Ultrasonography is normal in these patients, but if a biliary etiology of pain is suspected, cholescintigraphy should be obtained. Cholecystokinin infusion allows quantitative assessment of gallbladder emptying (ejection fraction). A gallbladder ejection fraction of < 35% and/or reproduction of symptoms with cholecystokinin infusion are considered positive results.

ERCP with bile aspiration may also be performed. The bile is then examined for cholesterol crystals. When present, these crystals predict a favorable response to chole-cystectomy. This "microlithiasis" may represent a form of calculous disease, albeit with a low stone burden; outcomes more likely parallel those for patients with calculous cholecystitis rather than those with acalculous disease.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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