You know, it’s interesting. We have to think about the gallbladder disease and when I teach the medical students and we discuss a particular pain in a particular body part, I like to ask them what is in the area, right? So, because just the gallbladder is there, but there are so many other things that are very close by. The liver is there, because the gallbladder sits right under the liver. Part of the small intestine called the duodenum is there as well. That’s part of the stomach, or rather, it’s a part of the intestinal tract that’s right after the stomach, where the patients actually can develop ulcers. Everybody has heard of duodenal ulcers, stomach ulcers, gastric ulcers. And so the symptoms of ulcer disease can mimic those of a gallbladder disease and vice versa. Because whatever is in that general vicinity can cause pain in that area.
And so you have to have a doctor who’s going to look very carefully at everything you do. And certainly a sonogram is going to be very important. But what if you’d have pains in this area and the sonogram doesn’t show any gallstones? Well, that’s the next step. Then you would have your gastroenterologists evaluate you, and perhaps your doctor will think that what’s called an endoscopy or a gastroscopy is necessary. Because sometimes gastritis, ulcers, can present pretty much in the same way. And so of course the treatment is completely different and we have to make sure that you or your loved one does not have something else, for example, that may require medical management, such as H. pylori, which is a very frequent cause of any gastritis or an ulcer in the stomach or the duodenum. So you always have to have what we discuss with our medical students and the residents as a differential diagnosis. In other words, you have your number one thing that you suspect first, and then you exclude that one by one by one til you come up to the right diagnosis, recommending the absolutely possible best therapy for your patient.