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4 years after clearing HepC I'd had for 37 years, I need my gall bladder taken out?

Hi. Has anyone had their gall bladder removed and not ended up with chronic diarrhea for the rest of their life? I had HepC long enough for it to leave me with cirrhosis; to be precise, "coarsened hepatic echotexture with a nodular contour consistent with cirrhosis", from my ultrasound 8/16. Also re the gall bladder polyps, "In light of its size surgical consultation is suggested although this could reflect the spectrum of cholesterolosis." I've feared this day was coming. I'm not afraid of the surgery, I'm afraid of all the problems people have afterwards. I've been reading forums all night. I'm not having any symptoms. I don't want to start having gall bladder attacks, but if I could just have some hope I wouldn't end up with chronic diarrhea for the rest of my life I'd be fine. I wrote down a couple of medications people take to stop it. I'm 63 and have an active lifestyle sailing with a new guy I've been dating since May. Chronic diarrhea would ruin everything and likely end the relationship. My surgical consult is September 26. Thanks, you guys. Please don't be too harsh.
3 Responses
683231 tn?1467323017
Diagnosed with cirrhosis in Jan 08 after being infected with hep c for 30 years.

Gall bladder removed in 2012 due to gall stones and multiple gall bladder attacks.

Treated and cured Hep C last dose May 2015 was infected for 37 years.

No chronic diarrhea. Have had esophageal varicies that needed banding. Low platelet count and some ascities.

Gall bladder attacks suck
2 Comments
I turned 60 in March and work full time

If a medical problem would ruin the relationship you may have the wrong guy
Thanks for your input. We’ve only been seeing each other for 3 months, so we feel this is a “Yeah, let’s see where this goes” point or “No, I don’t think so” point. I have other medical issues he’s cool with, but this isn’t a dating forum so I’ll stop there.

I have an active lifestyle I would have to give up if I had chronic diarrhea, and the thought of having chronic diarrhea is depressing beyond words.

No gallbladder attacks yet, but I hear they’re horrific.

Do you feel with our multiple issues - damaged liver and resulting complications - you really need a specialist beyond just a GI doctor? The one I’m seeing for the surgical consult referred me to the head of the Liver Center at one of the best hospitals in the country when my third attempt at treatment caused retinal hemorrhaging. The head of the Liver Center got me cured. The doctor here knew I got well but never called me in for follow-up.

Two years after cure I went back to head of the Liver Center to get on a transplant list, and he was very angry with my local doctor for not having ordered ultrasounds every 6 months since I got well. So I sort of don’t trust my local doctor to leave a bile clip on or to do something that would have prevented chronic diarrhea unless this is a pretty straightforward surgery.

The head of the Liver Center is also a specialist in gallbladder diseases. I trust him 100%. It would be challenging because it’s a 2-hour drive and I’ve read where people end up in the ER with problems after this surgery or is that unusual? And these are not people with liver disease or cirrhosis. Am I worrying too much or are my concerns legitimate?

I know I have to decide, but any input is welcome. I tend to worry too much?
683231 tn?1467323017
I would think the emergency room visits post gall bladder are not common. For most people gall bladder surgery especially when done laparoscopicly are well tolerated.

As for post hep c treatment follow up I see a hepatologist associated with the University of Washington liver center in Seattle. It is about an hour to 90 min drive in traffic for me.

Standard follow up for patients cured of hep c with cirrhosis per the AASLD is at minimum blood testing every 6 months along with abdominal ultrasound to look for early indications of liver cancer (HCC) as we continue to be at increased risk although with cure that risk is greatly reduced. Prior to cure our risk of HCC was about 5% per year.

This is how you should have been followed before you were treated with having cirrhosis.

Specifically, I have CBC, liver panel, and AFP tests done along with the ultrasound. AFP or alfafeto protine can be a liver tumor marker if elevated. It is not a perfect tool so it should be used along with ultrasound or other medical imaging.

I have had upper endoscopies in the past the first was when I was diagnosed with cirrhosis showing grade 1 esophageal varicies. Two years later in my next endoscopy they were grade 2 and the next year they were grade 3 and required banding.

I was having annual upper endoscopies since 2013 to monitor for return of the varicies but since they haven’t returned and I am cured of hep c we are going with every two years.

On diagnosis with cirrhosis I was also immediately vaccinated against hepatitis A and B and advised to get my flu shot as soon as it is available every year as we are basically medically frail (even if we feel fine)

Have you had an upper endoscopy? Have you been vaccinated against hepatitis A and B?

With low MELD scores we really aren’t eligible for the transplant list. Most centers wait until you have a MELD of at least 15 with most transplants occurring around 30 or higher due to limited organ availability. There are about 6,000 people in the list with about 1,600 liver transplants occurring annually. My MELD is about 7. I still see a doctor associated with a transplant center as they are best equipped to monitor patients like us with ESLD. I only see my doctor once a year so the long trip is not really a problem. She gets my results every six months and I can communicate with her or her staff anytime through a web page called MyChart where I can also view all my results any time.

To qualify for a liver transplant other then being sick enough you also have to not have other serious health problems that indicate you may not survive the surgery and that you have a care giver to support you at home during your recovery.
2 Comments
It's good to know the ER visits post gall bladder removal are not common. My local doctor has not ordered any bloodwork. My PCP was ordering ALT-AST before I got well, but I didn't even think about the AFP marker! My PCP also orders CBC every 6 months to check my thyroid.

I was vaccinated for Hepatitis A and B, and I get a flu shot every year and last year a pneumonia shot. I just had an upper endoscopy/colonoscopy earlier this month and it all looked good.

The interesting thing today was when I contacted the hospital that cured me, they asked who advised I have my gall bladder removed and why. When I said one polyp was 7mm, the woman I was speaking to (not a receptionist and was very knowledgeable) said their hospital watches gall bladder polyps until they're 10mm in their cirrhotic patients. And get this: they don't even have their gastroenterologists do gall bladder removals in their patients with cirrhosis. Only their transplant surgeons do those! I also have an umbilical hernia, and she answered the question I asked you before I asked her by saying that gall bladder removal in patients with cirrhosis is not exactly a straightforward surgery. So I don't know if they verify they have a liver available before doing the surgery in case mine fails, but the hospital has sort of taken that question out of my hands, and I'm glad to let them deal with those decisions. I feel I have my transplant question answered. I'm sure I'll learn more when I go down there next month.

What a relief! She said I did the right thing by calling and made an appointment for me to see the head of the Liver Center next month, and before I see him I'm to have an ultrasound at THEIR facility so the doctor will have it to look at before our appointment. I'm to bring the report of the one I had done locally with me. They also use FibroScan. Both the head of the Liver Center and my local doctor have patient portal websites.

I verified with my daughter and her girlfriend this morning, who live within an hour and a half of the hospital, that one or both can come help me out whenever the surgery takes place. I love the city it's in, so it's a treat to go there. I can't believe how this all fell into place and am now mindful of foods my gall bladder may have issues with so I don't have an attack, hopefully, and can go a couple more years maybe before I have to have this done.

You have been so kind and helpful. I wish you only the best. Thank god I haven't developed esophogeal varices or ascites yet, and both doctors said I likely wouldn't. I'll consider this question answered even though I don't know how to close it. I'll let you know what happens after my appointment!
Yes I had my gall bladder removed when I had cirrhosis for several years. I figured as I was already having attacks I should have it removed sooner than later while my cirrhosis was compensated before it should get any worse. My doctor didn’t say anything about doing it at a transplant center just had it done in a regular hospital.

We are in fragile health with cirrhosis so anything we do medically is risky.

I have read for example we should avoid eating raw oysters but I do anyway from time to time.

I did have one complication post surgery I developed an incisional super umbilical hernia a lump in my abdominal above my belly button as a result of the surgery which I later had repaired.

Glad to hear everything sounds like it is coming together for you. It’s always a great idea to get a second opinion especially as you aren’t having gall bladder attacks.

Best of luck to you!
683231 tn?1467323017
“Post-cholecystectomy syndrome
Some people experience symptoms similar to those caused by gallstones after surgery, including :
tummy pain
indigestion
diarrhoea
yellowing of the eyes and skin (jaundice)
a high temperature (fever) of 38C (100.4F) or above
This is known as post-cholecystectomy syndrome (PCS) and it's thought to be caused by bile leaking into areas such as the stomach or by gallstones being left in the bile ducts.
In most cases symptoms are mild and short-lived, but they can persist for many months. If you do have persistent symptoms, you should contact your GP for advice.
You may benefit from a procedure to remove any remaining gallstones, or medication to relieve your symptoms.”


I am going to go with while  diarrhea can be a post surgery symptom it is not common and can be treated
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