Atypical gastrointestinal symptoms are not associated with gallstones in patients with spinal cord injury

Objective: To determine if nonspecific gastrointestinal (GI) symptoms justi fy cholecystectomy in patients with spinal cord injury (SCI). Design: The frequency of GI symptoms was determined in a sample of patients with SCI in whom the presence or absence of gallstones had been previously determined by screening ultrasonography or a known history of cholecystect omy. The prevalence of various symptoms in patients with and without gallst ones was compared. Setting: The Spinal Cord Injury Unit of the Veterans Affairs Puget Sound He alth Care System, which provides rehabilitation and longitudinal primary ca re for SCI veterans. Patients: Two hundred ninety-four patients who had undergone either right u pper quadrant ultrasonography or cholecystectomy in the past, and who compl eted a questionnaire concerning GI symptoms. Main Outcome Measure: Bivariate logistic regression was used to calculate o dds ratios (ORs) to determine the strength of associations between the pres ence of each symptom and the presence of gallstones. Results: Pain in the right upper quadrant or epigastrium that occurred afte r meals or at night was significantly associated with gallstones (OR: 3.5; 95% confidence interval [CI] 1.02-11.73). Abdominal pain in other locations and nonspecific symptoms such as bloating and nausea, were not predictive of the presence of gallstones. Conclusions: Nonspecific symptoms in patients with SCT are not associated w ith gallstones and do not justify cholecystectomy in patients with otherwis e asymptomatic gallstones.