Suspected Gallbladder Dysfunction with Chronic Constipation

Case at a Glance

A 31-year-old male presents with chronic constipation and suspected gallbladder dysfunction, questioning the relationship between bile production and bowel movements. Patient reports observing correlations between stool color variations and constipation patterns.

Patient's Story

The patient is a 31-year-old male weighing 185 pounds who presents with ongoing digestive concerns. He reports experiencing what he believes to be gallbladder-related symptoms and has developed a theory connecting bile production to his constipation issues. The patient has observed that his stool color varies, sometimes appearing yellow, and he correlates these color changes with his bowel movement patterns. He notes that increased fiber intake paradoxically worsens his constipation rather than improving it, despite maintaining adequate hydration. He has tried various laxatives with limited success - magnesium-based laxatives provide the best relief but are inconsistent, while other laxatives either cause severe cramping or prove ineffective.

Initial Assessment

Patient presents with chronic constipation resistant to typical dietary modifications and over-the-counter treatments. He maintains adequate fiber intake and hydration but continues to experience symptoms. The patient has made personal observations linking stool color variations to his symptoms, suggesting possible bile flow irregularities. His symptom pattern and resistance to conventional treatments warrant further investigation into hepatobiliary function.

The Diagnostic Journey

Given the patient's symptoms and suspected gallbladder involvement, a HIDA (hepatobiliary iminodiacetic acid) scan was scheduled to evaluate gallbladder function and bile flow. This nuclear medicine study will assess gallbladder ejection fraction and help determine if bile flow abnormalities are contributing to his digestive symptoms.

Final Diagnosis

Pending HIDA scan results to confirm suspected gallbladder dysfunction as a potential cause of chronic constipation.

Treatment Plan

Diagnostic workup with HIDA scan scheduled. Current symptomatic management includes intermittent use of magnesium-based laxatives as needed. Treatment plan to be adjusted based on HIDA scan findings and further evaluation of hepatobiliary function.

Outcome and Follow-up

Patient scheduled for HIDA scan to evaluate gallbladder function. Follow-up appointment planned to review results and adjust treatment plan accordingly. Further gastroenterology consultation may be warranted depending on diagnostic findings.