Before considering a cholecystectomy I would give a trial of sucralfate and cholestyramine. I think that many people with these generalized forgut dysmotility issues have significant bile reflux gastritis as part of their dysfunction. The episodic loose stools may well be due to inappropriate “firing” of the gallbladder resulting in a bolus of bile into an empty duodenum with upstream gastric irritation and downstream secretory diarrhea. If this fails to improve things and symptoms were really reproduced with CCK I would then consider cholecystectomy. Christopher R Watters, MD