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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does my HIDA test report indicate?

Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1945 Questions

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Posted on Tue, 17 Apr 2018 in Digestion and Bowels
Question: I have constant pain and heaviness in my right side and was asked by the Gastroentologist to do HIDA scan. The ejection fraction is 46% so was told that
is normal rate. Can you please advise if there is any chance this fraction can improve.

Also the heaviness which I feel will that go away of I follow good diet. By good diet what kinds of food I need to eat and what to avoid can anyone please
advise in details that will be very helpful. I have good convection oven can I try baked food.

Earlier, I was told by a Dr. XXXXXXX Kiri, that I might be having postprandial distress syndrome which is causing this pain but unfortunately I could not
ask follow up question to him. I just want to go back to my normal life with no gall bladder issues and my gall bladder to be healthy. So will I be able to
go back to my normal life.

Can you please explain what is this Postprandial distress syndrome. What can cause this to syndrome to me? How can I remove this from my life and get back my
normal life. Is that possible that this heaviness and pain go away permanently? Is this pain due to gall bladder ejection fraction at 46%. I visited a
Gastroentologist and he has mentioned that is due to the ejection fraction and advised surgery on the gall bladder which I do not want to do.

I have also tested for H Pylori ealier and the result was negative.


Regards,
Nilendu Raha
doctor
Answered by Dr. Ramesh Kumar 7 hours later
Brief Answer:
Acitiamide wiyh proper food modification would help you a lot.

Detailed Answer:
Hello my dear patient,
Thank you so much for query.

Theoretically Rome criteria have divided functional dyspepsia into postprandial distress syndrome characterized by postprandial fullness and early satiation, and epigastric pain syndrome characterized by epigastric pain or burning.Its a umbrella term which covers patients presenting with a bunch of above mentioned symptoms.
So in lay mans term its just a type of dyspepsia.Dyspepsia in easy laungage means a sort of indigestion.
When despite of all available investigations we could not rule out any particular systemic condition we regards patient as having functional Dyspepia on basis of symptoms.

Test suggested-
Gastric emptying test.

Use medication along with changed food patern for 6 weeks-

Acotiamide 100 mg thrice daily should be taken for 3 months.Acotiamide is very effective in treatment of post prandial dyspepsia.You would need a prescription.

Take a probiotic like VSL#3 twice daily for 21 days.

Take Nexium 40 mg twice daily for 21 days.

Diet plans are-
Fruits and vegetables should be a significant part of any diet to help in recovering from symptoms. They are full of essential nutrients and are easy to digest follow a high carbohydrate diet,Fat contents of diet should be very low.However Olive oil, canola oil and flaxseed oil are all healthy fats that are recommended as part of a diet.

-Healthy proteins in the form of low-fat milk and dairy products along with lean meats, beans, eggs and soy products can also be a part of a healthy diet.
Consume high fiber foods as a part of high fiber diet. This will inprove overall digestion.Grain products: (6-11 servings of grain product in your diet is required daily) whole grain breads, whole wheat, whole grain mixed grain, cracked wheat, buns, muffins.dark green leafy vegetables contain heigest amounts of fiber like Spinach, broccoli, green peas, green beans, turnip greens.
Take a probiotic twice daily for few weeks.Probiotic consists of good bacteria in gut and would replete the level of depleted intestinal flora which would again help in improvement of overalldigestion.

Take lots of probiotic and prebiotic rich food like kimchi,Pickle,Curd,Low fat yoghurt.

No the symptoms are not at all related to gallbladders ejection fraction.Infact more then 35% EF is absoltely normal.
Why would you increase your EF its already normal dear.
You have not attached reports of HIDA or Ultrasound.So as per the details provided by you neither medications nor surgery is required for gallbladder.Infact you gallbladder is normal.


wish you a fast recovery.
Thanks!

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar 44 hours later
Hello,

I am in US right now, how can I get this Acotiamide 100 mg as this requires prescription. You have also mentioned VSL#3 and Nexium 40 mg will I get these medicines in here.

The discomfort which I face on the right side due to pain and constant heaviness will both go away with this medicine. SO are you saying this is not due to my gallbladder as I was told repeatedly here that my gallbladder is the issue.

I am currently taking few medicines like (Pantophrazole, Metformin 750 mg, Polyethyl glycol, gabapentin, vitamin D). So is it allowed to take new medicines mentioned by you while I am on these already, reason I am asking if there will be any side effects or not.

Please advise, Doctor.


Regards,
Anupriya
doctor
Answered by Dr. Ramesh Kumar 9 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello again desr,
You could get a prescription of acotiamide from any physcian.You need not to consult specially a gastroenterologist for it.

Take Omeprazole 40 mg twice daily(its over the counter)
VSL#3 is over the counter.

Most likely symptoms should settle down with proper medication and life style changes.

What doses of pantoprazole are you on?

These medicines are very safe and you need not to worry about side effects for short term treatments.

Please reply doses of pantoprazole you are on.
Waiting.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 2 days later
Hello,

Pantophrazole is 40 mg. Do I need to take Omephrazole 40 mg along with it. I live in US, will I be able to get VSL#3 over the counter. I have my primary care physician so what shall I say, I need this prescription Acotiamide 100 mg ? I think that can little problem as every Doctor treats different ways.


Regards,
Anupriya
doctor
Answered by Dr. Ramesh Kumar 14 hours later
Brief Answer:
follow up.

Detailed Answer:
Hi again,
Stop pantoprazole and start omeprazole.
VSL#3 is over the counter.
For acotiamide you can take a print out of my answers and can consult your primary with them so that he can prescribe you acotiamide.


Above answer was peer-reviewed by : Dr. Kampana
doctor
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