Post operative problems

I had gallbladder removal surgery nine weeks ago.  7 days out from surgery I started to experience intermittent waves of nausea, sick to stomach feelings, excessive belching, sour taste in mouth and burning in stomach/chest.  I am still able to eat and my appetite is still very strong and am in NO PAIN.  My symptoms are intermittent too..some days I feel good, others I feel crappy.  **Note..I did not have these symptoms before I had my gallbladder removed.

My doctors are diagnosing me with Acid Reflux/Bile Reflux.  They can't say for sure if what I am refluxing is Acid or Bile because I haven't had a endoscopy.  The put me on Nexium four weeks out and I tried that for two weeks with no relief of symptoms and now I have been on aciphex for two weeks.  My symptoms are still there and the dctrs are saying I need to give the medicine a minimum of four weeks to work, if not eight.  

My questions:

Can gallbladder removal caused ACID reflux?  Structually how can this happen?  Are there reported studies that says gallbladder removal can cause acid reflux?

Can gallbladder removal cause BILE REFlUX?  If so, is this a permanent condition because the gallbladder is no longer there??  Has this ever been reported?  

Do acid reflux and bile reflux cause the same symptoms??

How long does it take for the body to adjust to not having a gallbladder?  A month?  Six months?  A year?  (I know everyone is different with healing) but my surgeon is saying I should have been healed by now, but my MD is telling me it could be a year.

Do you think what I am experiencing is related to the removal of the gallbladder or mere conincidence timing wise?

Can gallbladder removal cause gastroparesis??

Could it be possible to have Sphincter of Oddi Dysfunction without the pain??  Could I have it with only nausea and reflux symptoms??

Is gastritis a possibility here with bile reflux?  If so, how do you get rid of gastritis when it is caused by bile reflux? How do you get bile to stop refluxing into the stomach.




Thank you for your help.

[Kevin Pho, MD]

To answer your questions:
1) I am not aware of gallbladder removal leading to esophageal reflux, nor am I aware of studies linking the two.

2) There are some studies that suggest that cholecystectomy leads to bile acid reflux, with the surgery removing the reservoir function of the gallbladder.

3) Bile acid reflux and GERD can have an overlap in symptoms, including abdominal pain, nausea, burning, or epigastric pain.

4) The recovery time varies between patients.  In most cases, recovery time can range from a few days to a few weeks to a few months.

5) I can't make a diagnosis over the internet without examining you, but it is possible that what you are experiencing is related to the surgery.

6) I am not aware of removing the gallbladder leading to gastroparesis.

7) Sphincter of Oddi dysfunction is possible - you can consider an ERCP with Sphincter of Oddi manometry for further evaluation.

8) Diangosis of bile acid reflux is via an endoscopy.  The definitive treatment is done via surgery.  There are various medications that you can try - including ursodiol, sucralfate, or cholestyramine.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b