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Gastroenterology  (Expert Forum)
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Controlling Gall Stone Symptoms, and Misc. Stomach Pain Question
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Controlling Gall Stone Symptoms, and Misc. Stomach Pain Question

by lkell, Dec 10, 2003 12:00AM
I am a 47 year old, obese female (5’6”, current weight @ 250 lbs) I have been on the Atkins diet for the past 8 months, and lost @ 25 lbs.  



Two weeks ago I had what my doctor believes was a gall bladder incident.  Six hours of severe pain, upper abdomen,  right side, under my breast bone.  Liver function blood tests came back normal.  I had an ultra-sound last week: my stomach, liver, pancreas and bladder all appeared normal, but I do have gall stones. At the recommendation of my doctor, I have a tentative appointment with a general surgeon next week to discuss a gall bladder operation.



I have never been sick, I have never been in a hospital, and the whole idea of this surgery scares me to death.  A web search on cholecystectomy, to try and learn more about it, pulled up hundreds of malpractice attorney sites.  It did not ease my mind.



I have drastically changed my diet, switching from Atkins to a modified Southbeach: omitting most fats and most irritating spice. I have lost 5 lbs in 10 days.  I am willing to forgo cheese and most fats for the rest of my life if it could mean no surgery.  



Question #1)  Is it possible to avoid gall bladder surgery by controlling the symptoms with diet?



I have not had a reoccurrence of the same type of pain my doctor said was from my gall bladder, however, since changing my diet these past couple weeks, I have been experiencing stomach discomfort and pain immediately (within a minute) after eating, with the pain lasting for 2-3 hours before fading.  The pain is located in the upper middle region of my abdomen,  between/below my breast bone.  It is not a burning pain and it is not nausea.  It is more a crampy type pain, and I feel very full.  On a 1-10 scale, I would put it about a 5, as I can still work/function.  My bowels are normal, no gas, no burping, no other symptoms.



The only medication I take is: Previcid, 30 mg, 2X a day (for about a year and a half), and an occasional Tylenol.  I have a history of stomach acid problems, mostly stress related. My weight has been up and down most of my life, with long periods of normal weight.  Six years ago I had a major life-style change, accompanied by a muscle injury that stopped my daily 2 ½ mile run.  Within two years I had put on 75 lbs, with the rest of the weight coming on gradually over the last few years..



During my running years I was a very heavy user/abuser of Advil. The Previcide has, for the most part, controlled my acidic stomach problems, provided it take it on a regular basis.



Question #2)  What could be the cause of the stomach pain immediately after eating?  Is this from the gall bladder?  Change in diet?  Could I have an ulcer?



Any info you can give would be appreciated.

Doctor's Answer

by Kevin Pho, MD, Dec 11, 2003 12:00AM
Surgeon has kindly addressed your question in his comments below and I agree with his assessment.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (13)

by surgeon, Dec 10, 2003 12:00AM
the gallbladder holds a small amount of bile, which is made in the liver and mostly drips constantly into the intestine. The bile stored in the gallbladder gets squezzed into the intestine when the gallbladder contracts, which it does in particular in response to food in the stomach, and especially if the food is fatty. When you have gallstones, if they happen to be in position to plug the gallbladder opening when it squeezes, it causes a "cramp" in the gallbladder muscles, which hurts. Limiting fat in the diet limits the squeezing, but doesn't stop it. Some people get attacks whenever they eat; others in relation to fat; others in no relation to eating at all. So dietary restriction may or may not help. The main reason to remove the gallbladder is to relieve symtoms. People with stones but with no symptoms are usually advised to leave it alone. Having had only one attack, and having modifed your diet, you are not one who would usually be told to have surgery absolutely. The other consideration is complications: gallstones usually just cause pain, but they can cause more serious problems, such as infections, jaundice, etc. People who have stones and who have symptoms are more likely to get complications than those without symptoms; but there's no predicting with certainty. No surgery is completely safe. Gallbladder surgery is very common, and for the vast majority of people is simple, quick, leaving no side effects. Which means if it becomes necessary, there's less to worry about than with many operations.

by tessa0825, Dec 10, 2003 12:00AM
If you do decide to have this surgery after talking to the surgeon, I wanted to tell you that as long as there arent any complications and you can have it done laproscopic (most are) then this is a real easy surgery to recover from...Im 51 yrs old and had mine removed this past March..I had it done one afternoon and came home the next, was off prescription pain meds the day after that and took tylenol for a few days...I went back to work at 5 days post op and felt pretty good...Usually the surgeon will tell you to stay home (off work) until he sees you at about 1 week post op...I remember taking care of my Mom, yrs ago, when she had hers removed, they only did the big open surgery back then. I went through nothing like what she experienced with recovery....

by lkell, Dec 11, 2003 12:00AM
Thank you both for your response to my question.  But I wonder if someone could render an opinion on question #2?  



I currently have moderately severe stomach discomfort and pain immediately after eating.  The pain lasts for 2-3 hours.  Its location is upper middle abdomen.  It is very uncomfortable.  It does not feel like acid, nausea or gas.  It is a crampy throbbing pain, with a slight full stomach feeling, that fades over time.  It does not hurt when I get up in the morning, or when my stomach