Aa
Gallbladder seems fine but PCP recommends removal
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!
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!
Talked to my GI about the above discussion:
He said that a biopsy was done during the Upper Endo for H Pylori, no H Pylori was found so that is the definitive answer and thus he does not recommend a breath test.
He recommends a MRCP before an ERCP to check the bi ducts - the ERCP was not performed during my Upper Endo. If the MRCP comes back normal then he sees no reason for an ERCP.
We talked about the Sphincter of Oddi, but he doesn't do this and is more of a specialty, and if I'm characterizing this properly, he says that there is not much documentation on this.
He also says that the ultrasound is the best initial test for detecting gallstones and sludge, and none was found from my results.
He says my gallbladder is functioning properly per all the tests and he sees no reason to remove it, and all my pain/discomfort may continue even with gb removal.
He said that a biopsy was done during the Upper Endo for H Pylori, no H Pylori was found so that is the definitive answer and thus he does not recommend a breath test.
He recommends a MRCP before an ERCP to check the bi ducts - the ERCP was not performed during my Upper Endo. If the MRCP comes back normal then he sees no reason for an ERCP.
We talked about the Sphincter of Oddi, but he doesn't do this and is more of a specialty, and if I'm characterizing this properly, he says that there is not much documentation on this.
He also says that the ultrasound is the best initial test for detecting gallstones and sludge, and none was found from my results.
He says my gallbladder is functioning properly per all the tests and he sees no reason to remove it, and all my pain/discomfort may continue even with gb removal.
Well, some comments:
1. If you are not BLOATED in upper abdomen, and if you don't burp, you don't have heartburn, then it may be assumed that H. pylori is not the cause. I mean, if no symptoms, no reason to bother.
2. MRCP before ERCP sounds reasonable.
3. Sphincter of Oddi Dysfunction (SOD) is well known disorder. It is diagnosed by manometry (measurment of pressures in the bile duct), ERCP and possibly HIDA scan. MRCP cannot show SOD, since this is a functional, not anatomic problem.
GI maybe wanted to say, that he doesn't deal with SOD, since he is not specially trained for that. Just search online for "Sphincter of Oddi Dysfunction (SOD)" and you'll see how much is writen about it.
4. Ultrasound is officialy always the first investigation in gallblader problems, but it OFTEN misses small gallstones and sludge. It was reported few times on this forum, that ultrasound showed nothing, but CT did. Ultrasound is really not good for these "borderline" issues. It can show fairly large stones, sometimes sludge, but not always.
I think, you should have MRCP, and ask GI, if this MRCP would also show eventual sludge or stones in gallbladder.
1. If you are not BLOATED in upper abdomen, and if you don't burp, you don't have heartburn, then it may be assumed that H. pylori is not the cause. I mean, if no symptoms, no reason to bother.
2. MRCP before ERCP sounds reasonable.
3. Sphincter of Oddi Dysfunction (SOD) is well known disorder. It is diagnosed by manometry (measurment of pressures in the bile duct), ERCP and possibly HIDA scan. MRCP cannot show SOD, since this is a functional, not anatomic problem.
GI maybe wanted to say, that he doesn't deal with SOD, since he is not specially trained for that. Just search online for "Sphincter of Oddi Dysfunction (SOD)" and you'll see how much is writen about it.
4. Ultrasound is officialy always the first investigation in gallblader problems, but it OFTEN misses small gallstones and sludge. It was reported few times on this forum, that ultrasound showed nothing, but CT did. Ultrasound is really not good for these "borderline" issues. It can show fairly large stones, sometimes sludge, but not always.
I think, you should have MRCP, and ask GI, if this MRCP would also show eventual sludge or stones in gallbladder.
You are as insightful as always, thank you. I will see my PCP to schedule the MRCP as soon as possible. In the meantime I'll see another GI, although the recommended one's next appointment is in mid-August.
I've been cleared for gb removal, but hesitant to go ahead at this point. Although, I just ran into one of my sisters who just had hers removed last week and she seems totally fine! She had a huge gallstone though, so the circumstances are different, at least as a result of the tests, and she only had an ultrasound performed.
In the meantime I'm focused on pain management - one of my doctors told me to use a hot compress and to drink warm water in the evening. I'll let you know how it all works out.
I've been cleared for gb removal, but hesitant to go ahead at this point. Although, I just ran into one of my sisters who just had hers removed last week and she seems totally fine! She had a huge gallstone though, so the circumstances are different, at least as a result of the tests, and she only had an ultrasound performed.
In the meantime I'm focused on pain management - one of my doctors told me to use a hot compress and to drink warm water in the evening. I'll let you know how it all works out.
My daughter was having bad abdominal pain and gallbladder appeared okay accorking to ultrasound. Hida Scan however showed it to ony be functioning at 10%. She then had the gallbladder surgery to remove gallbladder, but is still experiencing the same pain. She just had a MRCP mri yesterday and has been diagnosed with Median Arcuate Ligament Syndrome and is to see a vascular surgeon next.
A good idea to have all possiblities checked out before having gallbladder removed.....
We feel our daughter's was removed needlessly.
A good idea to have all possiblities checked out before having gallbladder removed.....
We feel our daughter's was removed needlessly.
After ongoing pain and discomfort and further discussion with my PCP and GI docs, I've decided to go for the gb removal surgery. The gb is noncritical and many people function fine without it. I asked about the MRCP and it would take a little while to get it approved by insurance. While not definitive, the bi ducts would've been seen to some degree with the various tests that I've had (ultrasound, CT, Hida, endo - not sure which ones). If the MRCP came back showing sludge, removal of gb would be recommended in either case.
The pain/discomfort is more constant and has built up over the past 8 months, and thus does not look like it's going away. Thus it appears that my chance of recovery is currently 0% ... with gb removal the docs are telling me it's 50% based on similar cases to me that they've seen. Surgery is for next week, I've at least asked the surgeon if MRCP can be done prior as part of the presurgery testing.
The pain/discomfort is more constant and has built up over the past 8 months, and thus does not look like it's going away. Thus it appears that my chance of recovery is currently 0% ... with gb removal the docs are telling me it's 50% based on similar cases to me that they've seen. Surgery is for next week, I've at least asked the surgeon if MRCP can be done prior as part of the presurgery testing.
I understand you are in a lot of pain and that removing your GB gives you hope that you will get better. However, I had this same hope and I remain sick after the GB removal. I urge you not to rush into it. While they say the GB is not essential it is helpful. I feel the doctors found mine wasn't working (0%) so it must be causing my left sided pain (even though the GB is on the right side). Since I am having the same problems I was having prior to surgery I do not believe my GB was the problem and now getting them to look further is almost impossible.
Did you get a HIDA scan? Just curious what they are basing the reason for removing your GB. You also posted the GI said it was not your GB... so it's confusing as to the reasoning behind the decision.
Did you get a HIDA scan? Just curious what they are basing the reason for removing your GB. You also posted the GI said it was not your GB... so it's confusing as to the reasoning behind the decision.
Have an Answer?
You are reading content posted in the Gastroenterology Community
Learn which OTC medications can help relieve your digestive troubles.
Is a gluten-free diet right for you?
Discover common causes of and remedies for heartburn.
This common yet mysterious bowel condition plagues millions of Americans
Don't get burned again. Banish nighttime heartburn with these quick tips
Get answers to your top questions about this pervasive digestive problem
