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Forum Name: Gastroenterology Topics

Question: GERD vs. Gallbladder


 KimberlyAna - Wed Nov 09, 2005 9:26 pm

I have had very occasional but rather severe heartburn
"attacks" since the age of about 25. In between these severe episodes, I seem to have almost no heartburn or indigestion ever, even when I eat a lot or very spicy foods. I am 39 now, female, and I am weighing 169 lbs. now at 5'5", down from 196 lb. a year ago. (I know the saying about "female, fat, and forty" for gallbladder trouble!) Despite being vegetarian for 17 years now, I have not had the greatest of eating habits until very recently, although I have managed to eat extremely healthily for good stretches at a time. My cholesterol has ranged between 151 and 185 during the last several years, so I think on average I've done fairly well.

Now, after about a month of eating extremely well, I went out to eat at restaurants 2 nights last week, a few days apart, and ate way too much and lots of things I don't normally eat. Anyway, I got another "attack" of severe burning pain directly under my breastbone around 3 am the second night of eating badly. I drank a good amount of Maalox and took a Pepcid complete and was able to make the pain, which seemed to subside a bit and then grow suddenly worse, die down enough to go back to sleep. However, I continued having burning pain without complete relief for the next 12 hours, until I took some Alka Seltzer, which finally relieved it. I then began self-medicating with OTC Prilosec once a day and am on the 5th day. I am finding that the heartburn is subsiding pretty well, but for the first couple of days, I was very concerned by its constancy. I've only felt the need for Alka Seltzer one more time, and the stronger heartburn that I started getting last night while I lay on the sofa was amazingly relieved by chamomile tea.

About 4 years ago, I had a similar type of attack after eating a very hot chili pepper on an empty stomach with only beer and a little Mexican food to chase it, and after several days of burning, I had it checked out. With simple lab tests and a GI cocktail, the ED doc ruled out a gallbladder problem and decided that it was gastritis and/or GERD. I was given prescription-strength Prilosec for 30 days (of which I ended up taking only about 15 days worth of) and told to follow-up with a GI doc, who turned out not to be taking any new patients. Since I felt complete relief fairly quickly and subsequently have had only about 3 severe "attacks" which quickly subsided with antacids, I have never followed up.

My main concern is whether this could actually be a gallbladder problem after all. If it is GERD, how could I be so seemingly syptom-free for a year at a time? I probably will go and be checked out, but I am trying to figure out just what is really going on. Also, I really do NOT want to have my gallbladder removed (ever) if that is at all possible, so you can imagine that I am not keen on seeing a doctor unless I feel I am in a really acute situation. I am feeling less acute by the day, and I think my pain should be completely gone soon, but I do think I should investigate further with a doctor who doesn't just want another surgery under his belt.

Final comments on this long post: I have been on medium-dose birth control pills most of my reproductive life and have never been pregnant. I do not seem to have "Murphy's sign": no discernable pain (maybe just slight discomfort) when I press around in the right upper quadrant under and behind the rib cage.

I would greatly appreciate any insight you can give me.
 Theresa Jones, RN - Thu Nov 10, 2005 7:25 am

User avatar Hi KimberlyAna,
Gallbladder "attacks" usually present with right upper quadrant pain which may radiate to the upper back or shoulder. The attacks may last from a few minutes to several hours. Nausea or vomiting may also occur. These symptoms often occur after ingesting a meal high in fat content. Gerd symptoms may present with a burning sensation just under the breast bone, worsens at night when lying flat, especially following a heavy meal. Nausea, belching, and food regurgitation may also be present. Diagnostic studies to identify gallbladder dysfunction are, for example, an ultrasound, HIDA scan, etc. I would suggest that you follow up with your physician to identify the cause of your symptoms.
Sincerely,
Theresa Jones, RN
 KimberlyAna - Thu Nov 10, 2005 6:37 pm

Thank you for your reply. I will be talking to a doctor or PA about this very soon.

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