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Old 12-16-2003, 06:46 AM   #1
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Angry Post-Gall Bladder Removal irritations

I recently had my gall bladder removed. I went through a battery of test including the HIDA scan which came up that my GB was not working (no stones just not working) I had a lot of pain just below my ribcage. However there were other things that bothered me.

For about 9 months I have been poked, prodded, scoped and doped. I went from a diagnosis of GERD to gall bladder. I have taken prevacid, nexium, prilosec, and every other PPI.

I'm 4 weeks out from my GB removal and I still have abdominal pain. My bowel habits have gone crazy. I don't have a movement for 2 or 3 days. Then I have a HARD movement and then in the next 5 minutes I have a complete cleaning out of loose watery stool. Once this is over I have a lot of discomfort. I feel like some one has wrung out my intestines from my mouth to my rear.

I also experience a lot of abdominal pain right at my belly button and feel full. I am down to 149 lbs from 170 nine months ago. I jsut feel so discourage. The Dr.'s all seemed to think the GB would take care of it all but it didn't seem to do that. I just need to know if others are experiencing similar things. Is this IBS? What should be my next step. I don't have a whole lot of other organs I would like to remove .

Rob

 
Old 12-16-2003, 11:16 AM   #2
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cheer up HB User
Re: Post-Gall Bladder Removal irritations

I'm sorry to hear of your post-gall bladder surgery troubles. It is stories like yours that have kept me from the gall bladder removal I am told I should have although I had only one "major" stone-passing pain attack and it was six months ago. I have certainly had minor pains and upsets since, but nothing like that one hours' long attack.

From what I have read and heard (and I've heard and researched a LOT about this topic), what you experience now post-op is not at all uncommon. In fact, some 15-30% of people who have the GB removed have the "dumping syndrome" which means it takes a very long time and many experiments with various diets and drugs to get the system back to semi-normal and end the diarrhea episodes. Many doctors downplay the number of people who are still suffering after surgery. They try to tell us it is a small minority but I do not believe that, based on what I have heard from patients and learned through research.

Other people may also (or just) have phantom GB pains, other digestive pains, i.e., gas, GERD, etc. I have grilled two gastroenterologists and only one was honest enough to tell me that if people think all their aches and pains in the abdomen/ribs/upper back, and digestive upsets of every variety (most especially IBS) will be cured by gall bladder removal they are sadly disappointed later. Only rarely is a person free of all the above symptoms just from GB removal. This one GI doctor told me the little aches and pains I feel in the right upper quadrant are NOT of surgical significance and are not what doctors are concerned about.

The primary reason to remove the GB is to prevent further horrifying pain attacks from gallstones or sludge trying to pass through the system and getting caught in the various ducts. It is also important to keep inflammation/infection and/or pancreatitis from setting in, situations that would be obvious from extreme pain and fever. Those are the reasons for surgery -- GB removal will not stop all the other garden variety digestive complaints so many of us have during our lifetimes, especially as we age.

A lady named Katie G. frequently writes on this thread of her experiences with gall bladder removal. She may well see your message and respond, which you will no doubt find extremely helpful.

There are a number of things that can be done post-op to help return you to a "normal" life where digestion is concerned, involving diet and supplements. Do not be shy about returning to your gastroenterologist and being persistent in asking for help. If none is offered, find another doctor, don't hesitate. The surgeon is pretty much out of the picture; he has done his surgical job and now it's up to the gastro docs.

I suspect I, too, will eventually have the gall bladder removed, but for the moment I am trying to stave off another attack via low(er) fat diet and weight loss. I'd call it a modified South Beach diet. I have lost over 20 pounds from this exercise, and my internist is all for it. She says "you should probably have the GB removed eventually, but there is no urgency at this time."

The two gastroenterologists and surgeon I consulted wanted to do it NOW. I work with an RN who is also an attorney. This woman is married to a retired physician/surgeon. When I told her I was considering surgery she said "Why?" You're not really sick -- you've had just one attack in six months. She said "of course the GI docs and surgeon recommend surgery now. That's their JOB!"

I am not hard line anti-surgery by any means, but see no need to risk the possibility of the "dumping syndrome" and phantom pains, etc., that so many suffer any sooner than absolutely necessary.

Good luck with your continuing post-op saga. I hope you get the help you need (and get the help soon) so you can return to your previous state of well-being. Best wishes to you -- I believe the answers to your troubles are out there and I hope you hear from Katie G. or others here who have been through what you are going through now.

 
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Old 12-16-2003, 08:20 PM   #3
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Re: Post-Gall Bladder Removal irritations

Hi Rob,

I had my gallbladder removed a number of years ago and for me it took 6 weeks till my digestion started to behave normally again. I have had irritable bowel for a long time though, so I can't claim that my digestion became perfect. I found that eating smaller meals closer together (3 meals + 3 snacks) helped to ease the discomfort as well.

Hope that is helpful,

Darene

 
Old 12-16-2003, 08:49 PM   #4
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Re: Post-Gall Bladder Removal irritations

Plus, a post for cheer-up:

I too procrastinated on making an appt. for my surgery until I had what I refer to as the gallbladder attack from you-know-where. I had only had minor troubles (like yourself) for about a year from when my surgeon recommended I have the op.

I ended up having a gallstone lodge at the base of my gallbladder/bile duct, requiring a full cholecystectomy and 6 weeks of recovery (and I sure wasn't jogging at the six-week mark!)

Anyways, my point just is to be careful. It's not always good to let things be, and a surgeon doesn't necessarily recommend surgery to make work for themselves. I'm not saying rush out and book a time, and I don't know how common my experience was, but it may help you to know that once in a while complications do come up from waiting.

Take care,
Darene

 
Old 12-17-2003, 08:45 AM   #5
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Re: Post-Gall Bladder Removal irritations

It just really grates on my attitude and outlook on life when I feel great for a few days and then I have a terrible day where I just feel awful. I really want a quality of life back that I used to have. I was a successful long distance runner in high school and college and was running up to 80 miles per week. Now I can't hardly run anywhere unless it is to the bathroom to "unload". I really would like to know if there is any diatery help out there. Can anyone give me books to read or diets to try and follow. Thanks

Rob

 
Old 12-17-2003, 01:44 PM   #6
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Re: Post-Gall Bladder Removal irritations

Most people try to avoid gall bladder surgery for as long as possible; hence the horror stories told by surgeons about "watchful waiting" with gall bladder/gallstone problems because patients' GBs sometimes tend to get infected or a stone lodges in a duct before they finally have the GB removed.

Internists are more likely to tell people they can probably wait-and-see for awhile than are gastroenterologists (who get all that business after the surgery when post-op complications are so common) or surgeons. Any consult with any surgeon will end with a surgical recommendation. You can take that to the bank.

However, I am willing to take the chance and wait at this time to spare myself the likelihood of disgusting digestive problems, possibly lasting for the rest of my life. For me, life would not be worth living, unless I had been in interminable pain beforehand and GB removal was absolutely the ONLY answer.

I also know the statistics on laparoscopy vs. "open" surgery and have learned that despite the somewhat longer and/or more painful recovery time, people who have had the "open" version have fewer LONG-LASTING digestive crises and less risk of nicked bile ducts, missed or lost stones during surgery, etc.

People I know who've had the "open" surgery were far less likely to have had to return to the physician/surgeon for ERCP procedures, repeated surgeries due to botched repair, ad nauseum. Surgeons are attempting to use the lap. version in nearly ALL cases now, at least in my community, even those who come in as an "emergency," as you did. From my research, this can be extremely dangerous and you were probably actually very fortunate to have had the "open" version for your emergency surgery. That would certainly be my preference.

As one who had a total hysterectomy years ago, has the six inch scar to prove it, and bounced back in four weeks (though certainly was not jogging), I would actually prefer the "open" old-fashioned surgery for gall bladder removal. The surgeons in Los Angeles don't seem to want to do that, however, much to my dismay. They prefer to continue honing their laparoscopic skills. My feeling is that if I am willing to spend a few extra weeks recovering, that should be MY choice, not theirs.

Laparoscopy requires extremely good surgical skills, frequently MORE time under anesthesia (risky, and to which I am extremely sensitive) and encourages more bile duct nicks (a horrific turn of events -- even the GI docs and surgeons admit this is a nightmare that can easily kill the patient) than does "open" surgery.

One doctor's receptionist told me she had the "open" GB removal a number of years ago and recovery was tough. However, she added that it was much EASIER than was her traditional hysterectomy! Well, since hysterectomy was a piece of cake for me, the "open" cholecystectomy sounds just fine and I will search for a doctor willing to perform surgery in that manner.

Glad to hear it only took you six months to regain relatively normal digestion. That doesn't sound too bad. A young woman I know (now only age 28) had her GB removed via lap. procedure 3 or 4 years ago and STILL can't eat anything much without making a mad dash for a bathroom. Doesn't that sound like a party you'd be happy to MISS? A friend of mine at work who had an "open" surgery in her thirties (many years ago) says she was fine after a few weeks with NO post-op digestive complaints.

As SO MANY on these boards and elsewhere claim, they simply never know WHAT causes this post-op (primarily from lap. surgery) digestive problem because one day they can eat something and be fine and the next day all hell is paid for the pleasure. They can never pinpoint exactly what will cause problems or when. I have read and heard this over and over again. I do not choose to live that way if it can be avoided or postponed, and it sure sounds like people with the lap. version of surgery fare far worse post-op.

It is indeed unfortunate that a stone lodged at the base of your duct and thus you needed emergency surgery, but that is a relatively rare occurrence. Usually people head for the ER in pain, have a few tests done, are given an antibiotic and painkillers and sent home with the admonition to see a surgeon very soon. Generally, the offending stone falls back into the gallbladder. Rarely, it passes through into the intestines and out of the body.

As another co-worker (the registered nurse/lawyer married to a doctor/surgeon) said: "any health crisis can befall any person at any time, whether gall bladder related or something else entirely," so since I have had no vomiting, no fever, no pain, etc., one 2 and 1/2 hour "possible" stone-passing incident that took place six months ago need not put me in the surgical ward now "just in case" it might happen again. Truth is, with the flu epidemic we're experiencing here and so many people running to the local ER, a hospital is the LAST place one wants to be for the next few months. If necessary, of course, I will undergo the procedure, but I intend to insist on the old fashioned, open cholecystectomy.

Happy holidays!





Quote:
Originally Posted by Darene
Plus, a post for cheer-up:

I too procrastinated on making an appt. for my surgery until I had what I refer to as the gallbladder attack from you-know-where. I had only had minor troubles (like yourself) for about a year from when my surgeon recommended I have the op.

I ended up having a gallstone lodge at the base of my gallbladder/bile duct, requiring a full cholecystectomy and 6 weeks of recovery (and I sure wasn't jogging at the six-week mark!)

Anyways, my point just is to be careful. It's not always good to let things be, and a surgeon doesn't necessarily recommend surgery to make work for themselves. I'm not saying rush out and book a time, and I don't know how common my experience was, but it may help you to know that once in a while complications do come up from waiting.

Take care,
Darene

 
Old 12-17-2003, 02:13 PM   #7
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runrobrun HB User
Re: Post-Gall Bladder Removal irritations

That is interesting. I haven't thought about that take. However it is too late for me to get the full surgical removal. I did feel that my surgeon was very thorough. He went did x-ray the ducts etc and was did a great job explaining what he was doing. I guess the frustration is in the "what's next". I really would like to find a non-traditional way of dealing with the aftermath.

Rob

 
Old 12-17-2003, 04:04 PM   #8
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cheer up HB User
Re: Post-Gall Bladder Removal irritations

Rob --

Yes, now that you've had your surgery, and thankfully it doesn't appear you have errant stones anywhere, just the miserable "PCS (post-cholecystectomy syndrome" diarrhea, it's time to find a way back to your "normal" active life.

From what I hear, people try all sorts of diets, eating smaller meals, avoiding all the foods that made them "sick" before the GB removal, etc. Plus, there are those powders/caplets known as Questran and Colestid that many people swear gave them a new life. I know I'd use whatever is available in order to restore my life to its pre-op routine.

As I said yesterday, talk to one (or more!) gastroenterologists in your area about this and don't back down. This is a post-op concern that is way too common to accept a shrug of the shoulders and "live with it" attitude from a doctor. The answers are out there -- you just need to find them in your community.

Good luck and happy holidays.

Joan



Quote:
Originally Posted by runrobrun
That is interesting. I haven't thought about that take. However it is too late for me to get the full surgical removal. I did feel that my surgeon was very thorough. He went did x-ray the ducts etc and was did a great job explaining what he was doing. I guess the frustration is in the "what's next". I really would like to find a non-traditional way of dealing with the aftermath.

Rob

 
Old 12-17-2003, 05:24 PM   #9
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Re: Post-Gall Bladder Removal irritations

Here is another quesiton: Does this so called "Dumping syndrome" cause significant weight loss or difficulty gaining weight? I was at 170 10 months ago when all this started now I'm down to 148. I can't seem to gain any back. Being a 5'11" 32 year old man I would like a little more girth. This kind of weight loss is scarry.

Rob

 
Old 12-18-2003, 12:04 PM   #10
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cheer up HB User
Re: Post-Gall Bladder Removal irritations

Rob -- I would say "yes" to your question. When you eat, and then experience the loss of much of what you've eaten so quickly afterwards, the body doesn't have the chance to absorb the nutrients necessary to add weight. That's why you need to get back to a gastroenterologist and possibly a nutritionist to see just what you can tolerate as well as get those additives that hopefully will prevent much of the "dumping syndrome."

Being thin is generally a good thing, but too thin is something else again. I do agree that 148 is too little weight for someone of your height. Not knowing your bone structure, I'd say you could probably use at least another 15 pounds or so. It shouldn't be hard to achieve that gain once you settle that digestive scenario down a bit.

Joan



Quote:
Originally Posted by runrobrun
Here is another quesiton: Does this so called "Dumping syndrome" cause significant weight loss or difficulty gaining weight? I was at 170 10 months ago when all this started now I'm down to 148. I can't seem to gain any back. Being a 5'11" 32 year old man I would like a little more girth. This kind of weight loss is scarry.

Rob

 
Old 12-19-2003, 08:34 AM   #11
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Darene HB User
Re: Post-Gall Bladder Removal irritations

Dear Cheer Up,

All I posted was a cautionary note, and I certainly don't presume to tell you how to deal with your issues. I wish you the best of health.

However, you do make presumptions about my experience, so allow me to respond to your comments:

1.) "Internists are more likely to tell people they can probably wait-and-see"

My surgeon was an internist, who said I could wait, but not for too long, just in case ...

2.) "Surgeons are attempting to use the lap. version in nearly ALL cases now, at least in my community, even those who come in as an "emergency," as you did."

I did not go into the hospital as an emerg patient - I had a scheduled lap (which I chose to schedule after a bad attack) and ended up having both procedures performed. The lap to start, which could not be completed because of the lodged stone. So, I have incisions from the lap and the full.

3.) "As one who had a total hysterectomy years ago, has the six inch scar to prove it, and bounced back in four weeks (though certainly was not jogging), I would actually prefer the "open" old-fashioned surgery for gall bladder removal."

Personally, I wouldn't knowingly choose the open procedure. I know family members and friends who've had the lap and went to work / felt great in a week. And if you're a singer or an athlete, there's a potential consequence for your abdominal muscular strength. It sounds like you've done lots of research on comparing the procedures though, so I hope all goes as you would like it to.

4.) "Glad to hear it only took you six months to regain relatively normal digestion. That doesn't sound too bad."

I have ongoing digestive issues or else I wouldn't have even visited this board. However, at this time I attribute none of them to this operation from 12 years ago.

5.) "Happy holidays!

Same to you, I wish you the best luck,

Darene

 
Old 12-22-2003, 11:01 AM   #12
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ELDERPANTHER HB User
Re: Post-Gall Bladder Removal irritations

If I did not know better I would be thinking that I was the one starting this thread. I had my GB removed in March 2003. I had the same problem it was not working. I will say one thing the pain near my rib cage has gone away as well as my severe heartburn attacks. My bowel functions are fairly normal now except for when I eat spicy foods then it is run for the bathroom. It took me about 2 months to get there. I do also have reflux and that seems to have gotten worse with the GB removal. I am also now experiencing pain and a feeling of bloatedness in my right quadrant about 10 minutes after I eat. So as you can see some things get better and some get worse. GOOD LUCK to you and HAPPY HOLIDAYS.

 
Old 12-23-2003, 11:00 PM   #13
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Re: Post-Gall Bladder Removal irritations

Hello! Wow, I can sure tell you about my experience with gallbladder trouble. I had my gallbladder out in June of 2002. It was full of stones, to the point where they were blocking my ducts. They started with the lap procedure, but eventually had to open me up when I had some stones embedded in my bile duct. I was in surgery for 5 1/2 hours and was in the hospital for 6 days. I had 2 drainage tubes and 1 "bile bag" coming out of my side and was MISERABLE. I don't want to scare anyone away from this procedure, but nothing, especially surgery ever goes "perfectly". Recovery was far from over once I was discharged. It took me months to "bounce back"...in fact, at times I wondered if I ever would. But, my doc said I was doing well, and gradually I felt better day by day, so I was encouraged.

In reference to the "dumping", I can also tell you about my experience with that issue. It's actually "bile salt diarrhea" that they refer to when you have bowel troubles after gallbladder surgery. The bile has no gallbladder anymore to "store" it in, so the food you eat just goes right through you. I'm sure someone else could explain that better, but hey, it's late and I'm sure you get the point. Anyway, the lifesaver for me, I mean LIFESAVER for myself and many others on this board has been Cholestyramine. This medication basically acts like a sponge to soak up all the extra bile salts and slows them down during digestion. After surgery I would eat something and not 10 minutes later be in the bathroom. It didn't matter what I ate, when I ate, or how much/how little I ate. I couldn't even eat lunch at work, because I knew I'd be in the bathroom all afternoon long. Life was miserable...until I started researching what could be wrong. Many patients have this problem after gallbladder removal, and after reading about it, I took the information to my doctor and said "HELP!". She sent me home that day with a Rx for Cholestyramine and the first day I took it, BOOM, no trouble. Some people take longer to "adjust" to the medication, but for me it was the first day. Yes, I'll have to be on this for the rest of my life, but it is a VERY small price to pay for not having to worry about where the bathroom is everywhere I go.
I suggest that if you have this problem, then talk to your doctor. Do a little research about it, and if it seems like something that would help you, by all means, take it to the doc. I have a great doctor, but I had to do this one on my own and I'm sooooo thankful I did. Give it a shot...the inconvenience of taking the medication is nothing compared to suffering with this problem OR dealing with gallbladder attacks.
Sorry this is so long of a post, but I wanted to include all I could since I've experienced a lot of what this topic is about...just my 2 cents.....
DAnn

 
Old 12-24-2003, 07:56 AM   #14
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Harry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB User
Lightbulb Re: Post-Gall Bladder Removal irritations

Rob,
The Biggest problem with bowel movements is that most people don't intake enough or the right kind of fiber in their diet whether they have a gallbladder or not.
You are suppose to have 20 to 30 grams of fiber daily for your gastrointestinal system to function properly.

I am a firm believer in --- "Health Begins with your Digestion"-- because all the nutrients that you need for your body to work properly begins there!!!

After having your GB out, you may develop a problem but most people don't. Only about 5% develop Bile Salt diarrhea.

Before taking the medications that absorb the bile, I suggest you start taking a water soluble fiber supplement like Metamucil or Equate from Wal Mart. Psyllium is a safe natural fiber that is used as a bowel regulator. I used it for about 14 years prior to having my gallbladder removed in 1997. And, after GB surgery that is all I have ever needed to use--I have never had to resort to taking a medicine that is use to reduce your cholesterol. And, you could always take that if needed.

When taking the water soluble fiber, start off slow because it will produce gas cause the natrual fiber is brokendown by digestive bacteria. As your body gets use to it then increase the dose until you take it twice daily with the amount of water recommended.

This usually produces a gentle BM with very little straining and It helps from getting hemorrhoids.

I wish you well---Harry

 
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