Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|KCGuy - Sun Nov 15, 2009 7:12 pm|
I have just been diagnosed with gallbladder dyskinesia following a hepatobiliary scan showing an abnormal ejection fraction of just 10%. The reviewing doctor recommends seeing a surgeon and having the gall bladder removed. But I am concerned because I am just a 21-yr old male in college, I have chronic nausea (my main complaint) but no vomiting or pain. For those with pain, I understand the removal has a high degree of success, but the success rate is much lower for those without pain and there is a disturbingly large number of cases where the nausea gets worse afterwards. I am going to see a gastroenterologist for more info, but the one I saw earlier wasn't very helpful. I don't understand why the nausea and the condition came on so quickly earlier this summer and why there isn't the telltale pain. If there isn't pain/inflammation, is there something else involved? What other conditions/tests should we be looking for?
I am a 21-yr old male junior in a midwest college. During a family car trip to CA in June 09, we stopped at a fast food restaurant. Soon after, I got sick with minor vomiting and nausea. We thought it was food poisoning but no one else got sick. After a day, I felt better, but the nausea has not gone away. It seemed to get a little better later in the summer, but it is now back to the daily episodes from early in the summer. It gets worse in the PM as the day goes on. I can sleep. No pain, heartburn, vomiting, diarrhea; only slight constipation with normal BM every 1-2 days. The larger the meal, the worse the nausea. So I try to eat a number of small meals each day. Nevertheless, I have lost about 5 pounds since the beginning of summer. I am a math major with a moderate load, good grades. I miss a few classes each week and I had to drop one course. I am 5' 9", 140 lbs, active in a church youth group, normal otherwise. My mother and her brother have ankylosing spondilitis, a genetic autoimmune disease. The prednisone led to kidney disease in my uncle, but my mother's case is at a low level - eyeritis and occasional joint inflammations. One of my uncle's kids has a low level case of lupus. No other family disease history.
I had my wisdom teeth removed in January, and a benign growth removed from my finger in May. Pathology was negative. No operations or history of diseases. I do have some problems with ear wax which an ear doctor checks on and cleans up about once per year, but no hearing problems. I have seasonal allergies for which I take ClaritinD. I also take a multivitamin supplement at the recommendation of the PCP. Antinausea drugs (prilosec, Reglan, and dramamine) haven't had much effect, although a prescription dramamine seems to help off and on.
All tests (allergens, insulin, thyroid scan, Heliobacter, CBC, metabolic panel, etc) were negative/normal. A gastroenterologist did an abdominal ultrasound and upper endoscopy. All normal, no stones. In October, a nurse relative suggested a stool sample and hepatobiliary scan, and our PCP was getting desperate so agreed. The stool sample showed no parasites (what we were looking for) but detected Aeromonas hydrophila. I took a Ciprio RX for 3 days, but no effect on the nausea. Will have a followup stool sample at Thanksgiving. As noted above the hepatobiliary scan showed gallbladder dyskinesia, which we will now follow up on.
|Dr.M.Aroon kamath - Thu Dec 31, 2009 12:36 am|
The list of possible causes for chronic nausea is exhaustive.
Therefore, i will mention a few of the causes some of which are being identified more often of late.
a) Eosinophilic gastroenteritis:
Benign eosinophilic infiltration of the gut is a rare disorder which can involve the intestinal tract anywhere from the esophagus to the colon. The symptoms depend upon the part of the involved gut and layer of bowel involved. Gastric mucosal disease is typically associated with nausea and vomiting.
b) Viral gastroparesis:
As many as 50% of patients with chronic idiopathic nausea and vomiting evaluated in tetiary referral centers may have gastroparesis. Usually starts with an acute onset of nausea and vomiting associated with other features of a viral illness.
c) Complex partial (temporal lobe, psychomotor) epilepsy is a fairly common type that can occur at any age.This may in some individuals manifest the seizure activity as episodes of nausea with or without other GI symptoms(abdominal epilepsy).This cause is often overlooked.
There are no symptoms that can be proven to be caused by Biliary dyskinesia, unless, a symptom thought to be due to Biliary dyskinesia (nausea, in your instance) DISAPPEARS after cholecystectomy.
|trmr - Sun Jul 11, 2010 1:42 pm|
I have very similar symptoms as you as well. My ejection fraction was 9%. My symptoms are not that severe at all and if I do have a twinge of pain, it usually is gone within minutes. My dr. , however, is suggesting gallbladder removal. I am very leary of surgery, wondering if it is even necessary since I am not that sick. I am curious to know what you have decided and if you have ad the surgery yet, how did you do with it?
|Dr.M.Aroon kamath - Sun Jul 11, 2010 9:23 pm|
As for the question of indications for gall bladder removal, i refer you to the following link where it is discussed in more detail.
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