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Old 03-16-2012, 03:41 PM   #1
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Right Upper abdominal pain. Gallbladder, liver, or Crohns?

Hi. I'm 24 years old and I've been experiencing chronic abdominal pain in the upper right area of my abdomen, underneath my ribs for 3 months now. The pain is constant, and is accompanied with a lot of gurgling and a pressure that feels like there is a balloon inside. I haven't noticed any relation to anything I eat, it is pretty much constant, and I rarely have diarrhea. I have had almost every test done with inconclusive results, so I'm looking for any suggestions here.

My HIDA scan reported an ejection fraction of only 14%, but I have had two gastroenterologists tell me that my symptoms do not mimic common gallbladder issues and they do not believe it is the source of my pain. CT scans and ultrasounds have not shown any gallbladder stones or noticeable inflammation. The other tests that came back abnormal are a high bilirubin level in the blood (3.0 in the last test), a borderline low Vitamin B12 level, and a positive indicator on an IGG test. I have had an EGD, colonoscopy, and capsule endoscopy all of which did not find anything. With all of this, my gastroenterologist has diagnosed with me Crohn's disease and put me on Prednisone and Asecol HD medications. She admitted that Crohn's disease can sometimes be hard to diagnose and she can't confirm that is actually what is wrong with me.

Is there enough evidence to be treated for Crohn's disease? Can it still be a gallbladder problem even though my symptoms aren't the same as the general gallbladder symptoms? What does a bilirubin level of 3.0 mean? Can my high blood pressure medicine, Bystolic, be related to any of this? My biliribuin was 0.9 in 2009 before starting BP medicine. Should I be doing more or just take the prednisone for the next 8 weeks? Any help or suggestions would be appreciated since I have had a few doctors testing me for months without anything conclusive.

 
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Old 03-16-2012, 05:32 PM   #2
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Re: Right Upper abdominal pain. Gallbladder, liver, or Crohns?

With an EF 14% and an elevated billirubin, you should have your GB out. It may not cure all your ills but it should take care of some of them. Go see a surgeon.

 
Old 03-16-2012, 06:17 PM   #3
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Re: Right Upper abdominal pain. Gallbladder, liver, or Crohns?

Thanks for your reply Titchou. I agree it seems like these markers would likely indicate a problem with my gallbladder, which is mostly why I am seeking advice. I'm not sure I should settle with crohn's disease medication for the rest of my life when there is minimal indication of Crohn's disease. However, the first gastroenterologist I saw said that many doctors quickly suggest gallbladder removal when it isn't always necessary because it's not a vital organ. He said if every person in the hospital at that time had a HIDA scan, maybe 50% of them would have a low EF, but they're not all there complaining of upper right abdominal pain and don't need their gallbladders removed. The second gastroenterologist I saw (and am still seeing), affiliated with a different hospital, agreed. Is there a reason both of these doctors would suggest that I don't have it removed? I was actually scheduled to see a surgeon while in the hospital, but the gastroenterologist told me I didn't need to. Is there anything that can cause the EF to be low temporarily? What exactly does the elevated bilirubin indicate? Each doctor I have seen has made comment about it being abnormal, but hasn't indicated it is really an issue. It seems like more than double the normal range would definately indicate an issue to me? Again, thank you for any information you may have, everything is helpful!

 
Old 03-17-2012, 05:19 AM   #4
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Re: Right Upper abdominal pain. Gallbladder, liver, or Crohns?

Really? They both said that? Wow. Elevated billirubin can indicate many things. The ones applying to the gallbladder are: damage to bile duct due to blockage or stones passing and cholecystitis - infected/damaged gallbladder. Mine was 2 times normal before I had mine out (stones) and was back to normal 3 months later. Granted, having it out may not cure all your problems - esp if you fo have Crohn's - but it would probably help.

 
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