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Thursday, November 20, 2014
I have had constant pain on my right upper quadrant that radiates to my back, nausea with or without eating, pain increases with food, light color stools, burping, flatulence for past 2-3 months; with episodes of severe pain, fever, nausea, diahrrea requiring me to be taken to the hospital. I have had CT scan with revealed small non obstructing kidney stone ( which I have had before, not the same pain), ultrasound of gallbladder which was normal, no gall stones and a HIDA scan with CCK injection which caused increased pain and nausea and a result of ejection fraction of 86% which my GI doctor said is hyperactive. He recommends I have and endoscopy to rule out ulcer disease before recommending any gallbladder surgery. Is the HIDA scan result of 86% really hyperactive? I have read so many different answers, I am wondering what is true. I am tired of feeling sick all the time, is there anything else I should be doing?
It is considered "hyperactive" but that does not necessarily mean that is the problem. We are more concerned when the ejection fraction is low (less than 40%). That usually means a poorly or non-functioning gallbladder. I don't think there is agreement on what to do with a high ejection fraction. Most surgeons will tell you they will take out your gallbladder but will not guarantee that your symptoms will not persist afterwards. I would go ahead with the upper endoscopy before proceeding with surgery.
Annette Kyprianou, MD
Senior Clinical Instructor of Medicine
School of Medicine
Case Western Reserve University