30-Year-Old Female with RUQ Discomfort and Digestive Issues - Possible Gallbladder Concerns?
Hello everyone, I’m a 30-year-old female from the UK. I’m currently taking mirtazapine and thyroxine, and I do not consume alcohol. For the past few months, I've been contending with several troubling symptoms: - Intense pain in the right upper quadrant, which occasionally radiates to my back. - Frequent nausea and vomiting, particularly after consuming fatty meals. - Daily occurrences of steatorrhea, characterized by pale, greasy stools that tend to float. - One particularly severe episode resulted in extreme RUQ tenderness upon examination, leading to a visit to Accident & Emergency where I was given IV antibiotics. - There has been some slight, temporary relief when adhering to a low-fat diet. Here's a summary of the tests conducted and their results so far: - Faecal elastase levels were measured at 1138, indicating normal pancreatic function. - Calprotectin levels returned normal. - Liver function tests revealed: - GGT was mildly elevated yet categorized as “normal” (65). - ALT and ALP levels have shown an upward trend over time. - During my A&E visit, my eGFR was noted to have dropped to 53 but later returned to approximately 88. - An ultrasound of the gallbladder showed normal results with no stones detected, although it’s unclear if the gallbladder’s functionality was evaluated. - I am still awaiting results from some blood tests, including thyroid autoantibodies and a blood film. Currently, there is no follow-up plan or guidance provided. I’m seeking suggestions or advice on how to proceed and what questions I should ask during my next appointment.
Answers (1)
7/7/2025, 6:01:39 PM
OpenHealth AI
It sounds like you're dealing with a complex set of symptoms that are understandably concerning, particularly since they disrupt your quality of life. Based on what you've shared, your symptoms do align with potential gallbladder issues, but it could also be related to other gastrointestinal concerns. Here's a structured approach to help you navigate this situation.
Summary of Key Points
- Symptoms Suggest Gallbladder or Digestive Issues: Your RUQ pain, steatorrhea, and nausea after fatty meals are strong indicators of potential gallbladder dysfunction or other digestive problems.
- Normal Tests, but Further Evaluation Needed: The normal faecal elastase and ultrasound are reassuring, but the rise in your liver enzymes, symptoms, and previous A&E episode necessitate a reassessment.
- Actionable Steps and Questions for Your Next Appointment: Clarity about further diagnostic tests or treatment options is crucial.
Explanation
Given your history, it is particularly important to explore the reasons behind your discomfort. The fact that you've experienced temporary relief with a low-fat diet suggests that fat digestion plays a significant role in your symptoms. The mild elevation of liver enzymes and the acute episode requiring antibiotics raise concerns about potential underlying conditions that may need more thorough investigation.
Next Steps
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Dietary Management:
- Continue following a low-fat diet to minimize symptoms. You might find it beneficial to keep a food diary to track what foods particularly trigger your symptoms.
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Prepare for Your Next Appointment:
- Questions to Ask:
- Can we re-evaluate gallbladder function, perhaps with a HIDA scan to check for gallbladder contraction and function?
- Would it be valuable to pursue further imaging, like an MRI or CT scan, to look at the bile ducts (to rule out any complications like strictures or sludge)?
- Do the elevated liver enzymes indicate an underlying condition, and what follow-up tests (like hepatitis panel or specific autoimmune tests) are recommended?
- Considering your symptoms, would a referral to a gastroenterologist be appropriate for a second opinion?
- Questions to Ask:
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Monitor Symptoms:
- Keep a symptom log detailing when you experience pain, nausea, and stool changes. This can help your healthcare provider pinpoint triggers or patterns.
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Stay Informed:
- Research general information on gallbladder diseases and digestive health to better understand your condition, which will empower you to have informed discussions with your healthcare provider.
By taking these steps, you will be in a better position to advocate for your health and find relief from your troubling symptoms. If anything changes or worsens, such as increased pain or new symptoms, do not hesitate to seek immediate medical attention again.
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