I had a recent ultrasound, and while checking out my kidneys, the technician ran across my gallbladder. It showed a thickened wall and sludge. I went to see my GI doctor about it and, because of a family history of gb issues, he sent me to do a HIDA scan. The gb didn't show up on the scan after 4-5 hours. The tech who did the scan said that with that result, they typically send the patient straight to the ER for gb removal. The "problem" is, I have no symptoms - no pain, nausea, vomiting, fever, weird stools or anything. Still my GI doc and primary care physician think I should have my gb removed.
I have a long history of digestive issues, but now that I don't have any, they think I should have surgery. This makes no sense to me. Can something besides gallbladder disease cause a thickened wall and abnormal HIDA scan results? Could fasting too long before the tests cause either (or both) of the results? I asked about re-doing the ultrasound and my doc said it would be pointless since "once bad, always bad".
Easy question first, no, fasting would have made no difference in the test results.
As for whether or not to have it out, I would say yes. And this is why. You obviously have had damage to the gb - whether by stones that you've passed, the build up of sludge or an infection of some sort. This makes you more susceptible to other problems down the road - one possible one being to have it rupture. And just like a ruptured appendix, if it isn't caught in time, it's fatal. I know someone who died from this.
Since it is a very easy procedure and since recovery is normally quick and easy, I'd have it out as a preventive measure.
My husband also had a bad gallbladder with no symptoms...until he got pancreatitis one night. He had a HIDA scan that showed no action in his gallbladder as well. My hubby almost refused surgery for the gallbladder but then relented as he didn't want pancreatitis again.
Guess what? Because it wasn't functioning, it had become infected with gangrene. The surgeon said that if he had waited even another week, it would have burst, spewing gangrene all through his abdomen and he might have died.
Any organ that stops working is like a tooth that dies....they eventually all get infected or abcessed and the trick is to get it out before it gets infected....or the infection gets out into the body.
I was totally shocked as was my hubby's primary care doc as he had never had a single symptom of gallbladder problems. Listen to your docs.
The HIDA scan is the definitive test for gallbladder disease, that is not to say that it is perfect. Serial HIDA scans can produce different scores, but due to the cost they are unlikely to order another one. One known factor that will give false results with the HIDA is if you are on opiate pain killers (unlikely from what you have said).
As others have pointed out sometimes the gallbladder simply quits functioning, ie, it stops contracting and releasing concentrated bile. Sometimes due to disease or scarring of the walls; certain drugs like PPI's may also cause the contractions to weaken.
The goods news is that you have no pain or discomfort so you don't have blocked ducts, etc. If your gallbladder has ceased functioning and you are doing fine, its removal should not have any negative impact on you. As always make sure that you choose a surgeon with lots of experience.
Thanks, all. It makes more sense now with your explanations. I had wondered about gangrene or the gb rupturing.
I have an appointment with a surgeon tomorrow to discuss options, so I may go ahead and relent. Hopefully, I can get by with the laparoscopic surgery. This doctor has a very good reputation, so that increases my comfort level, as does the comment, "If your gallbladder has ceased functioning and you are doing fine, its removal should not have any negative impact on you."