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Doctors' Answers to "Frequently Asked Questions" - Gallbladder
Problems After Gall Bladder
Surgery [posted 12/04/98]
Answer: Well, there is a syndrome called post-cholecystectomy syndrome where patients develop similar symptoms after the gall bladder is removed. However, you should have an ultrasound of the common duct to ensure you don't have a retained stone. Sometimes an ERCP is necessary to ensure that you don't have stenois of the Ampulla of Vater (the opening to the small intestine).
Cholecystectomy (Gall Bladder Removal) [posted 11/19/98]
Answer: Does it work? Usually, we use a calcium channel blocker;but, women with this problem generally have life long problems.
Could These be Gall Bladder Symptoms
Answer: Certainly could, also occasional ulcers symptoms felt like this. Lastly, occasionally colon spasms occur in the turn by the liver and is called hepatic flexure syndrome. But, you will need to be seen and evaluated, possible gall bladder testing depending on the findings. Gall stones are very frequently familial, the calcium intake has little to do with it. Fat intake usually is a better predictor.
What to Do About Gall Bladder
Symptoms [posted 10/23/98]
Answer: Get a HIDA scan of the gall bladder. This is a functional test, also, an ultrasound may answer the question.
Gall Bladder Symptoms [posted
Answer: I suggest getting your gall bladder out.
Gall Bladder or Acid Reflux
Answer: Yeah, I hate getting old too;but, as a patient once told me-Beats the alternative. Anyway, I would get some studies to find the cause of this problem. An additional test for the gall bladder would be a HIDA scan with ejection fraction. This looks at the function of the gall bladder ( not whether stones are present) and a decrease ej fraction can be a reason to take out the gall bladder-given the right clinical situation. If your pain is due to reflux disease, this can turn out to be important. Prevention of reflux is necessary to prevent long term scarring of your esophagus. If you hate bothering your friend, see a colleague-don't sell your health short due to guilt.
Gall Stones [posted 8/11/98]
Answer: Post prandial nausea and pain. Usually about 30-45 minutes post prandially. Fatty foods are usually worse. Apples and cabbages are also offenders. Occasionally the pain can be felt in the chest, left jaw or left arm. Generally, a feeling of nausea and right upper abdominal discomfort. Jaundice can result if stones obstruct the common duct. There will be marked pain in this situation. Food should be as low fat as possible. Avoid apples and cabbages. However, no diet will completely fix the problem, surgery is the only effective answer.
Gall Bladder Pain?
Answer: Hard to know if this is gall bladder or not. You would need an ultrasound, or a functional test of the gallbladder to know. Gallbladder typically is 30-40 minutes post prandially and worse with fatty foods. Occasionally an ulcer or just spasm could give similar symptoms. If it is your gallbladder, only surgical removal will alleviate the problem. Low fat meals will buy you time, but, not fix the problem.
Answer: In a study of predominantly male silent gallstone patients, it was suggested that the cumulative risk for the development of symptoms or complications requiring surgery is relatively low. Decision analysis has suggested that the cumulative risk of death while on expectant management is small and prophylactic chlolecystectomy is not warranted. Complications requiring the surgery are much more common in patients who have symptoms.
Answer: If you are experiencing pain from your gallbladder and poor emptying (a low ejection fraction) you would be best advised to get your gallbladder removed. There are oral drugs which will dissolve stones (a possible cause of your problem), but they'll just come back over time if the gall bladder is left intact. There seem to be few side effects post cholecystectomy. Some patients continue to experience discomfort (especially after fatty meals) and this is called the post-cholecystectomy syndrome. Most patients don't notice any difference.
Gallbladder & Food Poisioning
Answer: There are two basic kinds of food poisoning. First is the food is
contaminated with bacteria. These bacteria will multiply in your gut causing diarrhea,
fever, etc. Since it takes time for them to multiply it will take 7-14 days before
symptoms occur. Second it a toxin produced by bacteria which is present on the food. This
will cause nausea, vomiting, diarrhea within several hours of eating the food. It will not
cause fever or an elevated white count(suggestive of infection not poisoning). Gall
bladder attacks occur when the gall bladder is either inflamed, contracting poorly, or
blocked(usually by a stone). Classically, it occurs with fatty foods, apples, cabbages,
etc. It is usually about 30-45 minutes after a meal and is worse with fatty meals. Pain is
usually in the area under your right ribs and occasionally with pain between the shoulder
blades or neck.
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