Thank you for taking the time to review my question. I am a 25 year old male and I started having possible gallbladder issues back in July of 2011. I was about a month in to a vigerous work out. I felt I was in the best shape of my life and was about half way through the work out program "Insanity." One day I started getting extreme nausea. This "episode" consisted of very high abdominal pain, right sided abdominal pain that was felt through the side of my ribs, and I was very sick to my stomach. The worst part in my opinion was the bloating. I felt pregnant. I didnt have very good insurance at the time so I didnt go to the ER. I was like that for 2 days. I was sweating and couldn't eat anything for about 24 hours. After about a week or so the symptoms decreased, but the nausea and pain has not. I have taken nexium in the past so I got a refill of this from my doctor and I have been on that ever since. I have had acid reflux for a majority of my life and this WAS NOT heartburn, not even close. The nausea seems better at times, but I still have this pain that feels like someone is sticking a pencil behind my right ribs and this radiates through my back now. The pain goes from dull to almost burning. This is definitly worse at night after I eat. From October of 2011 to now I have better insurance so I went and saw the GI doc. I had an ultra sound, Upper GI, and HIDA scan. The upper GI was clean with the exception of dueodenitis. No gastritis, no esophageal issues. US was clean. He wants me to take Dexilant so I am going to start that in a week when I get it. I started doing research and I found out that the gallbladder actually dumps into the duodenum and that an inflamed gallbladder can cause this, correct? I think it's really weird that everything was fine except for this. The HIDA scan came back with a 78% ejection fraction and according to them this is fine. I would never second guess a doctor but after doing some research last week Ii found out that some doctor's say this is normal where as others may find this overactive. I had the HIDA scan a week and a half ago and I am following up with the doctor in April. In the mean time, I am going to go to a different doctor to get a second opinion. I wake in the morning so bloated I feel embarrassed because I look very over weight and feel miseravle. I;m tired of the doctors trying to force extreme amounts of Nexium and Dexilant when I have never had to use these before and I don't believe in taking this type of medicine for a long period of time. I apologize for the long rant, but I would appreciate anyone's opinion. I have yet to have any kind of imaging test and I may request a CT or MRI.
My gi doc is the one who ordered the test. I don't need refferals with my insurance but some docs require one regardless. I was going to get a second opinion from a different gi doc but maybe I can see a surgeon?
SURe, why not? You need to find out if your insurance company will pay for the surgery though. And keep in mind, this may not be the cause of all your issues. 78% just isn't that far above the threshold.
I have similar. Have have had this on and off for 15 years. I need to get a HIDA. My pain is brought on by fatty foods. Last night I had a steak and about 90 minutes after I felt terrible. Not severe pain, but a mild pain under the right ribs with lots and lots of gas. Mine is definitely worse at night and almost non-existent when I first wake up in the morning. I assume the empty stomach is the reason. Dexilant does seem to help a little. Good luck
Last edited by Hypochondriacyy; 03-04-2012 at 07:12 AM.
A second opinion from another GI doctor sounds like a good idea. There are GI docs who do not believe that there is such a thing as an ejection rate being too high on the HIDA scan. The maximum normal range for the HIDA is 75.
In some cases they may prescribe ursodio or actigall if you have stones that are causing the increase in pressure/volume. It can dissolve stones over time. It is rather expensive and not necessarily a long term cure.
Nexium and other PPI's in at least one study caused the gallbladder to squeeze less forcefully--whether this is a solution to the problem is unclear.
The other solution of course is surgery. While this is a common surgery, always make sure you have a very experienced surgeon.
While he did die after this surgery, he had the full cut that they used to do, had waited years to have the problem taken care of due to a fear of doctors and hospitals and die from an arythmia several days after the surgery. The lap procedure done now is much less invasive and the recovery period is substantially shorter. However, for someone who has stones and a damaged gb, it can rupture and cause death (a friend's father passed away from this a few years ago.)
I had my gallbladder removed last august due to gallstones. I ended up with an odd result where my body did not ajust to my gallbladder being removed and I now produce too much bile which ends up causing me to get very sick. My Gastro doc proscribed Welchol to counter act this (it is appearently a cholestrol med). It also works as a Bile binding agent (as my gastro doctor explained). It has done wonders in helping me feel better. Perhaps it is a medication your doctor can consider as well.
Gallbladder surgery can help but it is just as likely that you will still have too much bile. I would suggest a way to control the bile level through medication if possible and concider surgery as a last resort. If it was not for the gallstones I would have avoided the surgery for myself.
A second opinion from another GI doctor sounds like a good idea. There are GI docs who do not believe that there is such a thing as an ejection rate being too high on the HIDA scan. The maximum normal range for the HIDA is 75.
In some cases they may prescribe ursodio or actigall if you have stones that are causing the increase in pressure/volume. It can dissolve stones over time. It is rather expensive and not necessarily a long term cure.
Nexium and other PPI's in at least one study caused the gallbladder to squeeze less forcefully--whether this is a solution to the problem is unclear.
The other solution of course is surgery. While this is a common surgery, always make sure you have a very experienced surgeon.
Thank you so much all of you that have replied. I scheduled an appt with a different GI doc that I dealt with over the summer. Its nice to hear from everyone that has had some experience with this type off issue. I'm not screaming that I want the surgery, but I want atleast some diagnostic imaging of it outside of an ultra sound. If anyone else has anything to add to this post, feel free to give me a shout
Just went and saw another GI doc and he suspects a bad gallbladder. He was not happy that the other GI doc was simply just giving me acid reflux meds and saying it was an irritated stomach. I also told him that I quit all reflux meds last week because the Nexium and Dexilant (Dexilant I think was giving me esophageal spams) did not solve most of the reflux problems and it did not help the bloating and the pain. He is setting up an MRI and also said he is referring me to a surgeon (which I didn't even ask for). I do understand the effect of too much bile reflux but Im hoping and praying that God puts me in the right direction with all of this. I will keep everyone posted. Also, to manage the reflux I have been drinking apple juice and a lot of water. I make sure I DO NOT eat any fast food or anything really unhealthy but I still get the reflux (I heard it could be rebound reflux from months of meds) and it seems manageable with the apple juice and a very small amount of apple cider vinegar. I'll keep everyone informed of the outcome.
Overactive Gallbladder? 96% Ejection Fraction Need to Find a Doctor
Hi,
I really could use some help finding a doctor that has experience with Hyperkinetic Gallbladders in Bucks County PA or anywhere near Philadelphia. For the past four months I’ve been having digestive issues that seem to point to a possible issue with my gallbladder, I also have strong family history of gallbladder problem with both my fathers parents having it out. I’ve been through numerous tests and scans the only test that came back abnormal (at least according to my own research) was the HIDA scan with a 96% ejection fraction rate and after the test I felt terrible. My GI doctor said he hasn’t seen an ejection fraction that high but he though it was normal, he said the higher the better. If anyone can point me in the right direction I’d be very grateful.
Overactive Gallbladder? 96% Ejection Fraction Need to Find a Doctor
Hi,
I really could use some help finding a doctor that has experience with Hyperkinetic Gallbladders in Bucks County PA or anywhere near Philadelphia. For the past four months I’ve been having digestive issues that seem to point to a possible issue with my gallbladder, I also have strong family history of gallbladder problem with both my fathers parents having it out. I’ve been through numerous tests and scans the only tests that came back abnormal (at least according to my own research) was the HIDA scan with a 96% ejection fraction rate and after the test I felt terrible. My GI doctor said he hasn’t seen an ejection fraction that high but he though it was normal, he said the higher the better. I also had an ultrasound of the gallbladder that showed a couple of small what the doctor described as polyps or lesions. If anyone can point me in the right direction I’d be very grateful.
Update. I had surgery this morning for the gallbladder to be removed. The gallbladder gas to be sent to the lab for dissection but my surgeon said the bottom of the gallbladder was inflamed and very firm which he suspects scar tissue maybe even travel. He is very confident that this was the issue with the right sided abdominal pain. I figured I would ku everyone know what is going on because I hate unfinished threads. I will key everyone know the results of the lab when I get them.
