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Is Small Sized Gall Stone A Matter Of Conern?

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Posted on Mon, 11 Aug 2014
Question: I have had upper stomach ache/ not sharp pain and after upper x-ray, after elevated amylase level, was a small gallstone. Have had recent diarrhea but okay now. Have been watching diet well tho on veggies am losing weight. Getting ready to go to bed and took my temp and it was 97.4. I have low temp in am but in day it elevated to 98.3 today even tho I was busy around home. Afraid of testing. Lost husband to leukemia. Also recently had Epstein Barr Virus titers up to 478 about 3 weeks ago but my strength has steadily improved. Alot of variables here, I know. Starting to really worrry. Any thoughts?
doctor
Answered by Dr. Vivek Chail (5 hours later)
Brief Answer:
Gastroenteritis needs evaluation

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail and sorry to hear the discomfort you are in.
A small gall stone in an adult measuring upto 10 mm in size is seen in 10% of the population and nothing needs to be done if there is no pain or obstruction due to the stone. I do hope you have consulted a surgeon on that and under regular follow up. Amylase levels may be raised due to obstruction of flow of bile due to stones and this must be discussed with your doctor.

The bout of diarrhea if not under control is a cause of concern. It may be due to a stomach flu. Please have properly cooked home food for a while. Body temperature is variable and continuous elevated temperatures need further evaluation.

EBV infection may cause stomach problems including ulcer and gastroenteritis but this is usually seen in those with a weak immune system. This may need an upper GI endoscopy should there be further symptoms of stomach flu.

Hope your query is answered.
Do write back if you have further doubts.

Regards,
Dr.Vivek

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Vivek Chail (4 hours later)
Just for clarity... one gallstone was 2mm; surprised it seems to be causing so much discomfort. temperature is not elevated but in 97.9 range to 98.3 in day so wondered if low temperature is a red flag for something, besides maybe thyroid. TSH is supposedly normal but alternative medic says more testing is good as often missed. Have a long history of viruses-- had EBV on and off for years so having a hard time separating virus, fatigue symptoms from stomach issues which aren't major but am hoping pancreas not involved. Gastro testing is fearful and lots of money and time and am trying to figure out and treat without thousands of dollars of gruesome testing. My family physician is not very diagnostic tho a nice guy and a somewhat personal friend. Does not explore issues. (I am a licensed SLp and still working in schools with 75 students to treat so am an academic and well read in medical things.) Have to be seriously sick to get testing recommended. What do you think of gallstone-liver flushing first? I know how to handle EBV tho wonder if thyroid off. ( Have a mtg in town shortly and must leave so give advice and I'll read when I return. Thanks.
doctor
Answered by Dr. Vivek Chail (2 hours later)
Brief Answer:
Gall stone is too small to be causing any problems

Detailed Answer:
Hi XXXX
Thanks for writing back with an update.

A single gall stone measuring 2mm is not likely to cause and pain or discomfort. However more than one stone can block the flow of bile. The common bile duct measures about 5 mm at your age and hence unlikely to get blocked by a 2 mm stone. Besides, an ultrasound scan would surely pick up any conditions to do with your pancreas if present.

Though thyroid tests are recommended regularly for those having abnormal thyroid tests and on medications for it, you need not have to get your tests repeated if done at a reliable lab. The temperature variation can be due to a medical condition or external environmental factors. A complete blood check can rule out any infections.

Having EBV for years and getting your antibody levels checked regularly is good. EBV can cause mononucleosis which is a mild infection in young adults. At your age it is unlikely to be a cause of concern considering your immune status is normal.

As mentioned earlier, a single gall stone of size 2 mm is not a serious concern and you may opt for medications and lifestyle changes. You do not need flushing.

The thyroid has to be assessed with thyroid function tests and if normal previously, there is no need to worry. If thyroid functions are abnormal, medications may be started after a screening ultrasound scan of thyroid.

A complete blood count is what you choose to get done just to be sure that the basic blood workup is normal. The stomach flu in question may also be confirmed by blood tests.

It is essential to reconsider your dietary changes and seek an appointment with a dietitian to know if your dietary intake is appropriate. Switching from normal food to veggies may need diet supplements as you report weight loss.

Hope your query is answered.
Do write back if you have further doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vivek Chail (4 hours later)
Thanks for your input; you have relieved some of my fears but I will keep check on why i have ache under L rib cage and sometimes in mid upper abd. Little on gallbladder right. Will watch and if persists will contact gastro doc. I will just have to ride out the fatigue from EBV. Thanks again.
doctor
Answered by Dr. Vivek Chail (12 hours later)
Brief Answer:
Welcome

Detailed Answer:
Hi XXXX
Thanks for writing back with an update.

You are welcome and I am glad to be answering your query.
Hope the pain is relived soon. However, persisting pain needs a consultation with the gastroenterologist doctor for medications.

Wishing you good health.

Hope your query is answered.
Do write back if you have further doubts.

Regards,
Dr.Vivek
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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Is Small Sized Gall Stone A Matter Of Conern?

Brief Answer: Gastroenteritis needs evaluation Detailed Answer: Hi, Thanks for writing in to us. I have read through your query in detail and sorry to hear the discomfort you are in. A small gall stone in an adult measuring upto 10 mm in size is seen in 10% of the population and nothing needs to be done if there is no pain or obstruction due to the stone. I do hope you have consulted a surgeon on that and under regular follow up. Amylase levels may be raised due to obstruction of flow of bile due to stones and this must be discussed with your doctor. The bout of diarrhea if not under control is a cause of concern. It may be due to a stomach flu. Please have properly cooked home food for a while. Body temperature is variable and continuous elevated temperatures need further evaluation. EBV infection may cause stomach problems including ulcer and gastroenteritis but this is usually seen in those with a weak immune system. This may need an upper GI endoscopy should there be further symptoms of stomach flu. Hope your query is answered. Do write back if you have further doubts. Regards, Dr.Vivek