slow functioning gallbladder questions

[hollyd28]

I have been sick for 4 years.  It began with episodes of nausea that would come and go with hot flushes and sweatiness and discomfort right between my ribs about 3 inches above the navel.  Then it progressed to chronic nausea (sometimes very severe), poor digestion, fatigue and some discomfort at my lower right ribcage.  I had many tests done 3-1/2 years ago, gastric emptying, barium swallow, 2 endoscopies, abdominal CT scan, abdominal ultrasound.  Everything was normal except constipation noted on CT scan and slight inflammation of duodenum on barium swallow (but endoscopy showed no notable inflammation).  I went from doctor to doctor and none found anything wrong.  Finally, I found a gastroenterologist a few weeks ago that ran another ultrasound and a CCK HIDA Scan.  The ultrasound was normal, but the HIDA Scan showed my gallbladder functioning at only 20%.  The CCK administration however did not duplicate my symptoms.  The doctor recommended surgery, but I have some questions and would like a second opinion.
1- Is nausea a typical symptom of biliary dyskinesia?  I am nauseous most of the time, not only when I eat, and it doesn't seem to matter what I eat.  Most of the time, right after eating, I get more nauseous.  It is like to food is not going down and just wants to come back up. Some days are worse than others.
2- Will having surgery get rid of the nausea?
3- Are there any natural or allopathic treatments that I can do to get my gallbladder function back without having surgery?  Someone told me that they took UDCA (ursodeoxycholic acid) for a few weeks for a gallbladder functioning at 18% and when they repeated the test, the function was normal.
4- What types of side effects are possible with the surgery?  I have heard some horror stories, and other stories where everything went fine.
5- I read that 90% of people who have their gallbladder removed end up developing diabetes later in life, is this true?
6- I know that the gallbladder aids digestion by concentrating bile.  How will my body be able to digest normally without a gallbladder?
Thanks so much.  Sorry for all the questions, I just want to make an informed decision.

[Kevin Pho, MD]

To answer your questions:
1) It is possible that nausea can occur with biliary dyskinesia - however many other diseases can present with nausea as well.

2) It's possible that surgery can cure the nausea.  With a low ejection fraction, some studies suggest that removing the gallbladder may lead to a resolution in symptoms.

3) There are no controlled studies suggesting that natural treatments can help the symptoms.  Ursodiol is used to dissolve stones and will not help a low ejection fraction.

4) As with any surgery, infection and bleeding are the most immediate complication.  As mentioned below, diarrhea can be a longer-term side effect.

5) I am not aware of diabetes being a long-term effect of the surgery.  

6) Digestion is normally not a problem with the removal of the gallbladder.  The explanation is eloquently stated in the comments below.

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

[surgeon]

1) Nausea is a very vague symptom and can occur with nearly any abnomality within the abdomen. Which means it could occur with biliary dyskinesia, but it's not at all specific
2) It's possible surgery could get rid of the nausea; however, the fact that the CCK didn't reproduce your symptoms, and that the ejection fraction is only slightly low suggest to me that it's a long shot
3) No, not as far as any proof is concerned. Ursadiol is for dissolving stones. Changes in ejection fraction from day to day are very non-specific.
4) Most people have no side effects. The most common side effect, if any occur, is diarrhea, especially when eating fatty foods.
5) Absolutely untrue
6) Bile is needed for proper digestion. Without a gallbladder, all the bile you ever made is still made, in the liver. It drips constantly into the intestine, rather than pulsing in with gallbladder contractions. Since we eat regularly, constant bile works fine. The gallbladder was designed, in my opinion, for the days when people went days between meals while they hunted. Most people have perfectly normal eating/digestion without a gallbladder.

[KaseyT]

Myself and 3 of my friends all had gallbladders removed with the last 2 years and we are all doing well. We all had varying symptoms. One had an infected gallbladder with severe pain after eating. Another had pain, sweats, nausea, passing out, etc.  I had very slow digestion and bloating.

After removal,as the Surgeon said, the bile just kind of drips into the intestine all the time so you need to eat regularly and not skip too many meals to give the bile something to work on.

You may also want to check out this web site:
http://www.liverdoctor.com/Section4/gallbladder.asp

[charchar]

hi , I have a daughter that has had her gallbladder removed because it wasn't functioning right. She first went into the hospital because she could not stop throwing up her meals , no matter what she ate it would always come up. They tried all kinds of meds and nothing seem to work. so we were hoping  that taking her gallbladder out since it wasn't working properly that it would solve her problems...WRONG!! She spent 9 days in the hosp. and was sent home still vomiting and was told to watch the weight and drink alot of water so we did so. 2 days later from being out of the hosp. she was eating dinner and 10 minutes later she was in this severe pain ...we didn't know why so we took her back to the hosp. and they said she had pancreatitis ( she has never been a drinker ) They put her in the hosp. and took all food and water away and just gave her iv fluids and pain meds. She was in for 5 days and just got worse and worse ,so they sent her to ok.city and they put a  central line and started tpn and fluids . Her enzymes came down and she was feeling better. She was there a week. This whole time she was on a dilaudid pump .They took her off and sent her home the next day. She couldn't get warm and she would sweat like you wouldn't believe ...we didn't know what was going on ... The very next morning from leaving the hosp. she was put back in for narcotic withdrawls. This child never seen a drug in her life unless the doctor precribed it after surgery. Now she's addicted?????? Well we got over the withdrawls after 3 more weeks in the hosp. But now our problem is she hurts so bad in her abdomin (abdomen) that we don't know what to do ..Her dr. said she did'nt know what else either so they are sending her to dallas next week. All her blood test came out normal except her liver is elevated some but her doctor said that was probably from the lortabs that she is now on to control the pain. This child has spent 45 days in the hosp. this summer.Are we ever gonna get to the end of this ?? They have never done a colonoscopy ... Does that sound right? Sometimes her amylase and lipase are elevated and othertimes they are normal. But the pain is still there so bad that she can't even walk. We have never heard of this(pancreatitis) until now. She is 19 yrs. old and weighs 105 at this time but has been down to 98 and she is 5'3" . I'm really worried that something is really wrong and they're just not finding it. Maybe we'll have better luck next week with the specialist. If anybody has any information it would greatly be appreciated. thanks...worried mother.

[Criddle244]

A related discussion, Unidentified cause for sickness was started.