an ERCP with manometry would need to be done and if the pressures are found to be high, a sphincterotomy can be done. But that muscle should not be cut unless the pressure are high.