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Dr. Anil
Dr. Anil, Doctor (MD)
Category: Health
Satisfied Customers: 8174
Experience:  M.B.B.S.M.D with over 30 years of experience in this medical field.
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This past Tuesday, I began feeling unwell - almost like a flu

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This past Tuesday, I began feeling unwell - almost like a flu but the only symptom being feeling a bit 'off' in my stomach. No pain, just very mild nausea. Wednesday wasn't much better - I didn't eat much all day but managed to eat a little at dinner time and didn't have a bad reaction after eating. Again, just didn't feel great.

Thursday I woke up feeling fine, but by about 11am I experienced a sharp pain in my upper, middle abdomen that came and went a few times. I managed to eat some lunch but didn't really want to. By dinner time, I felt so nauseous I couldn't eat anything and there were moments when I contemplated going to the hospital, I felt so off. Friday was another day of on and off nausea. I tried to eat but couldn't - it just made me feel worse. By Friday evening I felt pretty much constant nausea and a pain/pressure in the upper middle abdomen.

Finally, Friday night I went to a walk in clinic where my abdomen was palpitated and found to be tender, in the center and slightly to the right of center, under my ribs. I was given a CT scan with contrast that stated: appendix normal; liver, spleen and pancreas unremarkable; no evidence of cholelithiasis or biliary obstruction; no retroperitoneal or pelvic lymphadenopathy; no evidence of lytic or blastic lesion or soft tissue mass.

Then I was given an ultrasound (duplex dopper & colour flow doppler) that stated the following: liver normal in size, contour, echogenicity, no focal mass or perihepatic fluid; borderline gallbaddler wall thickening (2.8-3mm), no stones or pericholecystic fluid identified; common bile duct not measured; no intrashepatic or extrahepatic biliary ductal dilation seen; right kidney normal.

Can you please tell me your impression of all this? I'm now on Prilosec and Gaviscon (this was day 2) but it really doesn't seem to help much and I'm SO uncomfortable and worried - and still can't manage to eat much.

Thank you.
Hello,
I understand your concern and it's my first priority to serve you.
And as you describe,your CT scan and Ultrasound reports are fine apart from borderline gall bladder thickening.
However your symptoms are suggestive of other possible causes like Gastritis,Peptic ulcer so you need to be seen by a Gastroenterologist and further Upper GI scopy,H.Pylori test,HIDA scan should be done in your case.
Even as your symptoms are not relieving with Prilosec so you may require other prescribed medications which may include H-2-receptor blockers,Prokinetics,antibiotics.
It is very essential to undergo further investigations to make a proper diagnosis and further management.
In the meantime you can take Prilosec before meals and Zantac 150 mg twice a day( morning and at bedtime).
Drink plenty of fluids.
Avoid spicy,fried food,caffeine,alcohol,carbonated beverages.


I hope this helps.
Please rate me highly, if you are satisfied with our conversation.
If you have any further query then feel free to ask.
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Thank you.





Customer: replied 3 years ago.

Can a peptic ulcer cause borderline GB wall thickening? Or are the two unrelated? Otherwise, what could be causing the thickening? What does a normal GB wall measure (i.e. how far off am I from normal - or could I just be on the high side of normal)??

Hello,
Thanks for the follow-up.
There many causes of gallbladder wall thickening.
When you take diets that are heavy in fats,drink alcohol, you might possible trigger this.
A gallbladder wall should not be more than 3 mm thick.
As per your reports,you have borderline gall bladder thickening and it doesn't cause pain in abdomen by itself without any other significant findings like Gall bladder stone,Cholecystitis(Inflammation of gall bladder),pericholecystic fluid.
Thickening of the gallbladder wall is a relatively frequent finding at diagnostic imaging studies. And it should be screened at regular intervals.
However gall bladder thickening can be associated secondarily with peptic ulcer.

I suggest you to make an appointment with your Gastroenterologist for further evaluation and management.

I hope this helps.
Please rate me highly, if you are satisfied with our conversation.
If you have any further query then feel free to ask.
Bonus and positive feedback are highly appreciated.

Thank you.



Customer: replied 3 years ago.

Just to ensure I understand:


 


So my pain cannot be explained by the thickening of the GB wall alone, correct? But it might be explained by a peptic ulcer (which is what the emerg doctor was thinking)?

Hello,
Yes, such borderline Gall bladder thickening itself doesn't cause pain and it may be possible to have peptic ulcer which is causing such pain.


I suggest you to make an appointment with your Gastroenterologist for further evaluation and management.

I hope this helps.
Please rate me highly, if you are satisfied with our conversation.
If you have any further query then feel free to ask.
Bonus and positive feedback are highly appreciated.

Thank you.

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