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I am 38 years old, male.

About a year ago I started having pains in abdomen and mid back.

It started with mild mid right back pain, then mild abdominal pain just between sternum and belly button, accompanied by indigestion, hypersalivation, bloating, reflux, very bad smelling and sometimes floating stools and flatulence. The pain does not seem to be food or alcohol related. It does not really matter that I eat or drink for the pain pattern

I drink alcohol rarely, no more than a couple of drinks a month, but I used to smoke for ~ 15 years and I quit about 3 years ago, also I lost about 5 pounds during this year

Since then I had various test including:

1) Abdominal US, found slightly enlarged right lobe of the liver only

2) Upper endoscopy with H.pylory sampling – all negative

2) Various blood tests including CBC, liver/pancreas enzymes, Hepatitis A/B/C , celiac- everything normal or negative

3) Abdominal CT scan with oral and IV contract -all normal

4) Abdominal 3T MRI with contract – all normal

5) Fiberscan – normal

The only test that showed abnormality was HIDA scan, where delayed (more than 60 min) filling of gallbladder was found, the radiologist decided do not proceed with the second part of HIDA protocol - CCK injection, therefore injection fraction of GB was not tested.

Based on this finding the radiologist concluded that this finding is consistent with chronic cholecystitis , and since no stones were found during previous tests the GI concluded that this is acalculous cholecystitis with unknown etiology and referred me to surgeon.

Surgeon’s recommendation was to proceed with cholecystectomy, but she also said that there is a chance that surgery may not help to relieve the symptoms since the initial problem could be related to SOD or to the problem with biliary duct.

Now the pain is mostly on the mid back on the right side and for the last month it began to spread to the left as well.

The pain does not wake me up from the sleep, and usually laying down on the right side makes the pain to fade away, but if I sleep for longer than 7-8 hours the back pain kills me, then I walk it is getting better.

Also that makes the pain worst is if I stand still for longer than 10-15 minutes, on subway of doing some kitchen work.

I also recently noticed that sometimes then I am in pain if bend back I feel kind of click in the mid back and pain immediately goes away for several minutes.

Does this sound like gallbladder related problem?

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Before the tests I was thinking gallbladder stones causing cholecystitis.  I still stones are possible, though less likely given the vast number of scans you've had.  Very good chance you have cholecystitis requiring cholecystectomy.

Do you ever get oily/greasy poo?  Grease film in the toilet or anything like that?  Do you know your bilirubin level?

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Thank you for your reply, Timber

Sometimes yes, I get greasy poo, several months ago it was also yellow, the billirubin level should be ok, since I was told that all bloodwork came back normal.
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Sounds like a classic biliary tree problem. Most likely gallbladder. I can't explain why you needed so many scans, but my understanding is surgery is clearly indicated. I'm not totally sure though as you have not had an ERCP, which is the test I'm familiar with (I'm assuming HIDA is roughly equivalent).

The less likely alternative is there's sometime wrong with fat transport in your gut. The character of your pain makes this unlikely.
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Hi

I am facing the exact same symptoms as you. Have you been able to find the reason?

 

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