Post Operative Gallbladder Reflux

[princess7780]

I am four weeks and four days out from gallbladder removal surgery done lapro.  

Since one week out from surgery I have developed what my GP dctr and the ER diagnose as "REFLUX."  I have a very strong acidic/metallic taste in my mouth almost constantly.   I also have short ways of nausea that come and go.  I also woke up one night with severe chest pains and went to the ER where they checked out my heart (EKG and chest xray normal).   The Er doc said my muscles were spasming due to reflux.

My doctor has put me on Nexium (40mg once a day)to reduce the amount of acid in my stomach.  


My surgeron thinks that I am experiencing bile reflux because of my surgery.  I have never heard of this.  He is says it is very common (ie lots of his patients) for people to experience bile reflux for six to eight weeks following gallbladder surgery as their bodies are trying to ajdust to not having a gallbladder.  He said to wait it out and take some Zantac.

Here are my questions:


1) Do you agree with his conclusion???  Do you think I could experience this for a lot longer??

2) How do I know if what I am experencing is either acid reflux or bile reflux?  Is either of these common after gallbladder surgery?  What is the difference??

3) Is there anything I can do for this if it is indeed bile reflux?  Are there medicines out there that can reduce the amount of bile in your system or revert the flow of bile going into your stomach?  How in the world could bile be going all the way up to my esphogagus??  Did I have GERD before this operation or this is totally from the operation?

4) How long should I wait this thing out?  Can people never truly adjust to not having a gallbladder?  Will I have this reflux the rest of my life?

5) If it is bile reflux should I be taking Nexium?  Isn't Nexium for acid reflux?  I have read where taking a PPI for bile reflux can make the bile reflux worse because acid actually helps reduce bile..

6) Can't bile be real damaging to my stomach?

7)Is there anything relief out there for me?  I can't really see dealing with this the rest of my life.

Your honest opinion is appreciated.  

Thank you for your help.

[Kevin Pho, MD]

To answer your questions:
1) I cannot comment on the diagnosis without examining you.  I can say that bile acid reflux is possible in the scenario you have described.

2) Acid reflux can be suggested with an upper GI series or upper endoscopy.  The most definitive test is a 24-hr pH study.  Typically the diagnosis of bile acid reflux is made with the presence of stomach inflammation (via endoscopy) in the abscence of any other causes.

3) Surgery is the definitive treatment if bile acid reflux is the case.  Medications like sucralfate and Actigall can also be tried.

4) These are questions that you need to address with your personal physician.

5) Bile acid reflux is not normally treated with Nexium.  If you are concerned about bile acid reflux, you may want to consider the medications mentioned previously.

6) Chronic exposure to bile acid can damage the stomach lining similar the chronic NSAID use.

7) You can consider sucralfate and Actigall.  Another GI opinion to determine whether there is bile acid reflux can be considered as well.

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

[happee05]

I started to have problems with Epigastric pain when I was pregnant with my little boy in 2001.  After he was born it was discovered that I had Gallstones, after a couple of months of being in and out of hospital i had my gallbladder removed in November 2001.  Everything was great after that, and I got on with my life and looking afetr my son, unitl June 2002 when I got severe pain in my abdo just like the pain of the Gallstones, I was sent for an ERCP, which was absolutely dreadful as I could feel everything they where doing to me, anyway back onto the hospital ward and a few hours later had severe pain to which I was told I had delveloped Pancreatitus (pancreatitis) caused by the ERCP, I was seriuosly ill with this and was discharged from hospital 3 weeks later just in time for my wedding!!!
After a few months again the pain returned and i was taken to hospital and after some very strong pain relief I was allowed to return home.  I had investigations which turned out to be ok.  Then in 2003 I had a the pain yet again and also had an endoscopy which revield i had a hiatus hernia nd Gastritis.
In 2004 again throughout the months of being in and out of hospital, having ct scans etc, proving nothing.  Then 4 weeks ago was again taken to hospital which turned out to be Pancreatitus (pancreatitis) again, I would like to point out that I hardly ever drink alcohol.
I have today had another endoscopy which revield again a hiatus heria and gastrits.
Since having the Gallbladder op I have been taking 30mg of Zoton daily.
Why does this pain keep reappearing and why do I keep having reoccuring pancreatitus (pancreatitis)??  Is anybody else the same??  The pain just feels like it did when I had gallstones when I have an attack.

[joshua351]

A related discussion, Postoperative gallbladder pain was started.