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Medical Forum / General / General / February 2004

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Diagnosed with gallstones, but pains are on left side!

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MOTU - 06 Feb 2004 09:39 GMT
I need help on narrowing down what I might have! I'm male, 27 years old,
5'6, 160lbs toned fit physique, healthy-eater, non-smoker, and a
workaholic. I apologize about the length of this post, but I think the
history is relevant.

In mid-October, due to immense work-place stress I boiled-over and
collapsed. I went on sick leave, felt extremely fatigued (12-16 hours of
uninterrupted sleep every day), and suffered from constant chest ache - it
felt as though someone had kicked me in the heart, and I noticed what I
described to my doctor as frequent 'flutterings' of my heart with sudden
sharp pains in the same area (left of sternum but right of nipple). As
well I started to notice sudden (but infrequent) sharp pains on the left
side of my abdomen, best described as what I imagine a sharp knife stuck
in and twisted would feel like. As I'd had kidney stones 8 years ago and
noticed pain(twinging) in the same area, I mentioned this to the doctor.

He set me up with blood tests (ok.. however mentioned a slightly high
cholesterol - which I found strange as I specifically choose low-fat
meals), urine tests(ok), a halter monitor for the 'fluttering'(came back
normal). Suggesting it was psychological, he recommended to try and get
active again and to eat at regular times. I still slept a lot (10-12hours
a day), but made sure I ate properly, and over the next 4 weeks the upper
chest pains seemed to subside, in fact the sharp pains returned only every
2 or 3 days now, and were less severe.

However, at Christmas, for the first time in my life, I noticed I was
having difficulty eating the first serving, let alone seconds (I've never
turned down Christmas dinner 2nds!). By New Years, I noticed the left-side
abdomen pain (at bottom of ribs) was pretty much a constant ache, with
more frequent sudden sharp pains (especially while driving, while
Christmas shopping, whilst waiting in lines, etc.. probably brought on by
stress). Eating dinner is a chore now, I don't look forward to it. Doctor
ordered more blood tests & x-rays, and put me on Prevacid, thinking it was
an ulcer. All came back normal again, but by now I was feeling pain in my
stomach (centre, halfway between navel & sternum)- almost like the pain
you feel if you are punched hard in the stomach winding you. Prevacid
didn't help. Doctor ordered ultrasound -- I got the results on Thursday
and **he says I have a gallstone**.

He's arranging for an appointment at the hospital as he says it could be
what's causing the problem but as the pain is on the LEFT, he doesn't want
to remove the gall bladder if the stone is not the cause of the problem
(gall bladder is on the RIGHT side).

I am typing this at 4am as I just woke up from the discomfort - it feels
like my insides are burning.

Eating has no noticeable affect - the pains are there when I have an empty
stomach and when I've eaten.
I am sounding like a hypochondriac, but I've only made 2 unscheduled
visits to the doctors in the last 15 years and only go if something is
really bothering me-- otherwise I ride it out. Not this time!
Any ideas??

Thanks
J - 06 Feb 2004 20:54 GMT
> I need help on narrowing down what I might have! I'm male, 27 years old,
> 5'6, 160lbs toned fit physique, healthy-eater, non-smoker, and a
[quoted text clipped - 49 lines]
> really bothering me-- otherwise I ride it out. Not this time!
> Any ideas??

You had kidney stones at age 19? and gallbladder age 27? and a male also? How
do you explain that?
Sheesh !
I had gallstones age 22,must be a Canadian thing eh?
removed gallbladder.
Gallstone pain can refer anywhere...mine was out lower left rib and out left
lower back, doctor back then told me I'd caught a cold on my rib. 18 months
later, another doctor x-rayed and removed gallbladder. I phoned the idiot
doctor and told him he should retire.

My friend had pains similar location to you, she put up with it for 4 years
and thought it was her heart, it was her gallbladder and GERD. She ended up in
ER many times before she finally decided to get hers out. It was infected by
that time.  Another co-worker waited until she's now stuck with chronic
pancreatitis.
Friend still has GERD, but won't take meds. Maybe you have all 3 or 4 or 5?
Let us know how it all works out.
J-not a doctor

And can cause lots of potential problems.
http://bmj.bmjjournals.com/cgi/content/full/311/6997/99
Symptomatic gall stones--Symptoms are the most reliable factors indicating the
prognosis and hence the necessity for treatment of gall stone disease. The
most common symptom of gall stones is intermittent pain in the right upper
quadrant of the abdomen, classically but not exclusively after a meal and
lasting one to several hours. This is known as biliary "colic." It is
frequently mild but can be severe, requiring medical attention and narcotic
analgesics. Once gall stones are symptomatic, worsening of symptoms is likely
and the risk of progression to more severe disease such as acute cholecystitis
or pancreatitis is increased, roughly a quarter of patients developing
complications over the next 10-20 years.30

Complicated gall stones--Cholecystitis and choledocholithiasis, with or
without cholangitis or pancreatitis, are the most common complications of gall
stone disease.34 Acute cholecystitis caused by cystic duct obstruction by
stones or stone fragments frequently requires hospital admission and can lead
to abscess formation, gall bladder perforation, or mucocele of the gall
bladder. The chronic low grade inflammation caused by gall bladder stones,
infection of gall bladder bile, and intermittent duct obstruction results in
scarring, contracture, and loss of function of the gall bladder wall--the
picture of chronic cholecystitis. Gall bladder cancer is an uncommon long term
outcome.

There are 3 types of gallstones cholesterol, pigmented and mixed (I've lost
the url that explains all three).
If your cholesterol is up, it might be your liver, thyroid and/or the
gallbladder problem. The liver is ^upsdie down V-shaped so can cause pain
anywhere in the Vshape ..across the abdomen, right side, left side and I think
lower right almost pelvic area.

http://www.umm.edu/non_trauma/gallstones.htm
The symptoms of gallstones may resemble other conditions or medical problems
such as heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal
hernia, pancreatitis, or hepatitis. Consult a physician for diagnosis.
Who is affected by gallstones?

What is a risk factor?
A risk factor is anything that may increase a person's chance of developing a
disease. It may be an activity, such as smoking, diet, family history, or many
other things.

Different diseases, including cancers, have different risk factors. Although
these risk factors increase a person's risk, they do not necessarily cause the
disease.

Some people with one or more risk factors never develop the disease, while
others develop disease and have no known risk factors. But, knowing your risk
factors to any disease can help to guide you into the appropriate actions,
including changing behaviors and being clinically monitored for the disease.

The following are suggested risk factors for gallstones:

obesity - a major risk factor for gallstones, especially in women.
estrogen - excess estrogen from pregnancy, hormone replacement therapy or
birth control pills appears to increase cholesterol levels in bile and
decrease gallbladder movement, both of which can lead to gallstones.
ethnicity - Native Americans have the highest rates of gallstones in this
country and seem to have a genetic predisposition to secrete high levels of
cholesterol in bile.
gender - women between the ages of 20 and 60 years are twice as likely to
develop gallstones as men.
age - people over 60 are more likely to develop gallstones than younger
people.
cholesterol-lowering drugs - drugs that lower cholesterol in blood can
actually increase the amount of cholesterol secreted in bile, which in turn
increases the risk of gallstones.

diabetes - people with diabetes generally have high levels of fatty acids
called triglycerides, which increase the risk of gallstones.

rapid weight loss - as the body metabolizes fat during rapid weight loss, it
causes the liver to secrete extra cholesterol into bile, which can cause
gallstones.
fasting - decreases gallbladder movement, which causes the bile to become
over-concentrated with cholesterol.

Last time I checked a barium x-ray or GI scope looks for ulcers. (oh, yes,
also bloodwork if there's infection)
MOTU - 07 Feb 2004 01:18 GMT
> You had kidney stones at age 19? and gallbladder age 27? and a male also? How
> do you explain that?
> Sheesh!

Yep, that seems to be the case. Kidney stones I'm told were due to calcium
build-up - from the age of 16-18 I worked out with weights quite a lot,
and ate plenty of protein - sources included plenty of milk & cheese.
Never taken any supplements or vitamins of any kind. Since the kidney
stones, I have not worked out at all, and have obviously reduced my
intakes to normal levels. Low fat, sensible diet - and no junk food
whatsoever, no pop, maybe 1 coffee a day (if that).

> I had gallstones age 22,must be a Canadian thing eh?
> removed gallbladder.
Hey, you got me beat there! Any similarities in diet history?

> Gallstone pain can refer anywhere...mine was out lower left rib and out left
> lower back, doctor back then told me I'd caught a cold on my rib. 18 months
> later, another doctor x-rayed and removed gallbladder. I phoned the idiot
> doctor and told him he should retire.

My doctor says the left side pain *might* be a torn muscle. Somehow, I
doubt it.

> My friend had pains similar location to you, she put up with it for 4 years
> and thought it was her heart, it was her gallbladder and GERD. She ended up in
[quoted text clipped - 4 lines]
> Let us know how it all works out.
> J-not a doctor

Thanks, I will have to look up GERD - that's the first time I've heard of
it.
Thanks for the additional info that I snipped from the end of your post.
J - 07 Feb 2004 10:48 GMT
> > You had kidney stones at age 19? and gallbladder age 27? and a male also?
> How
[quoted text clipped - 3 lines]
> build-up - from the age of 16-18 I worked out with weights quite a lot,
> and ate plenty of protein - sources included plenty of milk & cheese.

Well milk and cheese have calcium also.
And *high* protein is not good for the kidneys, so a balanced whole food diet
is where I come from and remain.

> Never taken any supplements or vitamins of any kind. Since the kidney
> stones, I have not worked out at all, and have obviously reduced my
[quoted text clipped - 4 lines]
> > removed gallbladder.
> Hey, you got me beat there! Any similarities in diet history?

No, I had other two of the (other) risk factors.
Keep in touch and let us know how you are faring.
J
J - 07 Feb 2004 17:00 GMT
> Thanks, I will have to look up GERD - that's the first time I've heard of
> it.
> Thanks for the additional info that I snipped from the end of your post.

GERD, acid reflux, acid in the stomach,
that's what's meds like Prevacid, Pantoloc and Prilosec are for, if other
anti-ulcer meds don't help.
There are some mentioned here.
http://adultpain.nursing.uiowa.edu/GenePain/Stomactt.htm
Also eat 3 or 4 small meals /day even if you are not hungry and see if
anything improves.
J
MOTU - 07 Feb 2004 18:44 GMT
> > Thanks, I will have to look up GERD - that's the first time I've heard of
> > it.
[quoted text clipped - 5 lines]
> Also eat 3 or 4 small meals /day even if you are not hungry and see if
> anything improves.

I'd already written that doctor thought it might be acid reflux and had
prescribed Prevacid  - which hasn't helped in the slightest. As well, the
tests show I do not have an ulcer.

You mentioned in another post you had 2 of the other risk factors.
Just wondering are you M or F? Overweight or normal weight for you height?
anon - 07 Feb 2004 02:32 GMT
> J-not a doctor

Gee...really?
J - 07 Feb 2004 10:43 GMT
> Gee...really?

An MD and that's all you have to contribute to this thread?

Sheesh!
J
 
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