Gallbladder or IBS?


About 3 and a half months ago I had an episode in the middle of the night. I threw up and had diarrhea all night. The next morning I went to the clinic, they took my temperature (no fever), and said it would probably clear up in a couple of days. After a few days I felt much better so I went back to my regular diet, but a few things upset my stomach and made me throw up more. Those include fried foods and something I found interesting was lactose (I now have to drink lactose-free milk). After I would eat these types of foods I would get an extremely full feeling, almost like bloating, but it wasn't gas. A few week after that I began getting a pain/pressure located directly below my rib cage in the middle of my abdomen, and after a few days it moved to the right of my abdomen. These pains could last anywhere from a few minutes to around 45 minutes was the longest. I also experienced a shoulder ache during this period (could be unrelated). I got an ultrasound (everything normal) and an upper endoscopy (no ulcers, etc.). I also received a HIDA scan, but they were unable to determine the percentage my gallbladder is working, so my doctor diagnosed me with IBS. I am fine with that and the pains went away for about 3 and a half weeks, but then slowly came back. After every meal I feel the same pressure in my upper right abdomen. I wasn't sure if I should still be concerned about my gallbladder (and if so, are there any more tests?) or if IBS can cause all of these symptoms.

Also, my grandmother and cousin had gallbladder disease which is why I was leaning towards my gallbladder to begin with.


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Answered by:
Harpreet Singh

Although no definitive diagnosis can be made online but from the data that you have provided,it seems that you may be having IBS as you initially responded to IBS treatment. But since IBS is a diagnosis of exclusion we need to rule out any organic pathology first.IBS is most likely if you have recurrence of abdominal pain with altered bowel habits and onset of symptoms is during periods of stress or emotional upset and there is no fever or weight loss. But if you are older than 45 years and have pain and diarrhea at night it is more likely that it is not IBS and something more serious.As far as the gall bladder pathology is concerned you have had both gall bladder ultrasound as well as HIDA scan.Ultrasound has >95% accuracy for gallstones and HIDA scan is useful for accurate identification of cystic duct obstruction and assessment of bile ducts and both have been shown to be unremarkable,the likelihood of gallbladder disease is very little but your doctor may like to repeat these tests and conduct some other tests to completely rule out the same for which you must see your doctor.


Thank you for your quick reply Dr. Singh. I am glad you brought up weight loss because when I posted this yesterday it somehow completely slipped my mind. After the initial incident, I began losing weight rapidly, totally about 20 pounds in roughly a month. I am not sure how this fits in with either the gallbladder or IBS or something else. Is there another test I should suggest?

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