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I have been feeling unwell. Have pale stool. I did an

abdominal mri which showed accumulation...
I have been feeling unwell. Have pale stool. I did an abdominal mri which showed accumulation in gall bladder consistent with sluggish gallbladder. Also my bilirubin was measured and total one was ok. But the direct bilirubin was at the upper end of normal. Could this be related? Could there be a blockage not seen by mri?
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Customer reply replied 4 months ago
The reference values for the bilirubin direct were 0-0.2 and mine was at 0.2
Answered in 4 minutes by:
3/6/2018
Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5,761
Experience: 20 Years in Internal Medicine, Neurology and Sports Medicine
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Hello. Your direct bilirubin level is normal. The normal range is designed to capture 95% of normal individuals. About 5% are a little higher and yet do not have any disease process. In other words, this may normal for you all the time and not reflect any internal problems. That said, gallbladder sludge can act like a gallstone at times, temporarily clogging the bile duct and causing back pressure into the gland or the liver itself. Once the sludge passes, symptoms return to normal again.

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Customer reply replied 4 months ago
It’s been months though
Customer reply replied 4 months ago
Can it be so long for the sludge to pass ?

The sludge is constantly being formed inside the gallbladder, so it can be an intermittent process. To further clarify what is going on in the gallbladder, liver and pancreas, you could ask your doctor to do an abdominal ultrasound. Another option would be to do a hepatobiliary (HIDA) scan to look at the function of these organs.

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These tests can add important information that an MRI does not pick up.

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Customer reply replied 4 months ago
But in terms of tumors or something bad an mri would have picked it up?
Customer reply replied 4 months ago
Hida scan looks at gallbladder liver and pancreas ?

The MRI is excellent at picking up tumors. Unfortunately, it tells one nothing about the function of the hepatobiliary system. The HIDA scan does this.

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Customer reply replied 4 months ago
Last question. Could there be a blockage somewhere even if the mri was clear ?

Yes, sludge in the bile ducts can come and go, so it could be missed on imaging (including on ultrasound, though the technician can press on it during the study to look for movement of sludge or stones, which you can't do during MRI or CT).

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Customer reply replied 4 months ago
Ok so if the mri is clear for stones or tumors ... (sorry I’ve heard stories of pan cancer that was supposedly not detected on a scan.... )then it’s a hepatobiliary disfunction? And even if the hida scan is done and shows issues then the only option would be to take it out ? I don’t know of any medicines that can improve that ...

MRIs rarely miss cancer, so that is unlikely. Hepatobiliary dysfunction can often be managed with dietary changes (e.g. avoidance of fat, oil, grease and eating only small meals), regular exercise, vigorous hydration, smoking and alcohol cessation, weight loss and medications (e.g. ursodiol chenodiol). In recalcitrant or emergent cases, surgery is required.

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Customer reply replied 4 months ago
Thank you

You're welcome. Hope all works out for the best for you. Let me know if you have any additional questions. If you are satisfied with my assistance, a positive rating would be appreciated.

Thanks for using JustAnswer.

Dr. Bob
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