Interesting ... I'm a 23 year old college student who just went through all that. The pain that you are experiencing (i.e., the location, the intensity, and the connection to meals) is very much symptomatic of gall bladder disease. The nausea is also symptomatic of gall bladder disease.
Ultrasounds are not terribly useful. For the classic patient, they can be helpful, because the classic patient will have large gall stones. However, many techs unfortunately do not take the time to really study the film, so they miss smaller gall stones, as well as "sludge" (which collects in the gall bladder and causes the pain & nausea).
The endoscopy results are also fairly consistent (at least in my own personal experience). I never had any symptoms of acid reflux until my gall bladder started acting up. I was put on medication (Protonix) and stayed on it until my surgery. It's been 4 months since my surgery and I haven't had any acid reflux symptoms at all. I do also recall being told by my doctors that it was common to see acid reflux in a patient experiencing gall bladder pain.
As for the HIDA scan, it is a pretty powerful tool in detecting gall bladder disease. It also takes a while. What they do is put an IV in and then feed radioactive dye (very low level of radioactivity, so relatively safe) into the IV. They then start taking pictures with a machine, every twenty to thirty minutes, until the dye has reached your gall bladder. At that point, they have you lie down on a table with the machine over your belly. They start administering a second medication, CCK, into your IV. This medication forces your gall bladder to contract; it kinda makes your gall bladder think that there's food in the digestive tract and that it needs to pump bile out to aid in digestion. Well, if you're a typical patient, you will experience waves of the exact same pain & nausea that you have been experiencing each time they inject the CCK (my tech did it three or four times). A high ejection rate is good; anything below 25-30% indicates that your gall bladder is failing and needs to be taken out.
I do have some bad news, though. About 30% of patients will gall bladder disease are "lucky" enough to have completely normal test results. I had COUNTLESS blood tests, urine tests, CT & ultrasounds, as well as the upper endoscopy & the HIDA scan. Each and every one of them came back completely normal. My ejection rate was 68 or 69%. Something else odd about my case was that I was constantly in pain and constantly nauseous, but it got worse after fatty/spicy meals. The lack of test results & the weird timing of my symptoms cost me eight months. It was absolutely horrible. The pain was extremely intense, but since my test results were normal, the doctors starting suspecting that I was making it all up. In fact, one nurse refused to pass my request (for a refill of Vicodin painkillers) to the doctor because "we all know here that there's nothing wrong with you". I was persistent, though, and changed doctors because I was tired of the old ones' BS. My new gastro doc tried other medical problems, namely gastropareoses (where your stomach does not correctly move food from the stomach to the rest of your digestive tract. It causes pain, sometimes on the right side; nausea; nausea; and a feeling of fullness in the abdomen. Only two medications treat that and both almost killed me. I broke down in tears in my new surgeon's office, because I was so frustrated and exhausted. She left the room and came back with a refillable prescription of Vicodin and the pamphlet for surgery. During surgery, it was discovered that I was one of those 30%ers; I had exterior, structural damage to my gall bladder, so minute that scans couldn't pick it up, but large enough to cause extreme pain & nausea.
Another thing that can occur in that 30% of the population is called SOD (sphincter of oddi dysfunction). The sphincter of oddi is attached to your gall bladder and is the valve through which bile passes when bile is pumped out of the gall bladder. SOD occurs when the sphincter loses the ability to regulate the flow of bile. It causes the exact same symptoms. One test, the ERCP, examines the sphincter of oddi to see if this is the root of your problems, but most doctors refuse to administer the ERCP before surgically removing your gall bladder because there is a 5% chance of the patient developing a potentially life-threatening case of peritonitis. Most doctors also don't look for SOD during gall bladder surgery. Basically, if you have the surgery and the symptoms continue, there's a strong possibility that you have SOD. Luckily, though, the ERCP test (which is similar to that upper endoscopy you've already had) not only looks at the sphincter of oddi, but can also fix the sphincter.
It sounds as though your doctors actually care about you. Count that as a blessing. Try to eat simple, low/nonfat foods (low-fat & sodium chicken broth was my best friend for months), fruits & veggies, and fibers, and try to limit your beverages to clear liquids (water or apple juice). That should help minimize the pain and nausea. Ask for assistance in pain management (Tramadol is weak and can cause insomnia; Vicodin, Percocet & Darvacet are all stronger, but can cause constipation) and ONLY take the pain medication when the pain is bad. My doctor told me to try Tylenol first and, if the pain wasn't alleviated after an hour, then take the prescription-strength painkillers. As for nausea, ask for Phenagran. It will make you sleepy, but it kills the nausea pretty quickly.
If you do have surgery, don't panic. Most gall bladders can be taken out laparscopically, which is much easier to recover from than traditional open surgery. Laparscopic surgery, or keyhole surgery, is where the doctors make 3 - 4 small incisions in your belly and feed tubes through the incisions. These tubes allow them to pump some CO2 gas into your abdomen, which inflates your abdomen, making it easier for the doctor to see inside you. Tiny tools are fed through other tools so that the doctor can sever the gall bladder. The doctor then drains the gall bladder (using a tool, of curse), and pulls the gall bladder sack out of one of your incisions. Without any complications, the surgery takes less than an hour (mine was 45 minutes, with the clock starting when they wheeled me into the room - so they still had to hook up my IV, situate me on the table, etc). If complications occur, they may shift to full, open abdominal surgery. I have no idea how that feels. I do know that the laparscopic surgery has a much shorter recovery time. It's also usually considered an outpatient procedure, so if your surgery is early enough in the day, you may go home the same day as your surgery. It takes 3-5 days for most of the pain from the surgery to go away - this pain includes pain from the incisions themselves, which may have a bruised appearance, and pain from the CO2 gas. While the doctors can pump the CO2 gas in, they can't really remove it, so there's this feeling of pressure in your abdomen. The best and fastest way to get rid of this is to be on your feet as quickly as possible after the surgery. Take short, frequent walks (I did circuits around my living room during every commercial break). One of the incisions does go through your right abdominal muscles, so while the incision & gas pain goes away quickly, you'll find it difficult to do things that require you to flex your right abdominal muscles. I had to spend the first few nights sleeping propped up in bed because it hurt too much to lie flat.
I know that this all sounds scary, but I also have a pretty good idea of what you're experiencing. The pain was so bad for me that some nights, all I could do was curl up in a fetal position and cry. While the surgery did cause discomfort those first few days, I woke up from the anesthesia and realized that I was completely free of that constant pain & nausea I'd been experiencing for 8 months. It was a wonderful feeling.
Please be persistent in finding a diagnosis & cure. Some patients whose tests come out normal give up and suffer for years, until they can't stand it anymore and go through those tests all over again. You don't need to be suffering unnecessarily. If you feel that one doctor isn't doing their job, don't be afraid to see another. Don't be afraid to seek second opinions. Do be careful about homeopathic "cures"; a good homeopathic practitioner will tell you that for some things, Western medicine is recommended. Some homeopathic cures could make you worse. Many have odd side effects with traditional medications (for example, St. John's Wort cancels out the effectiveness of some birth controls). ALWAYS tell your doctors & pharmacists every medication - traditional or not, prescription or OTC - that you are taking.
Best of luck.
