Post Cholecystectomy Problems

[Treb]

Beginning in July of 2006, I started having abdominal pain that at first seemed to be spread throughout my abdomen, but later I learned when the pain was severe, it was located mainly in the upper right quadrant.  The attacks did not occur with every fatty or greasy meal I would eat, rather, they would happen without warning every few weeks or so.  In between these attacks I would have other GI problems:  After eating, I would feel discomfort in my abdomen accompanied by gas (belching and flatulence) and bloating.  I would not have a normal feeling of satiety one experiences after eating.  Two to three hours after eating I would have an empty, hollow, feeling in my stomach like I needed to eat more.  The sensation was like hunger pains though not exactly.  
       In August of 2006 I went to see my PCP who at first thought I was suffering from lactose intolerance, but after going lactose free for two weeks it was determined that the pain was emanating from my gall bladder and that she would have some tests done.  The ultrasound in September turned to be negative (no stones, no sludge), but the HIDA scan done a week later had an unusual result:  The gallbladder did not even visualize.  The radiologist concluded I either had some obstruction in my cystic duct or the duct simply was not working properly.  My PCP then referred me to a surgeon, who, based on the symptoms I had been experiencing and the HIDA result, recommended a cholecystectomy.  
         The cholecystectomy was done laparoscopically on October 6th, and it accomplished one major result:  the absence of the occasional gall bladder attacks.  However, for about a month afterwards, I still had the same unusual GI symptoms I mentioned previously.  Abdominal discomfort, gas (again, both belching and flatulence), bloating, and the strange “hunger pains” two or three hours after eating a meal (sometimes large).  Many of these symptoms disappeared for about a month and a half but have recently returned.  Could these lingering symptoms be related to the continual flow of bile from the liver to the intestines?  Is this common after having one’s gall bladder removed and is there a treatment (surgically or medicinally)?  I would appreciate any advice or information you could offer.  Thank you.

[Kevin Pho, MD]

The removal of the gallbladder should have treated the symptoms.  If the pain and gas continues, you may want to look for other causes.  Normally, diarrhea or loose bowel movements after a fatty meal would be the residual effect of the surgery.  

You can consider more tests to evaluate the upper GI system.  This can evaluate an upper endoscopy to rule out things like an ulcer, GERD, or inflammation of the upper digestive tract.  I would also consider blood tests to evaluate for the bacteria H Pylori (which is associated with ulcers and inflammation).

If the continues to be concern about the biliary ducts, an MRCP can be performed.  

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.
kevinmd_

[arista6944]

I am 30/f and had my gall bladder removed about 5 years ago. In Sept. '06 I started having the same symptoms I had before the GB surgery (pain under my rib cage on right side, nausea, heartburn, etc.). I was misdiagnosed 7-8 times before they finally ordered an endoscopy and colonoscopy. After the procedures, I was diagnosed with Sphincter of Oddi and was given pain medication. The symptoms disappeared until about a couple of weeks ago (middle of January '07), and I have started taking the pain medicine again. Where do I go from here? I have done research on Sphincter of Oddi and it seems as though the next step would be yet another surgery, which can also lead to possibly more problems. Are there any alternatives? The pain is bearable most of the time, but I have had a few flare-ups that have literally stopped me in my tracks. I have lost my job over this, and I am afraid to start a new one if I'm going to have this on a regular basis. Please help.

[Tami3D]

Read the title "UPPER GI PRESSURE,PANCREATITIS,AND DIVIRTICULITIS". I responded to that. I had problems after my gallbladder was out and I explained what has happened so far.  Tami  

[Bektesh]

I had my gallbladder removed a week ago. I don't have any pain at all, but I suffer from fatigue and evern more worrying, I have yellow skin. When I wake up its less, then it further develops during the day and then almost dissapears during the night. Is this to be expected or is it something else? Please, help.

[Sweetater]

Jaundice is a symptom of what is called post-cholecystectomy syndrome.  Research on internet and you will find more information. This will sometime happen after you have gallbladder out.  If you are jaundiced, then you really need to see your gastro doc.  In my research, jaundice is related to liver symptoms.

Good luck.

[Bektesh]

Thank you for your advice. I had a CT on my liver and no major problems there. How is jaundice treated? I can't find much on Internet on its treatment.

[san1968]

HI I HAD MY GALBLADDER OUT 3 WEEKS AGO.I STILL HAVE THE SAME PAINS IN MY UPPER RIGHT RIBCAGE AREA WHICH GOES THROUGH INTO MY BACK.ON TOP OF THAT NOW I FEEL NAUSEOUS OFTEN AND SOMETIMES ITS REALLY BAD.I ALSO GET STOMACH CRAMPS FOLLOWED BY HOT FLASH AFTER EATING  FOLLOWED BY DIAREHA .IT DOESNT SEEM TO MATTER WHAT I EAT OR DRINK FOR THAT MATTER.DOES ANY ONE ELSE HAVE THIS PROBLEM??DOES IT ALL GO AWAY IN TIME??LIVING LIKE THIS IS WAY WORSE THAT BEFORE MY GALBLADDER CAME OUT!!!!!!!! THANKS FOR ANY ANSWERS

[mouse423]

hi there i had my gall bladder and stones in my bile duct removed 4 years ago, and was really ill aftere the surgery and have been ever since, i am in constant pain and have numerous surgeries since, i am unable to work and have been on medication ever since.  the meds i am on is a high dose of morphine as the pain is so debilitating,  i though i was the only one with this problem and i feel for each and every one of you as being a mother it is not easy way to live.  I constantly in pain i have diahorrea, have lost so much weight i now weigh about 50kgs, and all my friends are horrified at flatulence and the burping i have inherited.  Please if anyone has any comments for me email me on ***@****