By Michael Kirsch, MD, Center for Digestive Health and Endoscopy Center
I can’t count how many times I’ve been asked this by patients throughout my career.
Many patients offer support for their ‘diagnosis’ with statements such as the following: “My second cousin twice removed had the exact same symptoms, and it took a year before they figured out it was her gallbladder!”
We physicians usually seek more persuasive medical evidence before sending a patient to the operating room for a donation of the gallbladder. And, while the patient is convinced that his second cousin twice removed was saved from a delinquent gallbladder, we can’t assume that the gallbladder was truly the culprit.
I mention this as every physician, including me has advised gallbladder removal only to discover afterwards that the symptoms persist. While this should be uncommon, in some cases we do not know for sure if the gallbladder is culpable until it is removed. Patients need to be advised of this reality.
In many cases, it’s easy to determine that the gallbladder needs to go. However, this organ can be a sneaky suspect that may cause only subtle symptoms or even masquerade as other conditions. For example, gallbladder pain can resemble a heart attack, a fact well known to emergency room physicians.
Physicians have many tools available to evaluate the gallbladder.
Which of the following is the best test to determine if your symptoms are coming from your gallbladder?
- (A) CAT scan of the abdomen
- (B) Blood tests
- (C) MRI of the abdomen
- (D) Ultrasound of the abdomen
- (E) None of the above
The correct answer is (E). Without doubt, the most important piece of data I use in my office is my patient’s history. I will question the patient very carefully about various aspects of the pain, as well as the presence and absence of other symptoms. If I feel that your story is consistent with gallbladder disease, then I will likely order some tests to confirm my initial impression. The patient’s history must come first, before diagnostic tests are done.
And, just because imaging studies show a normal gallbladder, doesn’t mean that the gallbladder is innocent. Diagnostic tests are not 100% accurate, as we all know. This is when your doctor’s medical judgement and experience becomes extremely valuable.
Conversely, often, a patient is referred to me with gallstones and stomach pain, but I am not convinced that the gallstones are responsible for the pain. Clearly, removing this gallbladder would be the wrong move.
If you think that you may have gallbladder issues, feel free to see me in the office for a personal consultation. I assure you, that I will leave no ‘stone’ unturned!
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Special Medical Interest(s):
• Abdominal Pain
• Colon Cancer Prevention
• Constipation/Diarrhea Disorders
• Crohn’s Disease & Ulcerative Colitis
• GERD/Heartburn/Acid Reflux
• Irritable Bowel Disease
• Liver Disease & Hepatitis