Esophagus - Gallbladder link?

[MHern]

Hello everyone,
I am very desperate for sound advice. If you want a challenge in diagnosis -- I am it. I need House MD! Please bear with my story.  

I was a very healthy 50 year old male when suddenly almost overnight I started encountering digestive problems. Bloating, indigestion, diarrhea etc. Colonoscopy normal. Endoscopy #1 shows esophagitis and no celiac sprue and candida esophagitis.

Doc sends me for HIV due to candida -- all normal.  I am not ok. My bloating continues and my digestion is horrible. Diet is bland and light and all sits like a brick. Tells me I am fine, places me on diflucan for candida and I suggests have IBS.

Switch GI docs and he wants to repeat endoscopy (#2). Finds esophagitis worsening. Pylori negative. Finds small ulcer. Restricts my diet to no fats, dairy, caffeine etc which I happily do in hope that I will feel better. Places me on PPIs. and carafate. Have gastric emptying and small bowl series tests - all ok. Sends me for HIDAscan and tells me report was normal. Never got a copy of that report so don't know fraction rate. No improvement.

Take blood tests for celiac and results in Gliadin Peptide Ab, IgG of 22 (according to test 25 is positive and 20-25 is equivocal), the IgA was 6.9 (negative according to report and tTG Ab, IgG was 26.3 (positive). So even though sprue biopsy was negative, recommends I start a gluteen free diet. Can biopsy be negative and blood over ride it?

With GF diet, bloating and digestion improves but esophagitis continues. I know this because of a slight burning in my chest but no like typical heartburn. More like a soreness. I continue with diet. Very strict and compliant.

Sends me for capsule endoscopy. Capsule tumbles in my stomach for 7 hours. Inconclusive because it never enters small bowel during test period.My symptoms continue (pain in chest and upper right (from under arm to nipple area) but pain is more like a soreness. Not sharp.

I deal with these symptoms for another six or so months and then I get endoscopy #3 and confirms my esophagitis is worsening. Negative for barretts. Adds Gastritis to the mix and GERD. Changes PPI but all else is same. Still on carafate. He is stumped why I am not improving.

Six months later, for the heck of it. I goto an ENT and he performs a transnasal esophagascopy (TNE) and finds candida again. Why is candida recurring? Especially if they think acid is causing the inflammation in my esophagus. I keep reading that candida and acid don't mix well. No one has an answer which doesn't increase my confidence in my diagnosticians.

Several months later (Feb/2014 - now two years+ since initial issue surfaced and symptoms persisting). While planning for my annual endoscopy, I ask if it could be bile reflux and he says no and besides that is not dangerous and there is no test for that. That set off some concerns because I keep reading that it frequently misdiagnosed and a test exists call Bilitec for bile. I asked for a PH study and he says no becasue he KNOWS I have reflux. At this point, I feel that I need a new doc but let him perform the endoscopy #4. He sees what he thinks is eosinophil esphagitis but culture is negative. He has no clue why I am not healing. He suggest surgery for a fundoplication.

See a surgeon and bingo - he wants a manometry and PH study via Bravo. I get it and it shows normal motility and light episodes of acid but NOTHING that would explain my symptoms. Surgeon sends me for another HIDAscan and it shows a fraction rate of 24. During the scan after the injection, I felt mild to moderate pain and nausea but it wasn't a feeling I have ever felt. I keep reading that if your pain is duplicated, your gallbladder is probably bad. I felt pain as I was advised during procedure I probably would but it was unlike anything I normally experience.

Surgeon advises gb should come out based on what he sees and admits that there is little chance that it is linked to esophagus issues.

Is this sound advice? I don't have any typical gb issues. My diet for past two years is extremely fat free, bland and gluten free. I am just not improving and am very concerned that my esophagus issue is going to develop into something much more serious. Should I have the gb removed or should I just find an out of state medical center that deals with esophageal diseases? Is there any chance that the gb could be linked somehow to my so call reflux issues? - which I dount I have because PPIs and H2 blockers do little for discomfort and my esophagus is worsening. I am in Atlanta area and I am sure there are good doctors here but I haven't had much luck with anyone thinking outside the box - other telling me to take more PPIs or that I am fine. etc.

Thank you for listening. Any advice is greatly appreciated.
Manny

[MHern]

Thank you for your response. Believe me, I've done the research on the docs but sadly reviews are typically from people who have typical cases and finding a doctor that thinks outside the box has been a fruitless exercise. That's why I was hoping to get a lead or recommendation via this forum but that too seems like it's not going to happen. I appreciate your response.

[remar]

I'm sorry you're going through this and I'm sorry they haven't found any answers yet. I highly recommend you see another GI specialist before you let them remove your gallbladder. To me, it really doesn't sound like the problem.
You're right, there is a test to see if there's bile dumping. I have no idea why your Dr won't do this test. Find another Dr and demand the test be done.
I would also recommend you research any Drs you're going to see. Almost all of them will have ratings. The higher the ratings the better in my opinion.