Controversial medical diagnosis: overactive gallbladder (hyperkinetic)

Posted by jhue @jhue, Jan 11, 2025

On and off stomach issues for over 10 years. Currently: upper mid and upper right abdominal pain, nausea, bloating, belching, burning lower and mid chest, and occasional pain in back, right shoulder. Working with a Mayo gastroenterologist since November 2024. Had a HIDA scan in 2018 that showed a 97% EF. Nothing was done at that time, and I didn't understand the results. After reviewing my medical record recently, raised this as an issue with my doctor who reported that 97% isn't an issue. I've had gallbladder ultra sound, upper endoscopy, colonoscopy, 2 CT scans and blood work - all normal. I read online that "overactive gallbladder (hyperkinetic)" is somewhat of a controversial diagnosis, but I'm wondering if there are other doctors in the Mayo system who typically consider this as a possibility or if this has been widely debunked by the medical community?

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Profile picture for strun81 @strun81

I got several opinions on my hyperkinetic gallbladder. I’ve had chronic bloating for years now, along with nausea and vomiting. Pain is occasional. Two doctors told me how much relief patients with a hyperkinetic gallbladder have gotten from removal and two said without stones or sludge present, it would not help. I continue to be miserable after trying various diets and medications, so will be proceeding with removal.

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Hello @strun81 and welcome to Mayo Clinic Connect. It sounds like you have had this problem for a while now. I'm sure you are looking forward to good results after the surgery.

Is your surgery already scheduled? Do you know if the surgeon will be doing an open surgery or a laparoscopic surgery?

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Profile picture for susanlow @susanlow

Curious if anyone has experience with this. They say that this could cause similar symptoms as under performing gallbladder. Could the high gallbladder ejection rate cause diarhea, stomach pains, and weight gain/inflamation?

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@susanlow
I just had my gallbladder removed. I’ve been suffering with gallbladder symptoms for over 10 years.
10 years ago, I had a mild gallbladder attack, but all the testS showed that my gallbladder was normal
Two months ago, I had an acute gallbladder attack Prior to that, I have had increasingly horrible diarrhea for at least six months, increased belching, increased pain between my shoulder blades.
I had a HIDA scan done about a month ago and it showed a 98% ejection fraction . Again, this was labeled a normal gallbladder function. I decided to research above normal ejection fractions.(from a HIDA scan test).
I discovered that an overactive gallbladder like mine can produced similar symptoms to an under functioning gallbladder. In the meantime, my diarrhea was rust colored, constant, and I felt mild throbbing right beneath my ribs, especially after a bout of diarrhea.
After discussion with the surgeon, he said he would take out my gallbladder! It’s only been two days, but I feel so much better already. The pain in my back is gone, and I anticipate having normal intestinal function.

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Profile picture for Teresa, Volunteer Mentor @hopeful33250

Hello @strun81 and welcome to Mayo Clinic Connect. It sounds like you have had this problem for a while now. I'm sure you are looking forward to good results after the surgery.

Is your surgery already scheduled? Do you know if the surgeon will be doing an open surgery or a laparoscopic surgery?

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@hopeful33250
I am two days postop of gallbladder removal for a hyperkinetic gallbladder. I have had symptoms on and off for 10 years.(gas, diarrhea, nerve pain in the neck.(right side.), pain between my shoulder blades and a lot of belching. My HIDA scan showed to 98% ejection fraction, which was labeled as “normal.” I did some research and discovered that a hyperactive gallbladder can cause symptoms similar to a sub functioning gallbladder.
I had a severe gallbladder attack a couple months ago, followed by rust colored and very loose stools, constant belching, and increasing pain between my shoulder blades. I was taking 3 to 4 Imodium tablets a day along with Pepto-Bismol.
My gastroenterologist consulted with my surgeon and I had my gallbladder removed! It’s only been two days, but I feel so much better.

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Profile picture for cathivaughan @cathivaughan

@hopeful33250
I am two days postop of gallbladder removal for a hyperkinetic gallbladder. I have had symptoms on and off for 10 years.(gas, diarrhea, nerve pain in the neck.(right side.), pain between my shoulder blades and a lot of belching. My HIDA scan showed to 98% ejection fraction, which was labeled as “normal.” I did some research and discovered that a hyperactive gallbladder can cause symptoms similar to a sub functioning gallbladder.
I had a severe gallbladder attack a couple months ago, followed by rust colored and very loose stools, constant belching, and increasing pain between my shoulder blades. I was taking 3 to 4 Imodium tablets a day along with Pepto-Bismol.
My gastroenterologist consulted with my surgeon and I had my gallbladder removed! It’s only been two days, but I feel so much better.

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@cathivaughan

I so appreciate your post about the results of your gallbladder surgery. Given that you lived with these symptoms for over 10 years (without getting an accurate diagnosis), you must be so relieved to be feeling better!

I applaud your persistence in researching and continuing to advocate for yourself. It is important for all of us to advocate for our health needs and you are a great example!

Since your surgery was just a few days ago, I hope you will continue to post updates.

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Profile picture for cathivaughan @cathivaughan

@hopeful33250
I am two days postop of gallbladder removal for a hyperkinetic gallbladder. I have had symptoms on and off for 10 years.(gas, diarrhea, nerve pain in the neck.(right side.), pain between my shoulder blades and a lot of belching. My HIDA scan showed to 98% ejection fraction, which was labeled as “normal.” I did some research and discovered that a hyperactive gallbladder can cause symptoms similar to a sub functioning gallbladder.
I had a severe gallbladder attack a couple months ago, followed by rust colored and very loose stools, constant belching, and increasing pain between my shoulder blades. I was taking 3 to 4 Imodium tablets a day along with Pepto-Bismol.
My gastroenterologist consulted with my surgeon and I had my gallbladder removed! It’s only been two days, but I feel so much better.

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@cathivaughan Happy new year, how do you feel? It seems like over time the symptoms from my hyperkinetic GB (95% EF) have been getting worse and the GI motility doctor will only consider surgery as a last resort because there is no guarantee of improvement and I have coexisting medical conditions BUT the RUQ pain makes it hard to talk and think when it comes on. No stones/obstruction/sludge, I have been well studied. So it helps to hear success stories like yours, thank you.

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