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Home > Archive > Heartburn Support > April 2006 > Pipida Scan
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| Laura 2006-04-25, 11:09 am |
| I've been having upper abdominal pain for the past 5 or 6 days in the
middle and right side(basically where my gallbladder is located) that
comes and goes, and last night, I could feel something spasming in
there. The spasms lasted a few hours. (I still seem to have the chest
pain/reflux under good control--unless this is just a new manifestation
of the same problem). The doctor has me scheduled for a Pipida Scan
today at 1pm. I had a full abdominal sonogram last Friday that was
negative for gallstones but according to my doctor, that does not
exclude a gallbladder problem.
Anyone have experience with the Pipida or otherwise?
I also have a repeat EGD scheduled with a different doctor (Dr. Stella
Quiason in Olathe, KS--Howard, any chance you're familiar with her?) on
Monday to see if it's an ulcer or gastritis or something else entirely.
Hopefully, we'll find something (easy to correct  ).
Thanks for any and all input!
Laura
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| Howard McCollister 2006-04-25, 6:09 pm |
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"Laura" <shopwithlaura@gmail.com> wrote in message
news:1145975215.887012.134730@i39g2000cwa.googlegroups.com...
> I've been having upper abdominal pain for the past 5 or 6 days in the
> middle and right side(basically where my gallbladder is located) that
> comes and goes, and last night, I could feel something spasming in
> there. The spasms lasted a few hours. (I still seem to have the chest
> pain/reflux under good control--unless this is just a new manifestation
> of the same problem). The doctor has me scheduled for a Pipida Scan
> today at 1pm. I had a full abdominal sonogram last Friday that was
> negative for gallstones but according to my doctor, that does not
> exclude a gallbladder problem.
>
> Anyone have experience with the Pipida or otherwise?
>
> I also have a repeat EGD scheduled with a different doctor (Dr. Stella
> Quiason in Olathe, KS--Howard, any chance you're familiar with her?) on
> Monday to see if it's an ulcer or gastritis or something else entirely.
>
> Hopefully, we'll find something (easy to correct ).
>
No, I don't know her.
Pipida or Hida scans will test function of the gallbladder, whereas
ultrasound only looks at the anatomy (presence or absence of stones). Even
without stones, the gallbladder might still function poorly and cause
symptoms. This is called Biliary Dyskinesia. The Hida scan is a radionuclide
injected into the blood and is concentrated in the bile. You lay there for
awhile while they scan you with a passive Gamma camera and track how well
the radionuclide is concentrated in the gallbladder. If it doesn't
concentrate, the gallbladder is defective. Then, they will inject a chemical
called cholecystokinin (CCK) which will force the gallbladder to contract.
If that duplicates your symptoms, then that's significant. They will want to
know how much of the radionuclide-tagged bile is then ejected from the
gallbladder when the CCK is injected. If that ejection fraction is less than
30%, that's considered a positive test for biliary dyskinesion and the usual
result would be a recommendation for gallbladder removal.
HMc
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| Thank you for the quick response! The test took 90 minutes and they
injected the CCK at the sixty minute mark through an IV that ran for 30
minutes. It did accentuate my abdominal discomfort (I wouldn't call
what has been happening severe pain; painful--yes, but not ever severe
or worrisome like the chest pains I was having in Jan/Feb). He told me
typically it took 2-3 days to get the results from the doctor but mine
in particular was very good about following up with them (rather than
waiting to hear) and I would likely know tomorrow. He also said, at the
end of the test, by looking at the screen that he would guess my EF was
high--in the eighties, maybe even nineties.
Can he really tell that by looking? Is it still possible that the
radionuclide didn't concentrate as it should (or would they have
stopped the test at that point?)
Thanks,
Laura
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| Howard McCollister 2006-04-26, 1:09 am |
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"Laura" <shopwithlaura@gmail.com> wrote in message
news:1146005151.704355.165860@i40g2000cwc.googlegroups.com...
> Thank you for the quick response! The test took 90 minutes and they
> injected the CCK at the sixty minute mark through an IV that ran for 30
> minutes. It did accentuate my abdominal discomfort (I wouldn't call
> what has been happening severe pain; painful--yes, but not ever severe
> or worrisome like the chest pains I was having in Jan/Feb). He told me
> typically it took 2-3 days to get the results from the doctor but mine
> in particular was very good about following up with them (rather than
> waiting to hear) and I would likely know tomorrow. He also said, at the
> end of the test, by looking at the screen that he would guess my EF was
> high--in the eighties, maybe even nineties.
>
> Can he really tell that by looking? Is it still possible that the
> radionuclide didn't concentrate as it should (or would they have
> stopped the test at that point?)
>
Negative ultrasound, no severe pain with CCK, ejection fraction greater than
30%.....sounds like your gallbladder checks out OK.
HMc
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| Is it possible to develop gastritis or ulcers while on PPI therapy?
That is the other option I they're exploring but it doesn't make sense
to me. Is there something else I should be asking them to look at?
I am not crazy about the idea of 24 hour monitoring with the tube down
the nose/throat. What do you think of the Bravo test, if the GI doc
wants to go that direction?
Thank you so much,
Laura
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| Howard McCollister 2006-04-26, 1:09 am |
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"Laura" <shopwithlaura@gmail.com> wrote in message
news:1146010852.054837.148600@t31g2000cwb.googlegroups.com...
> Is it possible to develop gastritis or ulcers while on PPI therapy?
> That is the other option I they're exploring but it doesn't make sense
> to me. Is there something else I should be asking them to look at?
>
> I am not crazy about the idea of 24 hour monitoring with the tube down
> the nose/throat. What do you think of the Bravo test, if the GI doc
> wants to go that direction?
>
>
Bravo is vastly superior to catheter-based pH testing. I can think of no
possibly earthly reason why a doctor would recommend a 24-hour
catheter-based ambulatory pH test if a 48 hour Bravo ambulatory pH test is
available to them. Frankly, I think that a GI doc who is still using
catheter based pH testing instead of Bravo is NOT someone who is serious
about esophageal testing.
Having said that, people who have ongoing reflux symptoms in the face of
therapeutic doses of PPI's may well be in a different category of
refluxers - those who are having "non-acid" reflux. In that case, standard
pH testing (including Bravo) will be useless, and MII (multichannel
intraluminal impedance) testing needs to be done. That is not commonly
available, and if your gastroenterologist does do impedance-based esophageal
testing, I would be VERY impressed (not to mention totally shocked). Be
aware that MII of the esophagus DOES require catheter-based testing.
Look at http://www.google.com/search?hl=en&...edance+non+acid
and
http://www.google.com/search?hl=en&...stell+impedance
HMc
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