OpenHealth Q&A

Seeking Guidance on Gastrointestinal Issues

For the past couple of years, I've been grappling with persistent gastrointestinal problems at the age of 35. I've faced: • Frequent diarrhea alongside shifts in stool hue and texture, • Intense discomfort beneath my right rib cage, just below the sternum, to the point of inducing sweating and almost fainting, along with general pain in the liver region. Although the pain has been sporadic, it has notably lessened since I adopted a healthier diet and lost weight. My initial medical evaluations comprised: • Several gallbladder function tests and a gastric emptying assessment—results were normal, • A colonoscopy and endoscopy—found no major issues apart from eosinophilic esophagitis (EOE), • Stool analyses also returned standard results. I was given Dupixent to manage EOE. After five months without significant progress, I transitioned to a stringent clean-eating and exercise program, which led to major relief of symptoms and notable weight loss. --- ### Current Trends & History: • Flare-ups appear to be instigated by overindulging in large or fatty foods, • Episodes typically last from one week to a month, • Adopting healthier eating habits consistently alleviates symptoms, • Over these two years, I've shed fifty pounds through a combination of deliberate dieting and reduced intake during flare-ups, • My weight remains consistent outside of flare periods, and I lead an active lifestyle; however, flare-ups hinder my level of activity, • There are instances of suspected platelet reductions during flare-ups, though this is yet to be confirmed through laboratory tests. --- ### Family Medical Background: • Seven women on my mother’s side have undergone gallbladder removal, • One aunt from my father’s side has also had her gallbladder surgically removed. --- ### Current Medical Perspectives: • A gastroenterologist considered the possibility of non-ulcerative dyspepsia and suggested a low-dose antidepressant, yet referred me to a surgeon, indicating some diagnostic ambiguity, • I halted the antidepressant due to adverse effects. Dietary adjustments provided improvement until I encountered another flare following a rich meal, • The surgeon expressed a 75% likelihood that my gallbladder is to blame, despite normal HIDA scan results, acknowledging that not every case adheres to conventional standards, • Two general practitioners concurred that surgery might be a sensible next step, stating, "If symptoms remain post-surgery, we will have definitively ruled out the gallbladder as a cause." --- ### Recent Discovery: • A gallbladder polyp was identified within the last year, which wasn't present earlier. --- ### Summary of Symptoms (During Episodes): • Diarrhea or narrow, oily stools that are discolored, • Intense nausea, • Discomfort around the liver or upper back, • A strong urge to vomit occurring 2–4 hours after consuming rich or heavy meals, • Severe flatulence, with odors ranging from mild to very pungent, • General sensitivity in the gastrointestinal tract, • Possible drops in platelet count during flare-ups. --- ### Important Patterns Observed: • Posture influences my symptoms significantly: • I feel better when standing or sitting upright, • Symptoms worsen with movement, slouching, or lying sideways, • Using a heating pad on my abdomen provides some relief from the discomfort. --- Other noteworthy sensations include pressure in the gallbladder region and an intense feeling of tightening or contracting in my G.I. tract, akin to experiencing extended bouts of diarrhea without relief. ### Main Inquiry: Considering my symptoms, family medical history, the emergence of a gallbladder polyp, and the challenges in accessing specialists due to my rural location—should I proceed with gallbladder removal, or is it prudent to eliminate other possibilities first?

Answers (1)

7/29/2025, 5:41:32 PM

OpenHealth AI

It sounds like you've been going through a challenging journey with your gastrointestinal symptoms, and it's understandable to seek clarity on whether gallbladder removal could be the right step for you. Given the recurrent nature of your symptoms, the discovery of a gallbladder polyp, and your family history, it's important to consider your options carefully.

Summary of Key Points:

• You have persistent gastrointestinal issues, including diarrhea and discomfort in the upper right abdomen.
• Your history suggests a connection between fatty meals and symptom flare-ups.
• A gallbladder polyp has been identified, and family history indicates a tendency for gallbladder problems.
• Previous tests revealed no major issues, but you’ve experienced significant symptom relief with diet and lifestyle changes.

Explanation:

Based on your symptoms and medical history, it appears that your gallbladder could indeed be a contributing factor, particularly given the family history of gallbladder issues and the identified polyp. The normal test results for gallbladder function, however, make the situation a bit more complex. Often, gallbladder problems may not show up in tests until symptoms become more severe, and your experiences after consuming rich foods align with common gallbladder issues.

Since your healthcare providers have indicated that surgery could help rule out the gallbladder as a cause, it may be worthwhile to consider this option. However, it's also crucial to explore all other possibilities and communicate openly with your healthcare team about your ongoing symptoms.

Next Steps:

1. Monitor Symptoms Closely: Keep a detailed diary of your symptoms, including food intake, to identify any specific triggers. This can help in discussions with healthcare providers.

2. Consult with a Surgeon: Given the recommendation you've received and the significant likelihood that your gallbladder is a culprit, discussing surgery could provide definitive answers and relief.

3. Consider a Dietitian Consult: If not already in place, working with a dietitian familiar with gastrointestinal issues could help refine your diet further to reduce symptoms and flare-ups.

4. Evaluate the Gallbladder Polyp: Ensure that your healthcare provider is monitoring the polyp, as it may require follow-up assessments to rule out any malignancy risk.

5. Relieve Symptoms at Home: Continue to implement strategies that help you, such as using a heating pad for discomfort and maintaining good posture, which you've found helpful.

6. Document Any Changes in Platelet Count: Since you've noticed fluctuations in platelet count during flare-ups, ensure this is documented and discussed in your next appointments, as it may provide additional context for your condition.

Remember, surgery is a significant decision, so gathering as much information and support as possible to make an informed choice is essential. You're doing well by seeking answers and staying proactive with your health management. If you need further clarification on any specific aspect, feel free to ask.