Gallstones - your experience?

[Tee35]

Hello –

I was sleeved nearly a year ago (9/10/14) and gallstones were discovered in April of this year after horrendous pain sent me to the ER. I have had a couple of attacks since then and am scheduled to have my gallbladder removed on Sept. 9^th. The pain is quite unbearable when an attack occurs. I know that I have some of the classic symptoms… upper right quadrant pain that radiates to my back, lower mid-chest pain, and nausea. But I also have pain right below my left breast, also starting from mid-chest which I can also feel in my back sometimes but on the left side towards the middle, pain when I eat sometimes, every once in a while there’s a sharp pain which seems like it’s at the end/bottom of my stomach. Then there’s pain in my upper abdomen, but I think that could be gallstone related. I have had two abdominal scans and they only show gallstones, which is good, but the other pains are bothersome, if not worrisome. The surgeon showed me my latest scan and he said my gallbladder is oddly shaped, looked sort of like an unshelled peanut. And the gallbladder butts up against my stomach which is a bit unusual, it’s typically a little further to the right, just below the liver. Sooo… maybe since the GB touches my stomach, I have additional pains. I was told that some people can experience GB pain on the left and not the right, but it’s not that common.

Anyway, my reason for this post is to ask any of you who have had, or have gallstones, what your experience has been. What were your symptoms?

Thank you in advance for sharing.

[Ann2]

Jeez! I had a single gallbladder attack 10 days after my VSG surgery, discovered that night at ER via an ultrasound that it was indeed gallstones.

My symptoms were NOT the classic "I'm dying! Worse than childbirth!" that so many people experience -- and it sounds like you experienced. Instead, my symptoms were just massively uncomfortable, although not horrific.

The pain (a dull ache started and grew) on the right side of my body (front) underneath my ribs at the bra line. Then the pain expanded around to my right back, around and above my right shoulder blade. And then I developed what was described as a "referred pain" on my left shoulder. It was weird -- like having a painful ferret moving around my torso.

So four weeks post-VSG surgery I had gallbladder surgery. It was performed by my bariatric surgeon. Yeah, it was a bummer to have a second surgery, but I recovered completely within a week. No problemo. Love my surgeon.

I've never had any other problems at all. No more pain. No digestive issues or diarrhea (like some folks have reported post-gall bladder removal). It just fixed the problem. Period.

Good luck to you!

Ann

[Tee35]

Hi Ann - Thank you for sharing your experience. I wish mine was straight forward. Perhaps after it's removed the other pains with go away as well, if there isn't anything else wrong. Glad all went well, and is continuing to go well for you!

Tee

[Kindle]

I've had 4 severe gall bladder attacks since my VSG. The first one occurred about 6 months postop and the others have been spaced several months apart. These are severe, want to die now, nothing makes it better, curled up on the bathroom floor, vomiting/dry heaving for two hours attacks. I am a vet tech and my vet did an ultrasound after the first attack which showed thickened walls and sludge but no stones. After this latest one I went in for some bloodwork which showed elevated amylase. My PCP thinks I probably have pancreatitis secondary to temporary or partial blockage of the common bile duct. Not to mention I have pain every time I eat after this last attack, so I guess the problem is progressing.

So I'm biting the bullet and getting a "real" ultrasound next week. It's funny because VSG surgery never phased me, but I am hesitant to get my gall bladder out. VSG has a 1-2% complication rate while gallbladder removal can result in 17-40% of patients having long term digestive/diarrhea issues. Don't like those odds at all and My mom is in that category and it sucks for her. But if my pancreas is being affected, I guess I've gotta do it. My grandmother nearly had a burst gallbladder and ended up dying from pancreatic cancer.

Let us know how things go for you. I'm interested to hear other responses as well.

[mtngrl]

I had the same symptoms that you did. I was trying not to have my gallbladder removed and went a few years with pain on and off. All the dieting I had done before the sleeve helped stones form. I was full of them and had to have a second endoscopy procedure done the day after the gallbladder was removed, to take stones out of my bile duct.

I recovered quickly and did not have any problems eating any kind of fats after surgery. Now I wish I had done it earlier as all my fears for post op complications never happened.

[Tee35]

Hello Kindle and mtngrl. Thank you very much for posting. I thought some of the pain I have been experiencing was from pancreatitis, but my blood work was normal in that respect. The fact that gallstones can lead to pancreatis, along with the horrible pain, made it quite easy for me to opt for the surgery. My VSG was my very first surgery and I was really afraid of going under the knife as they say, but all went well. I've given no second thought to the gallbladder procedure and believe that the benefits outweigh any issues, at least for me. I know several people who have had their gb removed. Most have had no issues. One had diarrhea for nearly one year whenever she ate fried foods. But for the most part, no big complaints. Most were simply relieved to no longer have to suffer.

Thank you again, and I will keep you posted.

[Heather1979]

I'm just over a year out and I too have Gaul stones and am due to have my Gaul bladder out . I had the paramedics out a couple of times because the pain was that bad. Unfortunately it seams that it's the normal thing to suffer with Gaul stones after having the sleeve !! Hope everyone who's having surgery goes well .

[Dogofna]

I had my gallbladder removed 6 months after having my first child. The worst pain ever. Like a dagger going through you. You will feel so much better after. Just eat light for now.

[webby52]

I was sleeved 8/13, and almost a year later had a massive GB attack that landed me in the ER on last day of my vacation in another State 4 hours from home. About 6 hours later I was wheeled up to the OR only to wake up in recovery still with GB in me. Apparently to my dismay the omentum was so thick the surgeon was unable to get to the GB to remove it. That and the inflammation, allowed me to go home the next day with a drain in my GB for the next 4 weeks while they waited for the swelling to subside. Finally a local surgeon was able to skillfully remove the gall bladder though he almost had to open me up. Now I have 9 holes in my stomach as he was unable to use the access my WLS surgeon made from my sleeve. Since then have had no complications from the removal, but definitely suffering from a major weight loss stall almost a year now, as well as depression, some gain and mood swings. Clothes have become tighter and after speaking to my surgeon I've been cleared to start protein shakes again though its become quite an issue with constipation. Trying to use a stool softner now before I blow out my colon again...hoping to start 4 shakes a day with a light dinner to get back on track.

[cbrydges7]

I had some pains. Went to the bariatric surgeon becuase im a hypochondriac now and he did an ultrasound and found out before it was bad.

[Kindle]

Well, it's official. I have gallstones. One big one and a whole pile of tiny ones. It's the tiny ones that cause the problems....when they get stuck in the duct. So I'll consult with a surgeon in the next few weeks and try and schedule for the Wednesday before thanksgiving. That way I only have to miss one day of work (my entire life revolves around not missing work ). Meanwhile fingers crossed I don't have any more attacks or end up needing emergency surgery.

[Ann2]

Good luck, Kindle.

[Tee35]

Good luck to all who are due to have the GB procedure. I'm still in recovery mode and am having abdominal pain maybe 70% of the time. Seems digestive related as opposed to pain from the surgery. Yet another thing to have checked out. Bummer, but hanging in there.

[xxtac66]

I'm 3 1/2 years past vsg and have just started having gall bladder attacks. I did not know what it was at first and now they are coming more frequently. I had no idea that I would have issues with my gallbladder after being sleeved. As you can imagine three and a half years later, the onset of this is quite disturbing. I want to keep my gallbladder so I am doing gallbladder cleanse. Has anyone tried this to remove the gallstones versus surgery, have you had luck?

[Kindle]

The flushes/cleanses absolutely do not work. See the explanation below. Sure, some sludge or tiny stones may pass, but large stones will not. Its like having a softball in you stomach and expecting to poop it out as long as you take enough laxatives.

If you want to try a non-surgical method, your only options are taking ursodial to dissolve the stones....and this can take years, if ever. Or break up the stones with radiofrequency/ultrasound into small enough particles so they pass through your ducts. The problem with both of these methods is that it is not a permanent fix. The stones are likely to come back.

Believe me, I research the hell out of my options because I did not want my gallbladder out. However, I am 7 days postop from surgery and I feel great. No problems. back to work after 4 days (could have gone back after 2) and haven't had any issues eating, drinking or doing anything else including feeding horses and other ranch chores. It's like I never even had surgery.

The Truth about Gallbladder and Liver "Flushes"

Peter Moran, MB, BS, BSc(Med), FRACS, FRCS(Eng)

Gallbladder and liver "flushes" are widely advocated as a way of treating gallstones and helping with medical conditions ranging from allergies to cancer [1-4]. In the usual “flush,” half a cup or more of a vegetable oil is consumed together with citrus juice and Epsom salts (magnesium sulphate), usually after a brief fast. Many green, brown, yellow or black blobs of various sizes may later appear in the bowel movements. Some bear a slight resemblance to gallstones, but they are not stones. They are merely bile-stained "soaps" produced by partial saponification (soap formation) of the oil. A recent demonstration found that mixing equal volumes of oleic acid (the major component of olive oil) and lemon juice produced several semi-solid white balls after a small volume of potassium hydroxide solution was added. After air-drying at room temperature, these balls became quite solid and hard. When formed in the intestine, these objects absorb bile and become green [5]. It has also been shown that red dye will appear in the interior of the “stones” if consumed with the oil [1].

The fact that the material is due to some kind of transformation of the oil is clear from user descriptions and ultrasound images. The most obvious evidence is that the alleged “stones” float on the toilet water [2,3,6], as might be expected of a largely oil-based substance. Gallstones sink. Patients with medically diagnosed gallstones may be able to confirm this for themselves by looking at their own ultrasound scans.The stones, if free to move, will settle at the lowest part of the gallbladder, even though bile is much denser than water. The picture to the right shows a cross-section of the gallbladder (the oblong black area) with three moderately large stones in the lowermost area.

Supporters of the flushes claim that although some kinds of stones sink in water, cholesterol stones, being composed of lighter material, will float [2,3].That's not true. Cholesterol stones can display some buoyancy while in the gallbladder, but only by floating between the older, concentrated bile lying in the lowest part of the gallbladder and the fresher, less concentrated bile above. Radiologists can use this “layering” effect to determine whether the stones are likely to be mainly cholesterol and thus suitable for gallstone dissolution using bile salts such as ursodeoxycholic acid. The same stones will sink in water and also in the slightly denser formol-saline preservative commonly used in operating rooms when saving the stones for the patient or for laboratory analysis. This is why people accustomed to handling real gallstones simply know that they always sink. Other clues about the true nature of the "stones" include:
•They tend to dissolve into an oily smudge in time, or with heat [5]. Patients are advised to keep them in the freezer [1,2]. Gallstones are stable.
•They have an irregular globular shape and in the many available photos [4] never display the sharply facetted appearance that gallstones often have when rubbing up against each other in an overcrowded gallbladder.
•They are usually described as soft [7] and waxy or “gelatinous” [8]. Real gallstones are often very hard and difficult to crack. Softer gallstones always have a fine, crumbly, dry texture.
•Gallstones are thus difficult to cut cleanly with a knife, unlike the “stones” shown at http://curezone.com/ig/i.asp?i=7072.
•They may be bright green and possess a translucency never seen in gallstones.
•They can be produced in amounts far beyond the capacity of either the gallbladder or the entire biliary system, as long as flushes are continued and regardless of whether the user still has a gallbladder.

Could Gallstones Be Expelled?

It seems likely that gallstones might occasionally be expelled. Small stones are regularly expelled from the gallbladder. There is some risk that stones over about 5mm in diameter will lodge in the bile duct, but most pass on into the bowel and out of the body unnoticed. Gallbladders may spontaneously empty themselves of small stones, but this is rare [9].

Also, the large oily meal would stimulate strong gallbladder contraction. This could help expel small gallstones or even, very rarely, a whole crop of small gallstones or sludge. Whether the whole ritual is needed is another matter. A meal of fried fish and chips, or the “whole fat milk and a Mars bar” sometimes used to stimulate gallbladder contraction during x-ray examinations might serve as well.

The magnesium sulphate (Epsom Salts) could have an added effect, as it also stimulates gallbladder contraction and relaxes the muscles controlling the release of bile into the intestines. However, it acts in the same way as would fat or oil, causing the release of cholecystokinin from the upper small intestine [10]. The availability of that hormone and the ability of the gallbladder to respond to it would be limiting factors. The chance of success is further diminished by the fact that patients with symptomatic gallstones often have impaired ability of the gallbladder to empty (a factor in gallstone formation), stones that are too big to pass, or a blocked gallbladder duct (the “non-functioning gallbladder” in contrast studies).

Moreover, it can be predicted that even if occasionally successful, most patients would go on to form more stones. After successful dissolution of gallstones with ursodeoxycholic acid, 30-50% of patients form new stones within five years [11]. Despite much research, no simple, safe, or dietary measure has been found to prevent gallstone formation. The traditional fat-free diet has shown no consistent benefit [12], possibly because an occasional fatty meal helps expel small stones or sludge. This may be why patients on prolonged intravenous feeding are prone to develop gallstones.

In a popular variant, large quantities of apple juice are consumed in the days prior to the olive oil and lemon juice (or equivalent). Its supporters claim that apple juice is a stone solvent [13], usually offering in support a reference to the prestigious medical journal, The Lancet [14]. The cited item, “Apple juice and the chemical-contact softening of gallstones,” is merely a brief letter to the editor stating that the writer's wife had passed soft, brown, “fatty stones” after drinking a lot of apple juice and then a cupful of olive oil, apparently as part of a gallbladder flush. This source offers no evidence that apple juice can soften gallstones. Actually, there is no way for apple juice or any other agent taken by mouth to come into contact with stones in the gallbladder or bile ducts. A very effective sphincter muscle prevents intestinal contents from leaking back into the bile duct or gallbladder. Thus there is no logical reason to believe that any of the materials consumed in the "flushes" (oils, fruit juices, magnesium sulfate) could soften or otherwise affect the characteristics of gallstones in the gallbladder or bile ducts. Bile salts such as ursodeoxycholic acid can do so, but they must be absorbed into the blood stream and processed by the liver before they can affect the ability of bile to dissolve cholesterol stones—and a minimum of nine months of treatment is usually required.