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Avatar universal

Is my partner's gallbladder removal really necessary?

About five months ago, my partner started to experience intensely painful attacks which happened 2-3 times per week and could last anything from 20 minutes to four hours. They can happen at any time of day, onset is very rapid and the pain goes away equally suddenly.
At first we thought it was an ulcer but when Zotan (a proton inhibitor) had no effect, he was given a variety of blood tests. He tested positive for H. Pylori (and also showed elevated levels of a liver enzyeme, but on re-testing the level was nearer normal & the assumption seems to be that this was a red herring).
After further attacks which occurred after drinking milkshakes with a high fat content, we thought of gallstones. He had ultrasound and a number of very small stones could be seen on the scan. At the same time he went on an ultra-low-fat diet which appears to be controlling the attacks. He now has attacks less than once a week on average, and those that do occur seem mainly to happen after he has consumed more than 10gms of fat. Saturated fats seem to be worse than unsaturated.
Given the ultrasound and the effect of the low-fat diet, we were pretty confident that the attacks were due to gallstones. However yesterday we spoke to the surgeon who is due to remove his gallbladder on 21 November, and were shocked to be told that his pain was on the wrong side for gallbladder. The pain had been written up in his medical notes as being on the right, but in fact it is on the left, towards the front of the ribcage under the left breast. During an attack he sits in the shower directing cold water onto this spot which gives some relief (he also belives this area feels swollen and tender during an attack, but I can't tell a difference). He also has back pain during an attack, but says it feels more like reflected pain.
Hearing this, the surgeon said that removing the gallbladder may stop the attacks but he couldn't guarantee anything. We asked what other tests and diagnoses were possible, but the surgeon said there were no more tests that could be done, and the only other possible diagnosis was Irritable Bowel Syndrome. Is this true? Should he go ahead with the operation when the pain is on the wrong side?
NB. My partner is male, 38yrs old and overweight (less so after three months on an ultra-low-fat diet!). He has had problems with digestion all his life, not to the point of seeking medical intervention, but he experiences things like diarrhea, discomfort and bloating more often than an average person. As a child he had some kind of stomach or intestinal problem (no one can remember exactly what) which was treated with massage. Said treatment seems to have had no effect other than putting him off massage for life.
5 Responses
233190 tn?1278553401
Surgeon has kindly addressed your question in his comments below and I agree with his assessment.

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.
Avatar universal
so,did he get treated for h pylori infection??
Avatar universal
Hi there... I'm no doctor but I'm going through some fun with my gall bladder right now.  In fact it's coming out on Tuesday.  Anyway, there is another test that he can have done that will definitely tell if there is a problem with his gallbladder.  Tell his doctor to have a hida scan done.  It's a test to see if the gall bladder is diseased.  You can have stones and not have any symptoms, and you can have no stones and have a totally useless gall bladder because it's diseased.  That was my situation.  My ultrasound came back negative for stones... so I had a hida scan done and that showed my gall bladder to be diseased.  I wouldn't have his gall bladder removed without doing it...
Avatar universal
Like a lot of tests, HIDA scan is useful if it shows something: what it does is show if, at the time of the test, the gallbladder is functioning normally or not. It can be perfectly normal in a person whose symptoms are in fact due to the gallbladder, because in many cases, as soon as the attack is over, the gallbladder tests fine. Likewise, in humans, nothing is 100%. The textbook case of gallbladder pain is on the right. In some, it can be on the left. In fact, lots of gallbladder problems are diagnosed in the coronary care unit, where someone has been admitted with left chest pain to rule out heart attack. In the case of your partner, it's important to be sure it's not the heart. If not, then given stones, episodic pain, relation to fatty foods, it's a pretty good bet it's due to the gallbladder. As to necessity for surgery: the main reason to remove the gallbladder is to relieve symptoms. If the symptoms are under control to the point that your partner would rather not have the surgery, then it's not carved in stone that he must. The other issue is that gallstones can do more than just cause pain: namely, they can cause infections in the gallbladder, or blockage in the bile ducts, or pancreatitis, which can be serious. The majority of people who have gallbladder problems don't have those more serious things, but the ones that do can get pretty sick. It's also true that the majority of people who have their gallbladders removed have minimal if any side effects from having it, and the recovery nowadays is pretty rapid. Unless there are medical reasons to think the risk is elevated, in my opinion when people are having symptoms from their gallstones, they are better off having the surgery. Given the somewhat atypical location of the pain, it would be reasonable to get another opinion if he feels the need; a gastroenterologist would be a good choice. Also, it's necessary to have ruled out heart disease. Assuming there's no other explanation, I'd say it's a case of  "it walks like a duck, quacks like a duck, has feathers like a duck." I'm thinking it's a duck.
Avatar universal
I have had similar issues.  My pain is definately worse after eating fatty foods (a milkshake almost landed me in the emergency room) but the pain radiates in both my left and right back near my shoulder blades.  I am scheduled for an ultrasound because the Prilosec that was perscribed does not seem to be helping much.  I still get the attacks.  I noticed this weekend when I stuck to a diet of chicken and rice the pain was much better.  My guess is that the pain radiates differently is different people (like your partner).
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