If it's not my gallbladder, what is it?
September 11, 2013 6:57 PM   Subscribe

My tests are normal but I'm having classic gallbladder pain symptoms - please help!

YANMD and I apologize for the length of this explanation - I've got an appointment with my GI tomorrow but am looking for reassurance or advice based on similar experiences in the meantime.

This week I've had blood work, an ultrasound, a CT scan of the abdomen, and a HIDA scan after at least a month of fluctuating but always present pain in my upper abdominal area. So far everything looks normal - no gallstones and gallbladder function appears in the normal range, even though I'm experiencing all the classic symptoms.

For the past month, I've had a clenching type of pain (feels like someone is squeezing me on the inside) rather than a burning sensation and seems to be near the center area of up under my rib-cage (but feels slightly to the right). It gets way worse after eating and is always the least painful in the AM before I eat or drink anything. I'm barely eating (already underweight, so this is BAD) and my quality of life is pretty low right now due to the constant distraction of the pain.

I gave it a few weeks to clear on its own and then tried taking prevacid every day for a week but to no avail. I'm already GF and dairy free because that's always helped keep my tummy calm, so I doubt it's a food issue. I did, however, do a round of antibiotics earlier in the summer (metronidozole) for SIBO, which worked wonders for the IBS symptoms I was having. Now that the issues in the lower tum are resolved, it seems the pain has intensified and jumped up to under my ribcage.

I've got a follow up with my GI tomorrow, but I am just hoping to hear of anything anecdotal that might help drive our discussion of what to pursue next. I'm at my wits end and want to get this healed as soon as possible, so please help!
posted by shrimpsmalls to Health & Fitness (15 answers total) 4 users marked this as a favorite
Could it be pancreatitis? IANAD, but I am a hypochondriac, so I looked this up when I was experiencing similar pain (without the same dietary restrictions you are following, however).
posted by Schielisque at 7:42 PM on September 11, 2013

Doubtful to be pancreatitis, that would be seen on the bloodwork and probably the CT as well.

Here are some possibilities for you:
- Peptic ulcer disease (duodenal ulcers)
- Sphincter of Oddi dysfunction
- Duodenitis (this is often picked up on CT, but may not always be)

Good luck at your GI appointment, I hope they map out a good plan for finding the diagnosis!
posted by treehorn+bunny at 8:31 PM on September 11, 2013 [2 favorites]

By the way, I didn't mention being a doctor, but in case you knew that I was - as you mentioned, I'm not your doctor, and I am by no means a gastroenterologist.
posted by treehorn+bunny at 8:32 PM on September 11, 2013

Just a random guess, but hiatal hernia? Not a doctor.
posted by Ouisch at 8:46 PM on September 11, 2013

That sounds like an ulcer to me.
posted by gjc at 8:48 PM on September 11, 2013

exactly what I experienced personally about 10 plus years ago. I was having horrible, crushing pain NOT after eating fatty foods, NOT after any of the traditional gall bladder pain inducing things...my dr requested an MRI and a CT scan, both showed nothing...blood tests showed nothing...it was so absolutely ridiculous. I am not any kind of a dr, of course. I took my mom into a surgeon for a follow up visit, while we were waiting in the exam room I told my symptoms to the nurse, who asked the dr to just quickly talk to me. I did, he asked Mom and I to trade places on the exam table, did a quick palpate...said to his nurse, "schedule her for gallbladder surgery tomorrow first thing!" He found two huge gallstones that nothing else saw--yes, I'm fat. And I was getting pancreatitis... He was thrilled that my case was going to get him published! I was thrilled that after all that running around I was right and got better! Good luck!
posted by msleann at 9:11 PM on September 11, 2013

This is exactly what my severe GERD feels like. Pain like death and worse than childbirth but no burning so I really doubted it could be acid reflux. I could almost feel where it hurt by jabbing my fingertips up under my lower right rib cage but the pain was never in just one spot. When it was really bad I could feel it in behind my right shoulder blade too. One week on Nexium and my pain was totally gone. Other type of Acid Reflux meds did nothing for me only 40 mg of Nexium/Omeprazole worked. Omeprazole is available OTC for ~$5.
posted by saradarlin at 9:38 PM on September 11, 2013

Sounds kind of like my ulcer. Can you drink ice water? I always know my ulcer is acting up if drinking cold water makes me about keel over.
posted by fshgrl at 10:16 PM on September 11, 2013

Not a doc myself, but I had several episodes of this over a 10 year period. Went to the ED of my local and they would give me an injection of Toradol, a strong anti-inflammatory medication. It usually took care of the problem within 10 to 15 minutes.

Never had any gall stones and I still have my gall bladder.

Seemed to coincide with eating particular spices. Doctor thought that they might be causing inflammation to the bile duct or the valve that releases the bile into the digestive tract which, in turn was having the effect of preventing the gall bladder from being able to expel the bile when signaled by the stomach that food was present.

Obviously, its clear from reading this that I am not a medical professional, but the symptoms that you are having, and the tests which show otherwise normal liver and gall bladder function were the same in my situation.

Good luck. I will say that the pain associated with one of these attacks was the worst thing I've ever experienced in my life.
posted by mygoditsbob at 11:24 PM on September 11, 2013

I had similar pains for a while, and eventually the docs said it was costochondritis, an inflammation of my ribs. I also get this thing sometimes where I'll suddenly get a sharp, clenching, agonizing pain on one side or the other... it'll last for 45 minutes or so, and while it's happening I have to keep very still. It feels kind of like somebody is pinching my innards with a wrench. I've never had a clue what the hell it is.

Bodies are just goddamn weird. If your doctors are telling you they can't find something wrong, try to take comfort in that.
posted by Ursula Hitler at 11:32 PM on September 11, 2013

Nthing that this could be:

a) gastritis or ulcer (the pain can manifestly very differently for different people)
b) GERD or something like it.
c) A muscular issue (don't discount this, muscle pain can also manifest in very weird ways around the torse).
d) Could be something else.

I feel for you, keep perservering, you'll get there.
posted by smoke at 2:54 AM on September 12, 2013

I went through this two years ago. I was thinking it was appendix, kidneys, gallbladder or similar, but after three ER visits over the course of a few months (wives can be very persuasive when you're in severe pain at 2am) and some tests, the doctors diagnosed it as severe esophagitis. Change in diet and some small lifestyle changes, and I've had only a couple of very minor symptoms since.
posted by NotMyselfRightNow at 5:18 AM on September 12, 2013

I went through almost the exact same thing about two months ago. Went to the ER and they found I had about a gazillion stones in my gallbladder and it was seriously inflamed, BUT the surgical resident looked at me funny and said "It's your gallbladder but with your symptoms it might be something else, too. Maybe an ulcer. If your pain isn't totally resolved after your gallbladder comes out, have someone look into that." Fast forward to about a week after the gallbladder is out and horrible crushing pain again! He was right...one EGD later, I had a gastric ulcer, too. Lucky me. Good luck!
posted by fresh-rn at 5:39 AM on September 12, 2013

Another idea: Have you been tested for diabetes (or do you have diabetes)? There is a condition called gastroparesis, basically, nerve damage so that your digestive tract does not work as it should. The pain can be mild, moderate, or severe and can include cramping/spasm, along with heartburn, nausea, etc.

A lot of people with untreated type 1 diabetes (sugar diabetes) often lose weight and/or can't keep weight on. That part of your question really jumped out at me.

Hope you feel better soon.
posted by FergieBelle at 6:30 AM on September 12, 2013

I just had my gallbladder out in July after about a week of symptoms like this. It turns out there was a gallstone blocking my bile duct that was too small to show up on the ultrasounds or MRI I had - they didn't actually see it until they went in and yanked it out during an ERCP. But there were indications from my blood work before that that something was wrong, so my situation doesn't quite match yours.
posted by miskatonic at 2:53 PM on September 13, 2013

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