Question Title: Gallbladder disease or stones?

Six weeks ago my mother-in-law was experienceing severe headaches and mild nausea. It got so bad that she was rendered practically incoherent so she was rushed to the ER in the local hospital. A MRI revealed a large mass in her brain which was finally diagnosed as an abscess on the brain. Massive amounts of antibiotics were administered through a subclavean (?). She was hospitalized for about a month. The abscess sufficiently shrunk and she was sent home. Since she has been home she has been extremely weak and nauseated. She seems to have not gotten any better. She has constantly been in bed for the past 3 weeks. The nausea has been debilitating. She has been given shots of a drug (I forget the name) that has up until now given her some relief but she has not been able to be up and around only for short periods of time. Just yesterday she was not able to get out of bed and was rushed to the hospital again where she was given some sort of serum test for gall bladder disease because ultrasound showed no stones. The drs decided that the nausea was caused by the gall bladder being out of whack. They want to remove it. During the past 3 weeks she has had 3 MRI's and the abscess is still shrinking but not all the way gone. The headaches are gone too. Is this severe nausea a factor in gallbladder disease or stones? Or is this some other symptom of something else? She was otherwise a healthy strong woman.

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Dear MB,
Increases in the pressure in the brain, that can result from tumors or abscesses, can cause nausea, vomiting and malaise. The question that you ask: "whether nausea can cause the gall bladder disease', is not a simple one to answer. Patients with profound nausea have diminished or poor food intake. In this fasting state the gall bladder does not contract leading to stasis of bile in the gall bladder and possibly distention of the gallbladder. Some individuals can then develop a condition called acalculous cholecystitis in which there is inflammation of the gall bladder wall. Acalculous cholecystitis can present in several different ways. Mnay patients experience fever and pain in the right upper abdomen. If your mother-in-law is also receiving corticosteroids (to reduce the swelling in her brain) she may not present with pain but may have nonspecific symptoms such as malaise and nausea. It is important to emphasize, however, that acalculous cholecystitis is a relatively rare occurence. An impaired
gall bladder contraction in response to CCK would provide confirmatory evidence for the possibility of acalculous cholecystitis.

Nausea alone would not cause gall stones to develop (Based on your letter it appears that she does not have stones). Another possible explanation for the symptoms is the effects of increased intracranial pressure, a consequence of the abscess. Finally, you should ask the treating physicians why they think that she developed the brain abscess. This information may suggest other explanations for the nausea.

This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.

HFHSM.D.-rf
*keywords: nausea, gallstones
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