How To Avoid Discomfort After Gallbladder Removal
Every time you digest a meal, you can thank your gallbladder. Its only about four inches long, but its big enough to perform its very specific job concentrating bile from your liver and releasing it into your small intestine to break down your food.
When it malfunctions, becomes inflamed, or develops gallstones or polyps, you notice the symptoms right away, pain in the upper right area of your abdomen, nausea, bloating, diarrhea, and lightheadedness are clear signs that you have gallbladder disease.
If youre experiencing any of these symptoms, expert help is available at Surgical Consultants of Northern Virginia in Reston, Virginia. Our team of specialists conduct a thorough exam, determine an accurate diagnosis, and offer the least invasive treatment options possible.
In some cases, gallbladder disease responds well to medication and lifestyle changes, but often, its best to remove your gallbladder to eliminate the symptoms completely. Afterwards, you may need to make a few adjustments. Heres how to sidestep pain and discomfort after gallbladder removal.
What Is The Gallbladder
The gallbladder is a small, pear-shaped organ that aids in the digestion of fat. Located beneath the right side of the liver, it collects and concentrates digestive liquid from your liver. After you eat, your liver releases bile from the gallbladder into the small intestine. Typically, gallbladder removal does not result in any impairment of the digestive process.
What Tests Are Used To Diagnose Bile Reflux
- Upper endoscopy exam. This involves placing a tube with a tiny camera attached down your throat and into your stomach and small intestine. Youll have numbing and relaxing medication for the exam. The endoscope can also take tissue samples to analyze in the lab.
- HIDA scan. Also known as scintigraphy, the hepatobiliary iminodiacetic acid scan is a radiographic imaging test that tracks the flow of bile from your liver to your small intestine. This test requires you to lie inside a scanner bed for one to four hours.
- Bilitec monitoring system. This test detects bile content in esophageal reflux through a photo-colorimetric device.
- Esophageal impedance test. This test can confirm reflux into your esophagus and measure whether the content is acidic or non-acidic. For the test, a small catheter is placed in your esophagus through your nasal cavity. Youll have medication to numb and relax your throat. The catheter stays in place for 24 hours. During this time, it measures and reflux episodes, the reflux content and notes any symptoms that result. This is a reliable test for differentiating between acid and non-acid reflux.
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What Makes The Bile Reflux Back Into The Stomach
One reason would be a weak or too-relaxed esophageal sphincter. This structure is supposed to prevent stomach acid from entering the esophagus.
Likewise, a strong sphincter will prevent bile from refluxing up into the stomach.
If a burning sensation also occurs in the throat, this would be because acid and/or bile has refluxed high enough to make it into the throat.
There are several ways to treat bile reflux, including avoiding any triggers such as lying horizontally overnight. Elevating your bed can help reduce overnight reflux.
You should speak to your surgeon about treatment options.
Dr. Baigs specialties include gastrointestinal cancers and liver disease, plus gallbladder, biliary tract and pancreatic disorders. He is an assistant clinical professor of medicine at the University of Medicine and Dentistry of NJ/Robert Wood Johnson Medical School.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Top image: Shutterstock, srisakorn wonglakorn
Changes Of Esophageal Reflux Patterns After Cholecystectomy
Total and supine weakly alkaline reflux time , the longest episodes of total, upright and supine weakly alkaline reflux mediums , total and supine weakly alkaline reflux time in minutes , the number of alkaline reflux episodes decreased with statistical significance .
The number of total and upright gas reflux and time of pH < 4 increased wityh statistical significance in cholecystectomy patients compared to the results during pre-operative period. There was no significant difference in the comparison of the postoperative patients and control group’s parameters .
Even though the acid reflux increased after cholecystectomy, no statistical significance was detected in comparison with the control group. Although a decrease was determined in the postoperative alkaline reflux recordings, it showed no significant difference with the control group. In addition, the preoperative and postoperative average symptom scores presented no significant differences .
Individual differences between the preoperative and postoperative number of episodes pH < 4 presented no significant difference. Even though there were differences in average De Meester scores, these were not statistically significant.
- Tables
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How Common Is Bile Reflux
Bile reflux is not thought to be common in otherwise healthy individuals. However, acid reflux is very common, and some cases of acid reflux may also be bile reflux. Symptoms of bile reflux and acid reflux are practically identical, and doctors cant tell if youre regurgitating bile without actually sampling and analyzing the fluid you regurgitate. This is considered unnecessary when diagnosing acid reflux. But if youve been treated for acid reflux and still have symptoms, you might be a candidate for further testing.
Acid Reflux Bile Reflux And Gallbladder Surgery
Hello,
I had my gallbladder removed a few years ago and am having a recurrence of bile reflux symptoms. Im normal weight, dont smoke, eat healthy and sleep elevated. PPIs have no benefit. Is Ursodiol an appropriate medication to try? How often and how much? Thank you!
Dear Kelly,
Gallbladder disease and acid reflux or GERD are two common but different medical problems. 30% of the population in Houston have gallstones and 30% suffer from heartburn. Not all patients with gallstones need to have their gallbladder removed. Similarly, not all patients with heartburn qualify for acid reflux disease. Gallbladder surgery or laparoscopic cholecystectomy is indicated for acute or chronic cholecystitis as well biliary dyskinesia. Acid reflux surgery in the form of Nissen fundoplication with hiatal hernia repair is offered to patients with documented GERD. The diagnosis and staging of GERD are made using a number of tests mainly upper endoscopy and ambulatory esophageal pH testing. Bile reflux typically co-exist with acid reflux. Nissen fundoplication re-establishes the anti-reflux barrier and stop any form of reflux from the stomach into the esophagus. Proton pump inhibitors, PPIs, mask symptoms of acid reflux but do not cure GERD.
Ursodiol, a naturally occurring bile acid, prevents the formation of cholesterol gallstones. Ursodiol does not stop or decrease bile reflux.
Healthy Regards,
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Can I Treat Bile Reflux At Home
Unlike acid reflux, bile reflux cant be treated with over-the-counter antacids or diet changes. Bile reflux is difficult to treat even with prescription medications. Sometimes, surgery is necessary. However, some small lifestyle adjustments, including raising the head of your bed, losing some excess weight and eating dinner earlier, may help ease your symptoms a little.
How Is Bile Reflux Diagnosed
Bile reflux will usually involve abdominal symptoms and sometimes esophagus symptoms. While reflux into your esophagus is easy to diagnose based on your symptoms alone, reflux into your stomach will need to be confirmed by imaging tests. Your healthcare provider will probably order an upper endoscopy exam to look inside of your esophagus, stomach and upper small intestine. The endoscope can take tissue samples while it takes images, to test for inflammation, tissue damage and the presence of bile. For reflux into your esophagus, they may take additional tests to distinguish acid reflux from bile reflux.
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Why So Much Burping After Gallbladder Removal
There are a few reasons why you might be experiencing so much burping and gas after gallbladder removal surgery. The most common reason is that the gallbladder removed bile, a type of fluid that helps digest food. As the gallbladder is removed, the bitterness no longer has anywhere to go, and it ends up coming out through your mouth.
If youre experiencing a lot of gas and burping, its always best to consult your doctor to rule out any potential complications. In the meantime, try to relax and drink lots of fluids to help relieve the discomfort.
Youre In Significant Pain
Pain and tenderness are the most common reasons people seek diagnosis for gallbladder issues that require surgery. When gallstones develop and cause a blockage in the exit point of your gallbladder or in your bile ducts, bile can no longer travel normally. This will cause your gallbladder to become distended, with your body sensing this distension as pain. This pain tends to be sudden, severe, and occur at the center or upper right part of your abdomen. Your abdomen may also feel all-around tender when you have problematic gallstones.
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What To Expect Following The Procedure
You may need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
If youre a day-case patient, you will usually be able to go home when you feel ready but you will need to arrange for someone to drive you home. Try to have a friend or relative with you for the first 24 hours after your surgery.
Before you go home your nurse will give you some advice about caring for your healing wounds. You may be given a date for a follow-up appointment.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If youre in any doubt about driving, contact your motor insurer so that youre aware of their recommendations, and always follow your surgeons advice.
If your wounds are closed with metal clips or stitches, these will be removed by a nurse after about a week. Commonly, dissolvable stitches are used with this procedure. The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should disappear in about two weeks.
Once your gallbladder has been removed, your body cant develop new gallstones. However, if gallstones have passed into your bile ducts and remain there after surgery, you may still get symptoms. Gallstones that have passed into your bile ducts can be removed by ERCP.
What Happens If I Have Gallbladder Disease
Gallbladder disease is a serious condition that requires immediate medical attention. If you experience any of the symptoms above, its important to consult a physician. They might suggest gallbladder removal if your condition is serious enough.
The physicians at Agave Surgical Specialists will provide you with the proper treatment if you believe youre suffering from gallbladder disease.
Call our office in Chandler at 582-5233 to schedule an appointment with one of our surgeons today.
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When Should I See My Healthcare Provider About Reflux
Reflux of any kind is serious. If you have frequent symptoms of reflux, your stomach or esophagus may be suffering systematic erosion. You might be able to manage acid reflux with over-the-counter antacids, diet and lifestyle changes. But if your symptoms persist, or if they include abdominal symptoms, you might have bile reflux. This will require further medical testing and treatment.
A note from Cleveland Clinic
Bile reflux is not common, but its a known complication of certain surgeries. If you experience bile reflux following gastric or gallbladder surgery, you may be able to treat it with medications, but you may need a follow-up surgery to fix it. Other causes of bile reflux are just beginning to be recognized and understood. Non-surgery bile reflux, or primary biliary reflux, may take some testing to identify. But its symptoms including inflammation and pain will always be taken seriously. Talk to your healthcare provider if you have symptoms or concerns.
Youre Nauseated For No Other Obvious Reason
All types of gallbladder problems can cause nausea and vomiting. These and related digestive problems, such as excess gas and acid reflux, only take place when you have chronic gallbladder disease. The definitive treatment for this disease, which involves ongoing blockage of one or more bile ducts, is surgery to remove the gallstones causing the obstruction or the gallbladder.
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You Have Unexplained Fever Or Chills
Fever and chills could be a sign you need gallbladder surgery, if these symptoms derive from a gallbladder infection. When this is the case, prompt diagnosis and care are extremely important. Left unaddressed, infections affecting the gallbladder can worsen and become dangerous. If an infection spreads to other parts of your body, it can be life-threatening.
What Are The Alternatives To Gallbladder Removal
If you have gallstones but they arent causing any symptoms, or surgery to remove them isnt suitable for you, there may be alternative treatments. Sometimes gallstones can be dissolved using medicines, however gallstones often come back after this type of treatment and it is therefore rarely used.
If gallstones are in your bile duct and not in your gallbladder, they can be removed during ERCP. An endoscope, which is guided using X-rays, is passed into your mouth and down to your bile duct. Special instruments can also be inserted inside the endoscope to allow your surgeon to remove the gallstones from your bile duct. ERCP can only be used to remove gallstones if they are found in your bile ducts. If gallstones are in your gallbladder itself, you may need gallbladder surgery as well. Your surgeon will discuss any possible alternative treatments with you.
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How Is Bile Reflux Treated
Healthcare providers prescribe a variety of medications to treat bile reflux and its symptoms, but these have not been well studied. Youll have to see if they work for you. When they dont work, and your symptoms remain severe, your healthcare provider may recommend surgery.
Medications to treat bile reflux include:
- Ursodeoxycholic acid , which changes the content of bile in your stomach.
- Bile acid sequestrants, which bind and disrupt the circulation of bile.
- Sucralfate, which coats and protects the lining of your stomach and esophagus.
- Prokinetic agents to encourage motility between your stomach and small intestine.
- Baclofen, a medication that decreases the relaxation of your lower esophageal sphincter.
Surgical interventions to treat bile reflux include:
- Diversion surgery to direct bile away from the stomach.
- Anti-reflux surgery to strengthen and reinforce the lower esophageal sphincter.
What Else Causes Acid Reflux
Acid reflux happens when the lower esophageal sphincter does not close as it should, allowing digestive juices to rise into the esophagus.
Some health conditions can cause acid reflux. These include hiatal hernia, when the upper part of the stomach bulges through the diaphragm into the chest cavity. This means the lower esophageal sphincter cannot function as it should.
Hiatal hernia is a common condition affecting 5560% of individuals over the age of 50 and is a leading cause of GERD.
Other factors that can contribute to GERD include things that put pressure on the esophagus or affect how it works.
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How To Avoid Discomfort Immediately After Gallbladder Removal
Even minimally invasive surgery is still surgery, and youll need to take a few steps to keep pain and other symptoms at bay. We give you detailed verbal and written aftercare instructions and are always available to you if you have questions, but in general, you need to:
- Adhere to a liquid diet for a few days
- Introduce solid food gradually
- Avoid strenuous activity
As healing progresses, we let you know when you can start introducing more fibrous foods like nuts, broccoli, and legumes. The general rule of thumb is to take things slowly to allow your body to get used to a new normal.
Is Laparoscopic Gallbladder Surgery Right For You
If you are local to Houston, Dr. Ahmad can help you evaluate whether laparoscopic gallbladder surgery is right for you. While there are many advantages to laparoscopic surgery, the procedure is not right for everyone. If you have had previous upper abdominal surgery or certain pre-existing medical conditions, you will need to explore other options. You will need a thorough examination from your personal physician as well as a consultation with Dr. Ahmad.
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What Is A Gallbladder Removal
What is the Gallbladder?
The gallbladder is a small pear-shaped organ that acts as a storage tank for bile. The bile is made in the liver by liver cells and is sent through tiny ducts or canals to the duodenum and to the gallbladder. The gallbladder stores the bile to have it available in larger quantities for secretion when a meal is eaten. The ingestion of food and especially fats cause the release of a hormone, which in turn signals the relaxation of the valve at the end of the common bile duct which lets the bile enter the small intestine. It also signals the contraction of the gallbladder which squirts the concentrated liquid bile into the small intestine where it helps with the emulsification or breakdown of fats in the meal.
About Gallbladder Removal
You may need your gallbladder removed if:
- you have gallstones that are causing you pain caused by inflammation or infection of your gallbladder
- you have jaundice caused by a gallstone blocking your bile duct
- you have inflammation of the pancreas caused by gallstones
- you have cancer of your gallbladder
There are two surgical techniques used to remove the gallbladder.
- Laparoscopic cholecystectomy your gallbladder is removed through small cuts in your abdomen , using a surgical technique called keyhole surgery.
- Open cholecystectomy your gallbladder is removed through one large cut in your abdomen, using a surgical technique called open surgery.
