Clear ultrasound. Please help

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I've been having sharp pain under my right rib for about a month and a half. I went to the ER after getting a slight fever and an ultrasound was done and showed nothing. Was sent home with no answer. I also have vomiting an nausea. Usually feel worse after eating anything! Went to GP and simply said it was Acid Reflux even though I don't have any symptoms of acid reflux. I demanded a referral to see a GI and will be seen next week. Has anyone gone through all the test and found a diagnosis? I know the gallbladder can disfunction but I'd like to hear similar stories and what the outcome was.

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  • Posted

    Make sure you don't have pancreatitis or gallbladder disease. Do your research and get the best doctors. That's my advice.

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  • Posted

    Hi, Amanda, sorry to learn you're going through this.  Sometimes ultrasounds don't show very small gallstones or sludge.  Also, sometimes, the technician performing the ultrasound is less than proficient.  Press for a CT scan that should pick up gallstones.  Also, the GI can order liver function and other blood tests to narrow down what's going on with you.  Vomiting and nausea are some of the classic symptoms of gallbladder disease.  Good luck and let us know how you do!

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    • Posted

      I tend to think there is truth to what you commented. in my case, the emergency room doctor did indeed do cursory ultrasound examination and found basic information regarding my gallbladder and pancreas, that they were both inflamed and that the gallbladder has gallstones, but she sent me to an ultrasound lab for a more thorough diagnosis. =

      I'm fairly sure that the emergency toom doctor instructed the lab to do a thorough check on me since the lab technician spent over an hour on me pushing and prodding with her handheld gun all over my gallbladder and pancreas areas.

      Only thereafter back in the emergency rooom, the doctor returned and informed me that my gallbladder was infected, inflamed, and partly necrotic. Also, she said my pancreas is also inflamed and had a blockage.

      So, yes, I do think a quick ultrascan test can overlook the less obvious. Luckily for me the emergency room doctor not only did ultrascan exam on me herself, she die it twice, and afterwards she sent me to the ultrasound lab for even further examination.

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  • Posted

    Thanks for the suggestions. I'm convinced it's my gallbladder. I had a low grad fever 100.0F last night and sharp LRQ pain. Thought it might be appendicitis resulting from whatever else is going on. Vomiting again today. I've also been getting a lot of compliments on my "tan" even though I've barely been in the sun. I've read this could be jaundice as its more of a golden glow. I see my GI for a consultation in a few days but will continue to update in case anyone else is going through the same thing.

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  • Posted

    Not sure if my comment will help, but I had my gallbladder removed 12 weeks ago. I had both pancreatitis and gallstone attack simultaneously.

    I had acute, agonizing, nearly paralyzing pain in the upper right side of my abdominal area, just below the rib cage. I also had intense cramps and aches in my upper left side of the abdominal area, just below the rib cage.

    Pain in the upper right was from gallbladder/gallstone.

    Pain in the upper left was from pancreatitis.

    In my case, a large gallstone had gotten lodged in the common duct, but also the accumulated bile sludge plus smaller gallstones from my gallbladder blocked my pancreatic duct, which led to my pancreatitis.

    My symptoms, aside from the excruciating pains, were vomiting, intense all-around abdominal cramps, urinary bladder cramps, very dark yellow urine, cold sweats, shivers, and nausea. I also couldn't keep any food down, nor could I drink any water or fluid due to severe vomiting.

    The pain, nausea, and cramps got so bad that within 24 hours I had to call emergency ambulance service to take me straight to the nearest hospita.

    Initially in the first few hours, the doctor did ultrascan tests on my kidneys, urinary bladder, gallbladder, and pancreas. Kidneys were ok. Gallbladder was inflamed. Pancreas was inflamed. Gallstone was lodged in the common duct.

    For the next hour I was sent to an ultrasound lab. After an hour of exhaustive and detailed ultrasound examination, I was informed that my gallbladder was half necrotic, infected, and swollen, and also that my pancreas had a blockage that led to pancreatitis. Along with this, I was told that I had a large gallstone lodged in the common duct and a few more still in the gallbladder.

    I was given opiate pain killer injection through the IV every 4 hours along with antinausea medication. Blood tests showed elevated biliary levels, so surgery had to be delayed till it normalized with medication. On the 3rd day at the hospital, I had a surgery done by the GI specialist to remove the blockage on my pancreas and clear out the gallstone from the bile duct. On the 4th day, another specialist did the laparoscopic surgery to remove my gallbladder. By then my gallbladder was found to have had ruptured and spilt the infected bile all over into my abdominal cavity, for which the surgeon used 7 liters of cleaning fluid to wash and siphon out the spilt bile. He also took biopsies from the abdominal areas and the removed gallbladder to test for cancer.

    That was my gallbladder removal surgery experience. I had the best doctor in the State sheerly by chance and luck. Post-op recovery went well, surgery pain lasted only 2 weeks, and have had zero complications. The only side effect I'm suffering from gallbladder removal is chronic diarrhea. Though it has decreased significantly since the first day after surgery, I'm still dealing with it. Hopefully I'll find a natural dietary solution vs using prescription medication.

    Good luck

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    • Posted

      Hi, Webdk, there is a Facebook site for bile acid malobsorption.  You could try that for the natural solution. Your experience sounds awful, but you had a good doctor.  I'm glad things are better.  Best of luck!

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    • Posted

      It may well be bile acid malabsorbtion. Still, knowing the cause doesn't really solve the problem. I read about prescription meds like Questran and Welchol. Many give positive reviews on their effectiveness in controlling diarrhea as a result of bile acid malabsorbtion. I may resort to those prescription meds if nothing else helps , but for now I'm hoping that my symptom will diminish over time with a workable diet and steady recovery.

      In the mean time I'm on this forum to learn more and share my experience on gallbladder removal. Maybe my comments will prove to be helpful to someone.

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    • Posted

      I use cholestyramine, which is Questran.  I've been using it since 2009.  Just as with other meds there are side effects.  Also, in a pinch, I use Immodium, because it isn't just the excess bile; it's the emotions, too.  That can be a real roller coaster.  I do hope that your symptoms diminish.  Best of luck!

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    • Posted

      What are your side effects in taking Questran? Also, have you tried Welchol in tablet form? I'm curious because I am looking into possibly trying it if my D continues to be chronic.

      Yeah, I hear ya on how debilitating it can be. I have first hand knowledge because I suffer from it daily. In the time frame of 12 weeks since surgery, I have had many close calls, and depressingly I did have one accidental mess, and I was completely devestated. I'll skip the ugly details and move on to a positive perspective with this discussion.

      Through trial and error, I found coffee to be the worst offender, followed closely by milk, soy milk, barley and flax seed, and quite shockingly, leafy green vegetables. Since then I learned the difference between soluble and insoluble fiber foods, and leafy green vegetables being mostly insoluble fibers, they have devestating effect on me.

      Since surgery, I have been on ultra lean diet, so I cannot verify yet whether fatty/greasy/oily foods will worsen my symptom. Sooner or later, I will test hamburgers, steaks, and fried chicken to find out how they effect my digestive system.

      For now, I have recently discovered two foods that are helpful for my system. Grilled chicken and pastas (the ones with iron supplement). These two foods seem to help slow down food motility in my digestive tract, thus reducing the diarrhea by around half in my estimation. Since I love pasta and chicken anyway, they're now my staple food.

      I am tempted to visit the doctor for a prescription of Welchol in tablet form, but I feel I owe myself a few more weeks of trial with a strict diet of the foods that I know to be helpful. Also too, I'm thinking that perhaps 12 weeks post-op isn't quite long enough a recovery time for my body to have healed 100%, so I'm delaying taking any prescription meds for D.

      I may or may not end up losing this battle if ultimately my D proves to be chronic, but I figure it's worth the fight to find a solution through natual foods.

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    • Posted


      I'm glad to let you know about the Questran.  I haven't tried taking the other stuff.  I mix it with 3 ounces of water and 3 ounces of organic papaya nectar, or apple juice.  I use these because the texture of the questran is grainy.  It's not the most pleasant thing to drink. I take it at night before bedtime per my doc's instructions. The resin absorbs everything, including the bile.  So, if you need to take additional medications, the medications should be taken at least an hour before you take questran, or four hours after taking it. Questran can cause gas and bloating.  I'd suggest that you look at the side effects by researching them on line.

      As for your diet, I'd suggest that you include rice at least once a day.  My mother used to live in Vietnam and while there she got bad diareha (cant't spell it). A Vietnamese friend told her to keep boiling white rice in water, and to keep adding water until the rice was basically like a paste.  I don't do that, but I do use rice when I'm not feeling well.  I mix it with drained canned organic chicken breast, frozen green peas and chicken broth.  It makes a nice casserole and I only add the chicken broth when I heat it up.  You might find that you can use milk if it has no lactose in it or is A-2 milk.  Personally, I now can have sirloin steak, butterfly pork chops and turkey.  I try to keep to low fat meats, but I can also use irish butter sparingly.  

      I wish you good luck!  Let me know how you do!  

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    • Posted

      Thanks for the suggestions. I'm on rice every day as that's already a basic, staple food for me. I've added pasta recently and it seems to help. I still eat grilled chicken almost every day as it too seems to be helping. As for milk, I did try acidopholus milk, and also lactose milk, both skimmed, and neither seem agreeable to my digestive tract.

      And indeed I have done some research online on Questran and Welchol, so I do know about some of their possible side effects, but I wanted to hear about it from an actual user rather than from the generic warning-label tacted onto the medication bottle.

      After reading through a mass of blogs and forums on this topic, I've come to realize that everyone's reactions to foods, supplements, and medications are varied and different. While some experience zero problems with any foods after a gallbladder removal, some experience digestive problems and/or diarrhea in varying degrees.

      In my case, basically it's diarrhea, and I'm on this forum to find helpful solutions to my own body's needs. Every little bit of real-life solution is helpful if it proves to be agreeable to my own digestive tract. Hence, it's a hit or miss affair.

      The strangest suggestion being avoiding fluid intake an hour before to an hour after a meal to help reduce the diarrhea symptoms. I read about it only last night, so I have yet to test it out personally.

      If it helps, I'll be posting a comment in this forum in the hope that others may benefit from this info.

      Good to talk about this embarrassing problem with others who know about it. Thanks, I'll keep in mind your suggestions. And if nothing else works, I may resort to either Questran or Welchol.

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  • Posted

    I find it rather odd that despite reporting to your doctor about a sharp pain in your right side under the ribs you were sent home without a clear diagnosis. Hopefully you'll get a thorough diagnostic tests done by your GI doctor.

    The location of your pain sounds very suspiciously like a gallstone problem. Possibly it's a small gallstone that might be trying to pass through the bile duct. In my experience, the bigger the gallstone, the more intense the pain. Also, it causes nausea, vomiting, and pain in varying degrees. The pain may subside, in which case I'm guessing that the stone has moved back into the gallbladder.

    I hope you will get it properly diagnosed as leaving it untreated may lead to further complications later on.

    Based on my personal experience, my wild guess is that your pain is caused by a gallstone that's moving back and forth between the bile duct and the gallbladder. When you eat a meal, especially foods that are oily or fatty, the gallbladder will contract to expell bile into your small intestine for digestion of fats. Hence, your mentioning of experiencing pain and discomfort after eating a meal sounds to me like your gallstone is moving back and forth, thus causing pain, nausea, and vomiting.

    However I should stress that my comment is based on my personal experience and by no means do I have any medical training, and only that I have had similar symptoms as yours multiplied by at least 5x in pain level and illness resulting from gallstone and pancreatitis.

    A good hint to determine whether or not it's a gallstone: when you try to lay down or get up, does the pain intensify greatly? If it's a gallstone lodged in the bile duct, your pain will greatly intensify whenever you contract your abdominal muscles, especially the muscles just underneath the right side of your rib cage.

    In my case, I had gallstone lodged in the bile duct, inflamed and half necrotic gallbladder, and a blocked pancreas from the sludge and smaller gallstones that passed out of the gallbladder but got themselved lodged in front of the pancreatic duct and caused pancreatitis.

    Sounds to me like your condition hasn't gone as far as pancreatic problems, and that it's solely a gallbladder that either has stones or sludge that are causing your problem.

    I highly recommend that you see your GI specialist asap and get yourself properly diagnosed for treatment.

    Hope my comments help.


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    • Posted

      My GP is basically a "drug dealer" and I've been meaning to find a new one. The fever has gone down. Moving positions doesn't help at all. The pain has subsided a bit in my right side. But yesterday out of nowhere I felt like someone hit me in my back. The pain was all the way around my left side just below my breast all the way around the back. It hurt to even breath. I'm really trying to hold out rushing to the ER and waiting until Tuesday when I see a GI. I don't feel like the ER where I live is very thourough. Since they didn't see a stone on the U/S they said I was fine.

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    • Posted

      After reading through a mass of gallbladder logs in this site, I've come to appreciate the two surgeons who operated on me much more than before. I was very lucky to have had them handle my case with extreme dedication and care.

      Now, regarding your pain on the right side... Sounds to me like pancreatitis symptoms. From my experience, pain on the left side was from pancreatitis (a blockage in the pancreatic duct), and pain on the right side was from gallstone and a necrotic gallbladder.

      I'll remind you here that pancreatitis is usually caused by gallbladder sludge and small gallstones that came out and passed through the bile duct and got lodged in front of the pancreas, thus blocking the pancreatic duct, which causes pancreatitis.

      I have no medical training, but from my past experience, I learned that that is exactly what caused my pancreatitis.

      I don't recall having feaver during my gallstone attack and pancreatitis episode, which by the way happened simultaneously, but I did have severe vomiting, nausea, profusive cold sweats, shivers, intense all-around abdominal cramps, acute and spasm-inducing pains on the right side, and severe cramps and intense pressure-like pains on the left side, both just beneath the rib cage in the abdominal areas.

      Like you, I held out from calling emergency ambulance service at the start of my ordeal. I held out for 24 hours, but that 24 hours was the worst nightmare I ever endured in my whole life. I literally could not sleep and remained hunched over on my couch the entire night till the sun rose. Thereafter, I simply could not endure the sickness and pain any further, and I resorted to having the ambulance take me straight to the emergency room at the nearest hospital.

      Not sure what to recommend, but if feaver continues it's usually a sign of an infection. I recommend calling your GI and ask if you can see the doctor asap. Don't downplay your pain levels and symptoms when talking to the nurse if you do call your GI office. Let them know how much you're suffering so that they can either schedule you to see the GI doctor right away or recommend you to check into the emergency room.

      The experience of going through an illness/medical emergency is so varied among those who've gone through it that I find it incredible how callously some patients are handled. I was one among the few who were very lucky to have immediate and accurate diagnosis and treatment.

       If you don't get proper attention to your medical needs, I strongly recommend pushing the issue with your doctors to have your medial issues diagnosed and tended to asap.

      Fever is a sure sign of infestion, so don't hold back in contacting physicians and/or going into the emergency room asap. Listen to your body: if pain and illness are extremely acute and intense to the point of losing your sanity, ER check-in is what you absolutely require. If pain is manageable and tolerable, then perhaps it is more suitable for a schedule to visit your GI specialist asap.

      I wish you the best of care.

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    • Posted

      Oops, clarification. pain on left side is likely pancreatitis, pain on right side is likely gallbladder or gallstone.
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    • Posted

      Oh my god... Can you go to a nearby town or something where there is better care? I'm not intending to worry you but would just concern me if it were me. I wouldn't wait if I were you.... But that's my opinion

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