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:
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
Related Questions
Seeking Relief from Mild Fecal Impaction: Should I Go to the ER?
At 20 years old, I find myself dealing with a frustrating issue: fecal impaction. It's not something I've faced before, or at least I can’t recall, but I’ve had chronic stomach difficulties throughout my childhood, including constipation from ages four to twelve. Recently, I've been experiencing more digestive challenges after a few years of feeling normal. Currently, I’m under the care of a gastroenterologist, and we’re working on diagnosing the underlying problems. For about five days now, I haven't been able to relieve myself. While I’ve had considerable gas, that’s been the only symptom. Today has been particularly difficult; I’ve spent the last 11 hours in the bathroom grappling with severe discomfort and impaction. Each attempt to relieve the situation is excruciating, to the point where my body is resisting the effort—it’s so painful that I find myself in tears. I imagine this is what birth must feel like. I suspect this intense fear and pain are remnants of my past struggles, as for many years I’ve feared using the bathroom due to the agony it causes. Despite trying various remedies like Miralax mixed with coffee, a bullet suppository, and even a manual approach with gloves, nothing is yielding results. I’m genuinely tempted to head to the emergency room and ask them to put me under so they can help me without the pain. My mother suggests they would likely opt for a liquid suppository treatment like they did during my childhood, which was quite traumatic. I’m torn—it feels like the ER might be my last resort, but I'm concerned they won’t take me seriously since my situation doesn’t seem dire. How foolish would it be to bring up wanting sedation? I desperately want to avoid this pain; it’s becoming increasingly difficult, and I’m fighting back tears from the frustration. Can they truly provide sedation for this type of issue even when it isn’t severe? I worry that my parents might react negatively to my quest for relief and think I’m being dramatic. I’m utterly drained and don’t know where to turn. When there’s no painful push against my body, I can’t even sense the severity of the issue, yet, I am experiencing leakage, leaving me unsure. Would it be unreasonable to pose this question to the doctors in the ER? I apologize if this message is jumbled; I’m also dealing with a migraine, making it hard to focus. For context, my daily medications include phentermine, iron supplements, and vitamin D. I stand at 5’4” and currently weigh 204 pounds as part of my ongoing weight loss journey.
Eight Years of Persistent ‘Hunger’—Is It a Functional Gut Disorder?
Greetings everyone, I’m a 28-year-old woman standing at 5 feet 4 inches, and for nearly eight years, I have struggled with a constant, hollow sensation in my upper abdomen that resembles hunger. Here are some key points about my experience: - This sensation arises between meals or soon after I have eaten. - It gets momentarily better after eating but eventually returns. - Though it feels like hunger, I know it's not genuine hunger. - Mornings are especially tough as the sensation intensifies. I maintain a regular meal schedule and consume enough calories without any restrictions. Currently, I find it difficult to trust my hunger cues, so I'm tracking my calorie intake. I do not take any medications and have previously used proton pump inhibitors without any noticeable improvement. Additionally, I neither smoke nor consume alcohol. Visits to my general practitioner have yielded no definitive diagnosis, with much of the feedback being centered on dietary adjustments. I am currently facing a waiting period of approximately eight months for a gastroscopy. Strangely, I also notice that I feel particularly weak during my workouts, despite my calorie intake being sufficient. Has anyone else faced a similar long-term issue? Did you find it to be functional dyspepsia, gastritis, visceral hypersensitivity, or something entirely different? Were you able to obtain assistance through a gastroenterologist, a dietitian, or therapy? Thanks for your insights!
Rapid Heart Rate During Illness
A 27-year-old male, standing at 6 feet 3 inches tall and weighing 275 pounds, presents as non-smoking with a medical regimen including buspirone, sertraline, and Nexium. He does not consume alcohol or use illicit drugs. His medical background highlights anxiety and a previously noted Wolff-Parkinson-White (WPW) pattern observed on an ECG in 2023, without any prior ablation or recorded arrhythmias. On February 5th, I visited the emergency room after experiencing a sudden and alarming increase in my resting heart rate to approximately 130 beats per minute while at home. This spike was particularly distressing given my history of chronic anxiety. Reflecting on the earlier part of the day, I recall experiencing mild body aches, a cough, and a sensation akin to a low-grade fever, which now appear to have been early signs indicating I was becoming ill. Once at the emergency room, the medical team administered 10 mg of propranolol, resulting in a gradual decrease in my heart rate from 130 to the mid to upper 90s over a span of about one hour and 45 minutes. The ECG revealed only sinus tachycardia, and notably, the doctor informed me that the WPW pattern from 2023 was no longer evident. All laboratory tests returned normal results with standard electrolyte levels, kidney function (eGFR at 108), and a complete blood count showing only a typical stress response characterized by elevated neutrophils and reduced lymphocytes, alongside normal urine tests. There were no indications of dehydration, infection, thyroid irregularities, or arrhythmia. After returning home, it became clear that I was battling a viral infection. I experienced chills, extensive body aches, and fever peaking at 101.8°F, as well as a cough with medium brown mucus (not excessively dark or bright red). I have not experienced shortness of breath or wheezing at rest. Notably, my heart rate has paralleled my fever. When my fever ranges between 101°F and 102°F, my resting heart rate typically aligns between 105 and 125 beats per minute. Conversely, as my fever declines into the 99°F range, my heart rate drops to the 80s and 90s. Under normal circumstances, my resting heart rate hovers around 60 beats per minute. Currently, I am measuring a temperature of approximately 100.6°F to 100.8°F, with a heart rate around 110 to 115 beats per minute. About an hour ago, I took Tylenol, and am staying hydrated and resting. The only discomfort I feel is due to persistent coughing. I have a few inquiries: - Is this heart rate fluctuation typical during a viral infection accompanied by fever? - Should I expect to see an elevated heart rate persist even during sleep when my fever is elevated? - Is there any cause for concern regarding my previous WPW even though the recent ECG indicates that pattern is no longer present? Thank you for your assistance.
Navigating Health Anxiety and Gastrointestinal Concerns
At the age of 32, I am a male of Indian descent residing in the United States. I abstain from alcohol and tobacco, and my only supplements consist of multivitamins and probiotics. Health anxiety plagues me, leading to a constant fear that something dire is lurking around the corner. I'm actively addressing this issue. In April 2025, I had a dinner meal that resulted in intense bloating and discomfort the following day, with symptoms persisting for over a week. Shortly after, I tried Thai cuisine and suffered similar consequences. This time, my condition escalated, prompting me to visit the emergency room that same week due to fever and chills, where blood tests identified an infection. Imaging tests such as a CT scan and an abdominal ultrasound returned normal results. Additionally, a urine test indicated the presence of leukocyte esterase; I was prescribed a ten-day course of the antibiotic Vantin. My primary care physician also ordered a complete blood count (CBC), revealing elevated eosinophil levels at 1.5 x 10^3/μL, while the CRP was recorded at 1. Thankfully, I began to feel some improvement. In June, I contracted Covid-19, and later that month, I experienced another bout of viral flu, which I suspect might have been a subsequent case of Covid. Throughout these illnesses, my digestive issues persisted. I was going to the bathroom one to three times daily, with stools ranging from a Bristol scale of 3 to 6, but without significant diarrhea. A colonoscopy and biopsy conducted in July uncovered minor erosion in my terminal ileum. The biopsy indicated mild to moderate chronic inflammation with edema in the lamina propria due to eosinophil infiltration, showing a count of 12 out of 15 high-power fields across all colon samples. The crypt-to-villi ratio appeared normal, with no signs of granulomas, lymphocytes, or cryptitis present. My doctor suggested these findings might indicate a minor food intolerance. Despite this insight, my symptoms persisted, leading to a fecal fat test in September, which yielded a result of less than 5. I continued to experience abdominal pain, and my bowel habits had not returned to baseline, so we opted for MR enterography in early December, which also showed no abnormalities. After undergoing knee surgery on December 5, I was placed on antibiotics for ten days. Subsequently, I experienced minor digestive disturbances for three to five days, coinciding with a shift in my sleep routine due to a new night job, resulting in increased mucus and Bristol 5-6 type stools during this period. An ongoing concern is the disintegration of my stools in water; although they appear normal initially, they tend to break down into a powdery substance upon sitting in water. I worry about the possibility of inflammatory bowel disease (IBD). However, my gastroenterologist believes that Covid-19 may have led to significant dysbiosis, as supported by findings from a Thorne gut test that indicated a low inflammation score paired with a high dysbiosis score. It appears that restoring my gut health may require an extended period, possibly even years. My diet as a vegetarian includes a substantial amount of fiber. Am I overlooking any crucial medical aspects? Sleepless nights are filled with thoughts about whether my evaluations were sufficiently comprehensive or if something important has been overlooked. This ordeal has lasted nearly ten months; if I actually had IBD, one of the diagnostic tests would have likely revealed it. Perhaps I am overanalyzing my situation?
Insights on Meningocele and Related Symptoms
I would appreciate your thoughts on my situation—thank you! In 2019, during a meningitis incident, a right petrous apex meningocele was discovered when the white blood cell count in my cerebrospinal fluid (CSF) exceeded 7100. That's an astonishing figure! Unfortunately, doctors were unable to determine the exact type of meningitis, as bacterial cultures failed to grow, and the WBC count didn’t correspond with typical viral or aseptic markers. A specialist in infectious diseases expressed skepticism about a meningitis diagnosis, noting that my cognitive clarity remained sharp throughout the ordeal. I'll provide the latest MRI and CT findings as well as significant images in the comments section. The meningocele seems to be progressing, evidenced by bone erosion. Prior imaging indicated persistent fluid in the right mastoid air cells, which is no longer observed in recent scans. I have undergone numerous lumbar punctures; however, they struggled to record an opening pressure due to unusually low levels. During the last attempt, they could only extract about half the necessary CSF since there simply wasn’t enough present, even after three separate punctures and being positioned on a tilt table. I experience a range of symptoms, including changes in vision, pulsatile tinnitus, issues with posture, and episodes of tachycardia. The most intense symptom, however, is trigeminal neuralgia, which can lead to severe attacks lasting over 40 minutes. Based on my symptoms and various self-management strategies, I suspect my condition might fluctuate between low and high pressure. For relief, I either lie flat and increase my caffeine intake or sleep at an angle while consuming diuretic tea as if my well-being depended on it. Since receiving this diagnosis five years ago, I have also developed degeneration in my cervical spine, including joint slippage and bone spurs, along with right TMJ degeneration and thoracolumbar scoliosis. Although I’m not sure if these are all connected, I think it's worth mentioning. Thank you for reading! **CT Findings:** **Right Side:** - **External Auditory Canal:** Open without any visible mass or abnormal bone growth. - **Middle Ear and Ossicles:** Normal tympanic membrane; the middle ear and Prussak's space are clear. The scutum and ossicles show no signs of erosion, and the facial nerve appears unremarkable. - **Mastoids:** Clear. Stable lucency and thinning of the petrous apex bone, reflecting CSF signal intensity and continuity with the right Meckel's cave, indicating the likelihood of a Meckel’s cave cephalocele. - **Cochlea and Vestibular Apparatus:** Normal structure and function, with no adjacent bone erosion or signs of semicircular canal dehiscence or vestibular aqueduct enlargement. **Left Side:** - **External Auditory Canal:** Open without any visible mass or abnormal bone growth. - **Middle Ear and Ossicles:** Normal tympanic membrane; the middle ear and Prussak's space are clear. The scutum and ossicles show no signs of erosion, and the facial nerve appears unremarkable. - **Mastoids:** Clear. - **Cochlea and Vestibular Apparatus:** Normal structure and function, with no adjacent bone erosion or signs of semicircular canal dehiscence or vestibular aqueduct enlargement. **Other Findings:** - Scalloped lucencies in the right TMJ articular eminence indicate small areas of dehiscence, potentially due to a combination of degenerative joint disease and arachnoid granulations. **MRI Findings:** There is no evidence of acute or subacute ischemia or hemorrhage, nor is there any mass effect or midline shift. No signs of cortical atrophy or ventricular enlargement are present, and there are no suspicious marrow lesions. A prominent fluid signal near the right petrous apex, related to the right Meckel's cave, measures at least 1.8 cm diameter. It shows no complex imaging characteristics, maintaining discrete margins without enhancement or significant internal structure. Postcontrast imaging reveals no abnormal enhancement in the brain or meninges, with major draining veins appearing patent. Bilateral internal auditory canals are unremarkable, and there is no evidence of white matter disease or atrophy in the midbrain. The craniocervical junction and upper cervical cord are also normal. **Impression:** 1. A simple cystic lesion measuring 1.8 cm at the right petrous apex adjacent to the fifth cranial nerve root/Meckel's cave was identified, correlating with the history of right trigeminal neuralgia. Follow-up imaging should include dedicated internal auditory canal studies. If previous CT temporal bone imaging becomes available, adjustments can be made accordingly. 2. The remaining brain and orbits appear normal, and postcontrast imaging results are unremarkable.