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Gastroenterology (Expert Forum)
Abdominal Pain after fatty foods-Post gallbladder removal
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Abdominal Pain after fatty foods-Post gallbladder removal
by olsonkl, Jul 21, 2003 12:00AM
I am a 33 year old female, and I just had my second child 6 months ago. I had my first painful attack of severe epigastric pain (presumed to be a gallbladder) attack about 2 months ago (which was 4 months after my birth of my second child). At the time of the attack, I went to the ER where I had sonogram and blood work taken. However everything seemed normal. Upon leaving ER, tentatively diagnosed with Gastritis, however GI cocktail did not stop the pain. Since this time, I went to see a gasteroenterologist, he tentatively diagnosed me with gallbladder problems and ordered a CCK HIDA scan. The HIDA scan an revealed a gallbladder ejection fraction of 22%. Based on the ejection fraction, the Dr indicated my gallbladder was bad and instructed me to contact a surgeon to have it removed. I had my gallbladder removed a couple of weeks later. Prior to my surgery, I did not have any more episodes of pain. However, I did note I was unable to properly digest fats, symptoms included: Nausea, gurgling of stomach & diarrhea. Therefore, remained on a minimal fat diet until surgery was performed. Pathology from my cholecystectomy indicated my gallbladder had chronic inflammation of the gallbladder and think yellow-green bile. After the surgery my ability to digest fats properly seemed to get worse. My symptoms included a more severe case of a gurgling of stomach and severe diarrhea after ingestion of fatty substances. In order to get around this problem, I resorted to elimination of fats from my diet, although I still had a few problems with diarrhea and GI indigestion. My doctor also prescribed Colestid and Metamucil, and this seemed to also help, but the problem did not go away if I ate very fatty foods. I have had an MRI and an ERCP (where they were specifically looking for a choledochal cyst). It turns out I do not have a choledochal cyst, but I am not sure they were looking for other problems that are related to my other GI issues. Now, about 2 months post gallbladder surgery and 2 weeks after the ERCP, I had my second episode of severe epigastric pain after eating the chicken (not the skin) from fried chicken. I again went to the ER where they ran blood tests and gave my the GI cocktail, again nothing worked (but pain meds) and did not see anything unusual in my bloodwork. My question to you is, what else could be causing this epigastric pain? Is it possible it could be pancreatitis or IBS? Would this have been evident in the ERCP, even if they were not specifically looking for it? (I think they may have only been focused on the bile duct) What is causing this fat indigestion? Is this normal post gallbladder surgery, what else could it be? Can you suggest any addition tests I could have done to rule out other problems? Thank you in advance for your help!!!
Doctor's Answer
by Kevin Pho, MD, Jul 23, 2003 12:00AM
, Jul 23, 2003 12:00AM
Hello - thanks for asking your question.
There are several considerations. The first would be the other causes of dyspepsia including ulcers, or inflammation of the stomach and esophagus. Another consideration would be Sphincter of Oddi dysfunction - which can manifest after a cholecystectomy.
I would consider an upper endoscopy to look for the other causes (i.e. ulcers or inflammation) of your stomach discomfort. A test for H Pylori would also be recommended.
If those tests come back negative, I would inquire whether the ERCP include Sphincter of Oddi manometry - this would be a test to evaluate whether any dysfunction was present.
To answer your questions, pancreatitis and IBS would not necessarily be evident on ERCP. Pain may be present post surgery, but not for this long period of time.
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.
There are several considerations. The first would be the other causes of dyspepsia including ulcers, or inflammation of the stomach and esophagus. Another consideration would be Sphincter of Oddi dysfunction - which can manifest after a cholecystectomy.
I would consider an upper endoscopy to look for the other causes (i.e. ulcers or inflammation) of your stomach discomfort. A test for H Pylori would also be recommended.
If those tests come back negative, I would inquire whether the ERCP include Sphincter of Oddi manometry - this would be a test to evaluate whether any dysfunction was present.
To answer your questions, pancreatitis and IBS would not necessarily be evident on ERCP. Pain may be present post surgery, but not for this long period of time.
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.
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My thoughts to you, is to keep pressing your Doctor's for information and Don't ignore your body. It's definately a Catch 22.... do you want severe pain in your back and abdomen from the gallbladder or do you want severe episodes of diarrhea for the rest of your life. I never really got all the information needed or the choice either.
Best wishes to you.
Jepcap- Are you still undergoing these tests for your liver? Do they believe it is something inherently wrong with your liver or just the lack of the presence of your gallbladder?
I am relatively new to this and this is so depressing to think of it as a lifelong problem.
One more question, this is the first time I have heard of caloric intake instead of just fats? Also I did not know exercise would help? Have you seen that a direct relationship exists? What types of foods have you found good/bad?
I've been having gall bladder attacks since December of last year. I've done about 3, or 4 gall bladder flushes (olive oil, lemon juice, apple juice, grapefruit juice), and I've passed some stones. I've had one sonogram done back in April, and when I had another one done yesterday, I had about the same amount or more stones (gall bladder is about 1/3 full). I have made an appointment for surgery, but I still think there's something else I can do besides having one of my organs cut out. I am also well aware of the side effects (loose bowels, gas...etc...) that can follow having the gall bladder removed. Does anybody have any ideas about what I can do besides surgery? Has anyone here ever gone to a natural/alternative health care doctor?For those who opted for surgery, do you regret your decision? HELP!!!!!!!!!!!
Note that throughout this process, I never had diarrhea or any serious episodes, just this nusiance of these dull-mild pains. I decided to visit an alternative medicine doctor. She determined that my digestive system is inflammed and I needed to change my diet to get the inflammation down. Removing the gall problem was not the solution, since it does not appear to be the problem. I know for years I had too much sugar in my diet, as well as breads and dairy. However, as I exercised frequently, I got away with this, save for the past few years when my frequency of exercise decreased.
Basically the doctor put me on the Atkins diet, except I can eat rice and some fruits (all except bananas, grapes), all meats except pork, and any vegetables. Sugar, dairy and wheat/oat/corn products are a no-no. The only fluid I can drink is water, which I must drink a gallon daily. I also take various supplements (Vitamin, Pryxidol?, chlorcaps and pancreas tablets) with each meal. I have been on this diet for exactly 30 days as of today and the gall bladder pain is nearly gone. I still have the chest pains but not as frequent. After removing the sugar from my diet, I lost 10 lbs in SEVEN days.
Please note I am of normal build (5'11, 200 lb) and have no history of health problem prior to this. My advice to anyone is to explore alternative medicine methods anytime they talk about cutting you open, especially if the illness is not life-threatening. Alternative medicine looks at the function of the ENTIRE body, and not just one episode. I think we all can agree it is a lot easier to change one's diet, versus having to adjust to the loss of an organ. Less painful too.
I have a follow up visit with the dr in 4 weeks so I will keep you posted. I am also visiting a GI specialist who also disagreed with the other doctors who insisted my bladder be removed. He wants to see how my whole system is functioing as well, given I do not exhibit the classic systems of a person with gall bladder functions.
Sorry for the long post, but I hate to see peoiple go through unnecessary procedures. Good luck to all
I had my gallbladder removed and was fitted with a drain to drain the fluid from the site. This stopped working within hours of surgery. After 4 days of crying in pain, the surgeon visited me on the ward and instructed the consultant to get me for a scan URGENT. Upon returning to the ward I was told the fluid was all in my stomach & if it wasn;t gotten out straight away, I would be dead by the end of the day. Straight back to theatre I went.
I was in hospital for 15 days from start to finish and 4 years later I am still in pain and have constant diarhea (diarrhea). I have been for yet another ultrasound scan this morning and will let you know when I get the results. I just wonder, if the drain had worked properly, would I be in this state now????? Any ideas????
Good luck to all who have this surgery.
Anyway...in response to the surgery or no surgery debate..let me first say that my daughter had no stones & no sludge in her gallbaldder. She had 2 EGD's including biopsies of her small intestine and a bile sample taken from her gallbladder. She had a small bowel follow though series done and 2 HIDA scans at 2 different hospitals. She saw 2 family doctors, 2 gastroenterologists and one surgeon. The first HIDA said 32% ejection fraction, the 2nd one 6 weeks later said 8%. The surgeon informed us that with no obvious problem with the GB that the surgery success rate is not as good as if you have stones, etc. We agonized over what the right thing to do was. It seemed that the people that posted here still had problems folling GB surgery & then the problem was worse. I just know that by the time my daughter finally had her surgery ( a year and a half from the first doc visit) she was unable to eat anything with pain. Who wants to live like that?
It has now been 9 months since her surgery. she is a junior in college & IS better...but does have part of her digestive system gone...& she still has reactions sometimes to things she eats. Stress plays a major role in her digestive system. ( Hmm.. college=stress) She would tell you that she is glad that she had the surgery, but would have been happier if it hadn't stopped working in the first place. since we don't really know why it quit, something else could rear it's ugly head in the future.
The best part of this site is all of the contributors...those that found solutions and those that haven't yet. There is nothing like being able to talk to someone who has been there, done that. Best of luck to those of you still searching for answers.
I've had gallbladder pains since December of last year. I opted not to have surgery, and so far, I am doing much better. I started taking digestive enzymes a long time ago, and lately, I added some herbs and vitamins that support the gallbladder and liver. A couple months ago, I had SEVERE gallstone attacks once a week to 3-4 days a week, but lately, I've only had one every few weeks. I feel much better. So far, I'm glad that I haven't had surgery.
You said it the best. There's nothing like having other
people in this world to relate with. Best luck with
your daughter.
Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out. Sure enough, the scan and tests prescribed revealed a diseased gallbladder....
4 years later, food digestion is still strange. I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal. There is not a day that goes by that I don't have discomfort after eating.
As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier. High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).
Maybe these things will help... and I wish you all better health.
Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out. Sure enough, the scan and tests prescribed revealed a diseased gallbladder....
4 years later, food digestion is still strange. I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal. There is not a day that goes by that I don't have discomfort after eating.
As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier. High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).
Maybe these things will help... and I wish you all better health.
Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out. Sure enough, the scan and tests prescribed revealed a diseased gallbladder....
4 years later, food digestion is still strange. I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal. There is not a day that goes by that I don't have discomfort after eating.
As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier. High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).
Maybe these things will help... and I wish you all better health.
Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out. Sure enough, the scan and tests prescribed revealed a diseased gallbladder....
4 years later, food digestion is still strange. I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal. There is not a day that goes by that I don't have discomfort after eating.
As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier. High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).
Maybe these things will help... and I wish you all better health.
Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out. Sure enough, the scan and tests prescribed revealed a diseased gallbladder....
4 years later, food digestion is still strange. I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal. There is not a day that goes by that I don't have discomfort after eating.
As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier. High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).
Maybe these things will help... and I wish you all better health.
I had my gallbladder out in '96 after years of chronic problems that had made life really awful for me. I was 23 at the time, and I had terrible pains in my shoulders which at the time I thought was bursitis. I had gotten cortisone shots and was considering surgery, I was nearly disabled. I had no idea that the problem was related to my gallbladder. In fact, at the time I didn't even know what a gallbladder was! I started having random episodes of stomach pain. It wasn't always after eating. I associated it with drinking diet drinks sweetened with aspartame, for lack of a better theory. I was on a diet at the time called Nutri-System and had lost 20 pounds. I had always been forty-odd pounds overweight and since high school had always been on some crash diet. The stomach pain came and went, as did the shoulder and upper back pain, and I just dealt with it and thought I would have to deal with it the rest of my life. Then I got married and the stomach pain got worse. I remember one night we ate fondue and I thought I was going to die! I still didn't see a doctor about it since I thought it was just a result of being overweight and eating the wrong things; and I was tired of being told to lose weight when I had tried and tried and couldn't. My doctor finally did do some tests to see if I had ulcers, and it turned out that I had a hiatal hernia, and I thought that explained it. I was given lots of tagamet and cimetidine (prescription antacids) and thought that would take care of the problem. But it didn't. It got worse. One day I was in so much pain I thought maybe I had pancreatitis or something. I read on the internet that people can die from that so I went to the ER. They did an ultrasound and found a big fat gallstone about the size of a robin's egg lodged into my gallbladder. I didn't hesitate to get my gallbladder out. It was infected, and my liver was affected by it. I should have had it out long before.
The procedure was laproscopic, and I had very little pain afterwards. For about two weeks my muscles were sore, but I recovered well and I have not had any problems since then. I have been taking a supplement that contains ox bile (I know it sounds gross!) I got from a nutritionist. Basically, he explained that the gallbladder provids an extra squirt on demand of bile when you need it, which is when you eat fat. I'm supposed to take the supplement with each meal. I did it for awhile, but I don't like taking supplements in general and so I don't always take it. But I'm still okay. I don't really notice any digestive issues, and all my shoulder and upper back pain is gone.
I've discovered the Atkins diet, which I think I actually have a prayer of staying on, but I was curious as to whether not having a gallbladder would slow down weight loss. Has anyone else noticed this? If the fat just goes "right on through" then the body might think it's not getting enough fat and it seems like that would skew the carb/fat ratio Atkins talks about. Maybe eating small amounts of fat throughout the day might help?
I don't regret having my gallbladder out at all, in fact I regret not having it out sooner. Actually, what I regret the most is the misinformation I got when younger about low fat dieting. There were times when I ate absolutely NO FAT for WEEKS and did not lose weight-- in fact I gained some! Although I felt like I was STARVING TO DEATH! If I were more paranoid I would think the whole lowfat diet thing was a plot invented by skinny people to torment those of us unfortunate enough to be genetically predisposed to putting on pounds.
So far, I've been on Atkins for 3 weeks, and I've only lost 8 lbs. I'm just wondering if it's been slow because of my gallbladder.
These symptoms have gotten worse over time. What I've noticed after observing my diet closely is that my digestive system acts up when I combine refined sugar and fats, especially high levels of sugar (e.g., 3 glasses of coke and a cheeseburger). When I suggested this to my doctor, she poohed-poohed me and said the cause was the levels of fat that I was ingesting. But I had carefully separated the two items in my diet, and fat by itself didn't cause the problem; sugar did.
About 18 months ago, I went on the Atkins diet (low carbohydrates, no sugar; higher fat) and no longer had any digestive problems after eating as long as I stayed on the diet. When I ingested sugar--too much, too fast--my digestive problems returned. Levels of fat don't seem to affect me--except in combination with sugar.
Someone recommended that I take acidopholus or multidopholus and since I started taking it, my diarrhea has subsided. I eat pretty much whatever I want but in moderation. I notice if I eat a lot at one time it upsets my stomach. I also learned that the nerves in your spinal column can effect how your organs behave. I found out that the vertebrae between my shoulder blades were out of whack and that I desperately needed an adjustment. Well I also found out that it's the nerves in that part of your spine that controls your digestive system. So, for those of you who have not had your gallbladder removed, and even those who have, you may want to start visiting a Chiropractor, and not just any chiropractor. Try and find a chiropractor neurology office. Also, if you still suffer from diarrhea, you might want to get your electrolytes checked. They just draw blood. My potassium was slightly low, but enough to effect me. My neurology chiroprator also suggest bile salts. It helps to break down the fat so your body can digest it more easily (according to him and what I've read about it).
As for whether or not I regret the surgery, it's hard to say. I am now 6 1/2 weeks post-op and am still recoving from both the gallbladder surgery and the c-section. I wish I would have done more research first, yet at the same time, it could have been much worse. I could have passed a stone that would have gotten lodged in the bile duct and became extremely sick. So there's always a plus and negative side to any decision one can make, especially when it comes to surgery.
Best wishes to everyone.
Has anyone experienced this?
Funny thing is now, I don't wanna eat, PERIOD. Since the week prior to my GB surgery to current I lost 14 lbs...I guess you can say that I am a non-intentional anorexic....Nothing feels ok when I eat..
Does anyone have suggestions on what to eat and how to control this attacks...I thought that if I got my GB out, I would go back to normal....I don't have the stabbing pain in my shoulders like I did, but the nausa and diarriaha is worse...
HELP!!!!
Karen
Has anyone experienced anything like this? If so, how painful is it to have the drain removed?
Thanks for any help.
Desperation