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Following agallbladder hida scan, I was informed I had an 85% to 90%
ejection fraction. Doctor informed me this was very uncommon and that
they have no protocol for treatment other than to remove the gallbladder.
How can this be the only answer? Am I naive to think that here in the USA,
the medical profession should have a better solution? Does anyone out there know of this situation and have any other solutions?

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I too have a high number after my HIDA scan was done and still I cannot get a straight answer on what this means! Did you end up getting your gallbladder out anyway? And what was the deal? Thanks so much
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I too am having upper abdominal -- epigastric pain. The last time I tried to figure out what was going on was in 2003. Normal ultrasound and a HIDA/Pipida scan with an ejection fraction of 94%. No answers. I only have a severe pain attack about once a year. It's typically after drinking alcohol and never occurs until I lie down to go to sleep. Then, it is almost immediate and so painful I can barely cope. Now, I'm having less severe symptoms but somewhat constant. I feel epigastric tightness and pressure, sometimes pain but tolerable. So, I decided to try to figure out what's going on again. My last serious attack was in March. I had a CT abdomen and the radiologist said there appeared to be mild dilation of the extrahepatic duct. Then ultrasound showed CT to be incorrect. Then HIDA had an ejection fraction of 91%. Still no answers.

Has anyone with a high HIDA ejection fraction actually had their gallbladder out? Has it helped? Very confusing. I wish there were more definitive answers.
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Got my results today from hydascan. Doc says too high 95%. He wants me to record everyday what i eat and how i feel. Can't find any news on what exactly a high result means.
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i am so glad to hear that there are others that have a high ejection fraction. I can't seem to get any clear answers though. I saw my MD today and he said to do nothing. I have episodes of pain on my right side, but sometimes in my chest and back. i stay nausated most of the time. He told me to take 2 nexium instead of 1 per day. Tomorrow morning I am going to get an appointment with a Gastro DR and get a second opinion. Has anyone had thier gallbladder removed and been symptom free?
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Hi, This is my first time writting. I too have pain, bloating, and nausea. I have had one sevear attack three months ago. This is when it all started. I have had 2 Ct scans, a colonoscopy, a gallbladder ultrasound, and the HIDA scan. I have lost 31 lbs. and am tired of being sick! They told me that my HIDA scan showed that my gallbladder was not emptying properly. I think they said that I had a low ejection fraction. Anyway, I am set for surgey on Dec. 18th. I know this sounds weird but I am finally happy to have an answer and a solution! I am once again tired of feeling crappy! I will let you know what I feel like after the surgery.
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Hi, as others have described, I too have had the Hida Scan done. I had the liver scan, colonoscopy, ultrasound and blood work done. Everything seems to be good all but the Hida scan. I have a high ejection fraction 85%. My specialist suggested that I get my gallbladder taken out. I have no pain, I have bloating and nausea. I feel like I could throw up everytime I eat, but will not allow myself. Sometimes though I cannot keep it down. It seems to be taking a toll on my health. I am feeling very run down, and have started getting dark circles under my eyes. My energy level is next to none. I start getting sick about 1 hr or so after I have eaten. I was wondering if anyone has any info? Has anyone had there gallbladder taken out, or found anything that will help?
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High or abnormal gallbladder ejection fraction is very much like the mechanisms of a car it not functioning properly, some people just have nausea, others have pain, nausea, diarrhea & vomiting even if no symptoms a surgical consult should be obtained. High ejection fraction or deeper contractions otherwise named usually are the culprit for abdominal pain at the least. We usually refer only if our patients have symptoms to a surgeon for a consult, which you'll know. I work for a gastroenterologist. If you haven't seen one yet then definately get his/her opinion ASAP. Almost all our pt's with symptoms and this problem get immediate relief from gallbladder removal. I hope this helps!
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Pammers - You should get tested for gluten intolerance and celiac disease. The first is a simple blood test, the second requires an endoscopy to biopsy the small intestine. I had symptoms similar to yours and have done wonderfully on a Gluten Free diet.
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Hi y'all,

I am a nuclear medicine physician and I have seen high ejection fractons many times. I don't KNOW why, and I would highly doubt that we will ever know the answer to why. With research dollars shrinking and so many more life threatening and morbid diseases out there y'all may just have to live without knowing why.

That said, I can extend a few guesses. The gallbladder is a blind-ended muscular pouch that fills with bile and stores it between meals then contracts when stimulated by factors from the stomac and small bowel. In the case of gallstones and pain, the stone may block the duct leading frm the gallbladder and it hurts when the gallbladder contracts against the obstruction. The presence of the stone may also cause an inflammation in the gallbladder and cause pain. When this happens, the gallbladder may lose contratillity and the ejection fraction may be low. Stones could also pass through the cystic duct from the gallbladder and cause pain as it goes down the ductal system to the bowel (like a kidney stone in the ureter) or it could become lodged in the common bile duct. If it becomes stuck in the common duct, the pressure in the duct increases and it dilates (enlarges in diameter) to try to pass the stone. The gallbladder and bile ducts have stretch receptors. When the duct dilates, this causes pain.

OK, now for the guesswork. There is a maximum flow-rate that any tubular structure can sustain. The larger the diameter, the higher the flow-rate attainable. Under normal contraction by the gallbladder, the duct may dilate a little to accomodate the flow rate needed,but not so much that the stetch receptors are stimulated to cause pain. If, however, the gallbladder is hyperdynamic; and your ejection fraction is high (and I usually think of the 80's and 90's for the ejection fraction percentages) then you could get a flow-rate so high that the duct has to dilate beyond it's pain threshold. I have even seen the biliary ducts within the liver dilate with gallbladder contraction indicating that the bile is flowing backwards. The pain could continue long after the gallbladder itself stops contracting and the ducts are back to normal in size.

I know of nothing that can be used on a regular basis to reduce the contractillity of the gallbladder. There are probably things that can, but I would bet that the side effect profile would be unacceptable. There is nothing that I know of that we can do to increase the low-rate in the ducts. So, the only thing that I can think of to prevent the over-dilation of the ductal system when the hyperdynamic gallbladder contracts is to remove the gallbladder itself. It may not make you happy that you are the proud sponser of a hyperdynamic gallbladder, but I tried.
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It is so comforting to find that there are other people out there with the same issues- I was starting to think I was creating these symptoms in my head! I have been dealing with severe discomfort, pain and bloating after eating (generally within 10-15 min) for the past year. I went to one Gastroenterologist and he performed the typical blood work, an endoscopy, X-rays (GI barium series), Gall Bladder ultra sound and found nothing. I went on antibiotics thinking it was "an over growth of 'bad' bacterial", which didn't help. He also went as far as putting me on Carafate when I didn't even have ulcers. I am finally going to a different specialist and he recommened a HIDA Scan, which I am having done in a few days. I am honestly hoping this provides the answers I need, but it sounds like the only option/answer to these Gall Bladder issues is to have it removed. Does anyone knowing if the HIDA Scans are typically covered under insurance? I have called both the hospital and insurance company serval times and haven't gotten a definitive answer. Ugh!
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I have had three HIDA scans in the past three years. The first was in the 80s, the second in the 30s, which is when they suggested I have my gall bladder removed, but I moved and had another one done before the new doctor was willing to order the surgery, and the third one came up at 97%. Everything I've been told indicates that low means it should be removed and high is good. I have been given no explanation on why my results would change so drastically. Any ideas?
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A high ejection fraction is NOT necessarily a good thing. I have been suffering from right upper quadrant pain for over a year now, and the HIDA scan was the final straw. I discussed the ejection fraction of 98% that I had, and the doctor informed me that this indicates a hyperactive gallbladder. This is not a good thing, and I go in a few days to have it removed. A low ejection fraction is below 30% and a high ejection fraction is above 60%, although it does not become a large problem until it gets into the 90th percentile, particularly the high 90's. I am excited to get it removed and end the pain and problems that I have had for a while now. If you do have a high ejection when the CCK is administered, this could cause more serious problems if it is not removed asap.
Hope this helps.
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I have had upper rt quadrant pain for nearly a year now. finally got referred to GI who assumed gallbladder right away with the upper rt quadrant pain in the front and upper rt quadrant pain in the back. Ultra sound showed a normal gallbladder, neg. for any kind of infection or gallstones. The HIDAscan showed a functioning gallbladder, but the injection rate was at 95 percent. this leads to the diagnosis of "hyperactive gallbladder." i've been hurting, esp. after meals for so long now, im relieved to finally get a diagosis. the recommendation is obviously gallbladder removal, which is lyposcopic and fairly nonevasive, and routine for major abdominal surgery. its actually a very rare condition, but still requires the same surgery as the much more common gallstone problem. apparently this will permanently mitigate my chronic pain issues in the upper rt quadrants. really excited! thanks everyone for the information on this topic!
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Hi I am a 22 year old female. I just recently had an attack 2 weeks s ago. started out shrp pains in stomach and nausea. then i went to the E.R. throwing up and feeling horrible pains. They gave me an ultrasound on my gallbladder and it was fine and said i had pancreas enzymes elevated and sent me home....sweet ay? Well i wanted a second opinion so i went to a smaller urgent care and she checked my blood and urine and found white blood cells in my urine and said my lipase enzymes were elevated even more so i had to go take a HIDA scan... i guess my gallbladder ejection fraction was low. now i am waiting to be seen by a GASTRO guess what?? my appt aint for 2 MONTHS!!!!!!!!!!!!!!! i cant taqke this any more i feel nautious and soooooo tired every day and im moody and just feel horrible........... ugh any suggestions? anyone. i am now feeling sick like sore throat and rundown and congestion and sneezing can this be anything to do with any of this or is it just a cold or something?? o.O
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