If you Google "hyperkinetic gall bladder" you can find a little bit of research. Here is an article that was published in the Gastrojournal in May, 2014
The Hyperkinetic Gallbladder - An Ignored Cause of Abdominal Pain
Joanna K. Law, Alexander Antoniou, Anthony N. Kalloo, Eun Ji Shin
Background: Nuclear medicine hepatobiliary scans (HIDA) are frequently used to investigate
patients with typical biliary pain but with negative workup for structural disease. It is
generally accepted that a gallbladder ejection fraction (GBEF) of <40% is considered abnormal
and symptoms will typically resolve with a cholecystectomy. What is not known, however,
is whether a high GBEF (>80%) may result in biliary-like pain and also respond to cholecystectomy,
suggestive that a "hyperkinetic" gallbladder syndrome may exist. Aim: To evaluate
the clinical response to cholecystectomy by GBEF in patients undergoing HIDA scans for
suspected gallbladder disease. Methods: A retrospective chart review of all consecutive
patients with an intact gallbladder undergoing HIDA at a single institution from January
2005 - December 2012. Patient demographics, symptoms, and indication for HIDA were
recorded. HIDA results, cholecystectomy, and follow-up were recorded. Results: A total of
557 patients underwent a total of 572 HIDA scans during the study period; 567 events
were analyzed. The mean age was 46.4 years (range 8.5-91.4) with 376 (66.3%) female
patients. The most common indication for HIDA was right upper quadrant pain in 223
(39.4%); non-specific abdominal pain in 146 (25.7%); epigastric pain in 85 (15%); suspected
acute cholecystitis 87 (15.3%); and no indication recorded in 26 (4.6%). The mean GBEF
was 64.9%. Cholecystectomy was performed in 103 patients; 7 were due to acute cholecystitis
based on HIDA. Of the remaining 96 patients39 patients had GBEF<40% and 26 patients
had GBEF>80%. In patients with GBEF>80%, the response to cholecystectomy was 69.3%
and just as effective as in patients with GBEF<40% in whom the response rate was 59.0%
AGA Abstracts S-880
(p=0.44) (Figure 1). Conclusions: In this retrospective series, cholecystectomy appears to
provide just as good symptom reliefin patients with hyperkinetic bladders (GBEF>80%) as
compared to those with low GBEF (GBEF<40%).The hyperkinetic gallbladder should be
given serious consideration as a cause of abdominal pain but prospective trials are needed
to validate these findings.
Figure 1: Symptom relief in patients undergoing cholecystectomy based on GBEF
I hope your visit to Mayo proved beneficial and you had a positive outcome. I wonder if you might be willing to share a bit about the experience. I am scheduled to go to Mayo at the recommendation of my internist at the end of December to further explore my high EF from the HIDA scan, but am scheduled to meet with internal medicine first since I have some endocrine issues as well. I'm hoping that GI will make a recommendation to remove the gallbladder, but at this point, I'm looking for anything that will lead to a reduction in my symptoms. Thank you!!
can someone please tell me the name of their doctor or surgeon. Thank you
please tell me who your doctror was??Thank you
please tell me the name of your doctor or surgeon. Please! Write on this forum. Thanks
I have 97% on HIda and no doctor will listen. Anyone who could give me the name of their doctor or surgeon it would be greatly appreciated. Thank you
Hello, thank you for your post. I had a HIDA scan done on Monday and followed up with the Surgeon today. He explained that my EF is at 88%. I have been having pain over the years and sometimes vomiting. I have been in pain now for months and ended up in the ER a few weeks ago. They found no stones or abnormalities with the ultrasound or the CT scan. The Surgeon recommended that I get my gallbladder removed and did say that he has seen several people come in with the same problems. He explained that 100% of them got relief from the gallbladder being removed. I have to admit that I am a bit nervous about this, however I would really like to feel normal again. After reading all of these posts I think I am going to go ahead and schedule the surgery.
Hi, I am the one you replied to. I understand the nervousness you may have of the surgery, but it is definitely worth it and is very low-risk anyhow. The only problem I am having now is loose bowel movements after eating certain high-fat things but in most people, it steadies out after a month or so. There is also a drug called imodium, among other drugs, that can be taken OTC if the diarrhea is severe and consistent.
chronic diarrhea after gb removal is rare....don't let that scare you. My surgeon has been in practice for almost ten years and has only had one patient who had diarrhea last longer than the first 2-3 weeks after surgery. Good luck.
Would a EF of 80 be high enough to consider having the gallbladder removed? I have had severe nausea, some vomiting, loose stools (quite different than my normal) and bouts of pain, tenderness, pressure and cramping under my right rib cage for over a month now. Normal abdominal x-ray (no blockages), normal abdominal ultrasound.