Questions about Gallbadder

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Deanna in CO
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Questions about Gallbadder

Post by Deanna in CO »

Hi all,

I've been having pain in my right side under my ribcage for several weeks. It comes and goes, and it has for the most part been mild to moderate, so I've been talking with my GP's office about it and have had some blood work but hadn't really come to any definite answers until yesterday. When I went to the GP yesterday, she started poking around and found one spot that was really quite painful. She asked me if I had a history of gallbladder problems (I don't), and ordered an abdominal ultrasound. DH went with me to the ultrasound last night and he thinks he saw a fairly large stone, too big to fit through the ducts. The tech of course couldn't say anything, so I am waiting to hear back from my doc in the next couple of days.

Meantime I am asking myself some questions, assuming they do come back and say there is a stone there. (I did a search of the site and found some answers, but not to these specific questions.)

1) Is there a possibility of a relationship between my gallbladder issues and the MC? DH is daring to hope maybe the D will go away if I have my gallbladder out; I am much more skeptical but am wondering how they might be related.

2) If they come back and recommend removal, is that something I really want to do? The pain is uncomfortable, but not severe, and DH thinks the stone is too big to go into the duct, from what he could see last night. I'm reading here that removal can result in weeks of uncontrolled D; I think I've already had enough of that and am REALLY not excited about that possibility (I know you all on this site can relate!). But the pain is gradually getting worse, and I don't like the thought that it might suddenly become a full-blown gallbladder attack. OTOH, I believe our gallbladder is not there by accident, and I need to be able to eat fats for the calories, since I can't get them from sugar or from grains. I'm still slightly underweight; losing fat as a calorie source could be a real problem.

3) Are there nutritional approaches to gallbladder problems that might help me get the pain under control?

4) Might a bile acid sequestrant be helpful in my situation, either before or after surgery? What are the advantages and disadvantages of that as far as the MC is concerned?

Obviously I will ask my Dr too, but sometimes I think this group has more info on this kind of thing than most doctors do, so I wanted to go into conversations equipped. :)
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tex
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Post by tex »

Hi Deanna,

Those are some pretty tough questions, especially for those of us who don't even own a white coat. LOL. Here are my thoughts, but remember, I don't own a white coat:

Yes, gallbladder issues (and also pancreas issues) are frequently associated with MC, because these two organs supply inputs that are necessary for proper digestion, so they are controlled by the enteric nervous system, based on input signals from the entire digestive tract. IOW, when a monkey wrench turns up in the intestines, that alters the functioning of the gallbladder and the pancreas (both of which supply digestive enzymes by way of the common bile duct). Soooooooooooo, while trouble in gut city can cause the gallbladder to malfunction, removing the gallbladder is not likely to solve the original problem, (which is an inflamed digestive system).

That said, it's certainly possible for gallbladder disease to cause disruption of digestion resulting in D, for anyone in the general population, and in that case, surgery can often bring relief from symptoms (somewhere down the road, after the digestive system gets used to bile being dumped into the duodenum contantly, rather than just after meals. A cholecystectomy will not "cure" MC, however.

If you should elect to have surgery, you should still be able to eat fats after surgery, because the bile will still be produced -- it will flow constantly, rather than being stored in the gallbladder until it's needed.

Bile acid sequestrants are often useful following surgery, to disable the excess bile in the system, until the system can adjust and learn to compensate in the future. Some doctors prescribe bile acid sequestrants to treat MC, and in some cases, it does help to minimize D, but of course, it does nothing to address the inflammation that causes MC in the first place. Those drugs tend to cause C if taken in excess amounts, so it's usually necessary to regulate the dosage in order to prevent cramps and C, while still taking enough to control the D.

Hopefully, someone else will be able to help with the question about a nutrition-based solution -- I'm not much of a nutritionist. LOL.

The bottom line is that gallbladder issues and pancreas issues are often satellite issues of MC. Usually, those problems will resolve when the inflammation that causes the MC is controlled. That said, if the damage to the gallbladder becomes severe enough, sufficient permanent damage may accrue that the organ can no longer function properly, even after the inflammation subsides.

This is similar to the neurological damage that can be caused by untreated gluten-sensitivity. If treated in time (by a GF diet), the neurological damage will usually heal and the symptoms will fade away. If the inflammation continues too long, however, much of the damage becomes permanent. And unfortunately, we can't surgically remove our brain, and our central and enteric nervous systems, so we are stuck with the damage. :sigh:

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Deanna in CO
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Post by Deanna in CO »

Tex,

I got a couple of smiles out of your response - thank you! As far as I'm concerned, when it comes to issues relating to MC, you're as good as most of those guys who take such pride in their white coats! I wish there were a few more who made studying MC their primary specialty; if there were, we might actually begin to get some answers instead of just experimentation.

Your explanation about the gallbladder being affected somehow by the MC makes sense. It doesn't sound like removal is a very good option, though honestly I'm not sure what else the doctor will be able to offer. Living with the discomfort doesn't sound very appealing either, since the pain is getting worse.

Meantime I'm doing everything I know to do as far as diet, and feel like I'm spinning my wheels at the moment - the D has come back several times a day (at least it's only 3-5 as opposed to 10-15!) and alternates between WD and soft-serve over the course of the day. I'm GF/DF/EF/SF, and basically free of preservatives, additives, sugar, citrus, almonds, whole nuts, and raw fruits and vegetables. In fact, I'm eating little besides meat, potatoes, rice, a few well-cooked veggies, avocadoes, coconut, EVOO, and a few basic GF spices (added individually, not mixed, so I can be sure it's just the spice). The inflammation is obviously not going away, and since I started eating this way, the gallbladder problems have developed (didn't have them before).. Ugh!

Anyway, I appreciate your counsel so much. Hopefully others may have some thoughts about nutritional approaches. Then (assuming the doctor actually does think there's a gallstones) I will have to try to make the best decision I can.. Thanks for the support!

Deanna
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Post by MBombardier »

My sis-in-law still has her gallbladder because she did a gallbladder flush (or cleanse). It involves lots of olive oil and lemon juice. If you look it up online, there are a lot of websites. I'm not going to recommend it--you'll have to make your own decision there. :smile:

I have heard that fasting can help break up the stones, since it gives the digestive organs a rest and lets the body use that energy to work on other things.

Coconut oil is not supposed to have the same impact on the gallbladder that other fats do.
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Post by Bifcus16 »

Deanna,

I had to wait around 6 months for my gallbladder surgery. In the meantime my naturopath recommended an ultra low fat diet to prevent attacks, and it worked. I was having as little fat as was humanly possible - I think the aim was for a max of 25g a day from all sources including the fat in meat etc. To do that I found it helpful to keep a food diary and record how much fat was in the foods I had eaten.

To get an idea of how restrictive that was, 100g of low fat beef mince (a typical serve) has 20g of fat. A 200g large steak only has about 8g of fat. A large egg has 6 grams. But I never had a pain attack while I followed that diet. On the odd occasion I lashed out, the pain would come around 4-6 hours after eating the fatty food.

After the op I found that if I ate anything fatty I got D. It magically came good after about 9 months. On the other hand my Dad had his out and was into the fried fish and chips after six weeks with no problems.

You will have no trouble finding out about that lemon juice and oil routine for expelling stones. Even the naturopath said it was a bad idea as it could cause the stone to lodge in the bile duct and result in an emergency.

Lyn
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Deanna in CO
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Post by Deanna in CO »

Lyn,

Well, from what my husband says (assuming what he saw was actually a stone), this stone is much to big to fit in the duct. He doesn't think there's any danger of that, but the lemon juice and oil thing won't work if that's the purpose. I'd need something that would dissolve the stone, not just expel it, and that may not exist.

I was thinking I could probably at least relieve the pain some if I cut back on fats. I need some, though - I'm 5'4" and barely holding on to 105 pounds; like many here I can't afford to lose much more. But maybe if I can cut the saturated fats and the potato chips that have been one of my few indulgences, and stick to healthier fats like avocado, coconut, olive, and flax oil (and strictly limited amounts of those), I might feel better. I may have to experiment a bit.

Hoping my doc will call me tomorrow with a definitive diagnosis and action plan.

Deanna
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Post by carol1946 »

Hi Deanna...I've always wondered if others with any type of colitis have gone through gallbladder surgery. I can only speak from my own experience, not a MD, but I think if there was a serious problem with your gallbladder you would have heard something the same day from your MD.

You've probably heard the term "hot appendix"......I had a "hot gallbladder" which meant that in addition to stones, an infection had developed. I had never had any gallbladder pain before and no hint of CC until one day in April of 1995 when I consumed fries and a chocolate shake from McDonalds. Within 15 -20 minutes I was in the bathroom not knowing whether to sit on the toilet or hover over it. Shortly after, I went to the nearest urgent care. They took and x-ray and decided that I probably had a gallstone but they weren't positive.

The pain was excrutiating......they sent me immediately to the hospital. I had to wait for an ultra-sound, still in pain, and upon the results I was admitted on an emergency basis. Finally, they gave me some morphine but it was a couple of hours before the surgeon showed up. He explained that my gallbladder was full of stones and swollen due to infection. I had to be on a very strong anti-biotic for 24 hours. When I asked the MD for the stones the next day he said that the stones were so bad that they had turned to mush.

My CC started that day (diagnosed 2 years later) and, although I occasonaly have a brief period of remission I'm still battling the CC 17 years later. Last night an easy 15 times to the bathroom.....I call nights like that my "dumping" days. So sorry that you are having to deal with both the MC and now the gallbladder.....heres hoping that there will be something else that you can do to get your gallbladder under control.

Take care,
Carol
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Post by MaggieRedwings »

Good Morning Deanna,

My case is very similar to Carol's and had an attack so bad after years of discomfort that I went to the ER and was admitted immediately. The gall bladder was packed with stones and highly infected. I had to wait for the infection to clear and stayed in the hospital for 7 days before the operated and removed the gall bladder. I have the stones. :twisted:

I never ate fatty foods so that was not the cause. However, about 2 months after the surgery is when the onset of MC happened. The correlation between the 2 I have no idea why.

Good luck with your plan but would take this seriously since if that stone - if there is one - lodges in the duct you will be in for a very hard and painful time and will require emergency surgery.

Love, Maggie
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Deanna in CO
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Post by Deanna in CO »

Carol and Maggie,

Thank you both. I agree - I know others who've had gallbladder attacks and have been in severe pain. I consider myself very fortunate that so far my pain is only mild to moderate. Your stories scare me a bit, though - I really hate the thought that treating the pain could make the MC so much worse. I am still in a bit of a flare but the thought of having to go 15+ times a day instead of the 3-5 I currently do is not pleasant. :( I guess it's possible that your gallbladder attacks and treatment could have been the trigger, and since mine has already been triggered and I'm already on the diet I might not get any worse. (It's worth hoping, anyway, right?)

The radiology tech who did my ultrasound Tuesday night said 1-2 business days for my doc to get the results. My doc knows I'm not in severe pain. I've already been waiting several weeks, and it's uncomfortable, but not unbearable. I'll post again when they let me know anything.

Thanks again everybody!

Deanna
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Post by patc73 »

Hello, all!
I, too, had a gallbladder attack in 2006 that coincided with the beginnings of MC (although the MC wasn't diagnosed until 2011). I experienced the upper right quadrant pain under the rib cage and went to the emergency room. It turned out to be one huge stone (3.8 cm.!) and the operation was done the next day. Since then, I've had problems digesting high-fat foods (like those fish & chips!). I now take Questran (cholestyramine resin), a bile sequestrant, to control the D. Gall bladder infections run in my family: of seven adult women, only one has not needed surgery! My niece waited too long to have hers out (she was trying to finish college classes), and almost died in the hospital from pancreatitis! So please don't put it off. You can survive without the gallbladder, but not the pancreas!

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Post by carol1946 »

Hello Again,

Deanna.....Sorry to hear that the results weren't what you were hoping for but, on a brighter note, I have two friends, one female and one male, who have had their gallbladders removed and actually had their D improve.....at least so far and it's been several years for each.

AND

Pat.....Re: Cholestyramine.....I have an RX for this med but have never used it. The RX reads 2-4 grams (1/2 to 1 Scoop) twice daily. I have problems with new tastes and consistancies. I'd appreciate your input on that issue. Is it bad???

In Re: to pancreatitis.....Hospitalized 3 times for it. Once in 2003, and once in 2004, both in Tahoe. I followed up with a GI who said that it couldn't have been pancreatitis because the pain wasn't bad enough!!!

Then the third time, in Virginia in 2006, I was put on tube-feeding for over a week. My Lipasse (sp?) was 1160 upon admission to the hospital.....I think it should be below 100. When I was discharged 3 weeks later, my Lipasse was still over 600. Thankfully, my pancreatitis has not been an issue during the last 5 hospitalizations which were all for severe dehydration plus one colenectomy with partial ileumectomy. I now have trouble absorbing nutrition due to the ileumectomy so have to supplement with VIT D and B12. I suffer from osteoarthritis but, thankfully, no RA.

I've not been able to get my CC under control for about 3 months and, after reading many posts, I think that it is time that I admit that I also have food intolerences, primarilly dairy and gluten. I had been wondering for some time why my CC seemed to be getting worse.....I was able to eat almost everything, maintain a job and deal with the CC for 10 years but now I'm weak all the time and never D free. I was told by my GI when diagnosed with CC in 1995, that a side affect of the condition is that it primarilly happens at night. Now it's happening day and night. I'm fasting today and going to liquids tomorrow.

Guess I'm in one of my "I can't do this anymore moods." but, I'm not ready for the alternative!!!

Bless you all!
Carol
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Post by patc73 »

Carol, the cholestyramine isn't bad, but you have to get used to it. You stir it into a glass of water and it never dissolves completely, so you just chug it down before it settles to the bottom of the glass. I get the regular, not "Lite", with real sugar instead of artificial sweeteners, and it's kinda like orange-flavored Tang (remember that)? I use it as needed for D, usually once a day or less, and it usually works pretty well stopping the tummy gurgles.

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Post by carol1946 »

After thought.....I continue to have a pain that comes and goes right under my rib cage on the right side. One PCP said, since they left my gall bladder duct, there might be a small stone there.....that was several years ago. When I saw my current PCP last Monday, she had me take a deep breath while she applied compression on my liver. Good news, for me, the liver isn't swollen.....I was more concerned about the possibility of liver disease so I'm much relieved. She made no mention of the gall bladder duct. I think it's probably just a sensitive area.

Any thoughts on this?

Carol
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Deanna in CO
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Post by Deanna in CO »

Carol,

A fair amount of the material I'm reading suggests gallbladder surgery doesn't always relieve the pain. It's one reason I'm not convinced I want to go for the surgery. My pain isn't that severe, and the possible side effects of the surgery (especially severe D) are worrisome.

I'm definitely going to have a serious talk with the surgeon - I don't want the surgery without some assurance that it's going to make me feel better rather than worse. I figure God gave me a gallbladder for a reason, and apart from severe pain or some other emergency situation, I need the function it provides.

Deanna
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Post by carol1946 »

Deanna,

I understand. I think that I would have wanted a much better understanding of the pros and cons had mine not been needed on an emergency basis. When do you see the surgeon?

Carol
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