What can I do to keep my gallbladder healthy?
Hi April 25th I was admitted to the hospital with RUQ pain, super awful it only lasted a few hours but they kept me for additional testing. In the AM the surgical team came in and told me I should have my gallbladder removed. The ultrasound I had was clean, the CT I had was normal, the MRI showed a 5mm bilary duct dilation. Every other organ was unremarkable, and a little edema along the inferior wall of the gallbladder. They couldn't see anything else and recommended a HIDA scan out patient with a follow up in 3-6 weeks. That being said, my liver enzymes were elevated and trended in the right direction by the 3rd day of my stay. I was discharged home April 28th. Since then I have had no pain, but I have had some bloating, on and off heartburn, some mild indigestion, and elevated ALT at 94. I retest this Friday. No jaundice no fevers, no more weird bowel movements but at first there was a lot of fat and yellow colored stool. Today May 16th I had extremely mild RUQ discomfort I wouldn't even call it pain, I suspect it may have been the incredibly large meal I had a moment of weakness and went off my gallbladder friendly diet. What can I do to help this? No fever 97.7, no swelling I can't feel my gallbladder when I press my fingers in and it doesn't hurt when I press my abdomen. I do have some heartburn, and my back hurts. The thing is my back always hurts I missed my chiropractor appointment and it's been hurting for days until I can be adjusted again. I just don't feel like I did when I went to the hospital originally. I'm not jaundice but I am really worried. The elevated ALT after all my other numbers returned to normal is super concerning but no bile ducts were blocked. What do I do from here and how likely are the chances of developing NAFLD after having your gallbladder removed? I read a lot of stories about people having worse liver enzymes after having their gallbladder removed. I don't want that to happen to me I'm already with the disease Pernicious anemia, which is why I'm so hesitant to get surgery if it's indicated. I left the hospital that day and did not take the surgery. I was hoping to check in with my team before doing anything. I have blood labs I can get done to check my clotting factors and stuff to see if I'm even a good candidate for surgery even laproscopic has the risk of open. Secondly another reason I didn't get the surgery is because I followed all my tests and the radiology report did not indicate much of anything just a lot of suspected things that they couldn't prove. perhaps I did pass a gallstone, and I finished the antibiotics after which I deeply struggled with, but the liver stuff seems to be resolving as time goes on. I had that huge meal yesterday and that's on me. But every day I log my food, I log my exercise, I log my weight once a week, and I log my temperature 3x a day. I have a gastroenterologist appointment but it's far away very far away it was the soonest they could get me in. But I am still pretty worried the extremely mild pain today level 1 terrified me I was so terrified it would get worse. I fully understand I went off my diet and that's on me and the gallbladder could be pissed off.
To recap here are my questions:
1. What do I do from here with my gallbladder diet? Am I just never allowed to enjoy pizza night with the family ever again even in extreme moderation?
2. Why would my ALT be elevated when all my other numbers went down? In the hospital my ALT was 52, upon followup it was 94, liver on MRI was noted as unremarkable.
3. How do I know if a blockage is back? Do I just wait for this mild problem to resolve or do I rush right to the ER and have them run tests?
4. Was I right not to get the surgery? Did I make a mistake?
If additional info is needed and test results let me know I'll upload them thank you
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I def would not have surgery with what you have explained. But you may just have to accept the fact that you can’t eat certain things. Have you given thought to seeing a functional medicine doctor? They see the body as a whole, not just focusing on one thing.
I wouldn't get surgery either at this point but if my ALT levels are not stable Friday they may suggest I get it removed again in an effort to bring those levels down. However, there is not blockage visualized currently and no one knows how it is draining as of yet the HILA scan would give a lot of insight. I have looked for a functional medicine doctor here a few times I haven't really found anyone with super great reviews or anything but I seriously would like to see one.
I am a 1%er.
i.e. 99% of all gallbladder surgeries go as planned with no complications, yet I am the other 1%.
That said, breathe! Breathe in. Breathe out. It's one of the more common surgeries and become merely a boring footnote in most people's lives. So, first thing you need to do is relax a bit. I get the anemia puts you in a somewhat different class, but considering you don't have a fatty liver, I'm going with you have other things going for you too. Mostly you're young enough not to have a fatty liver. (I know. Middle-aged people don't consider themselves young, but a a third of the world disagrees. lol) Chances are good you'd be a 99%er.
I know this sounds weird because something did go wrong with me and you're probably thinking I'm telling you to go for it. On the first part, right. I get how bad it can get. I'm disabled with chronic pain, (and across two quadrants, so I don't fit with the handy charts either), but from what I've learned since, I'm on the good end of being a 1%er.
BUT it's not like there are two choices. There are four choices and you don't even know that yet.
1. Get it done, because they said so.
2. Find out why they said so.
3. Don't get it done.
4. Go for the alternative, if they answer the second one like I think they will.
First thing to know is why do they want your gallbladder out? I know three reasons — gallstones, pain in upper abdomen, (sometimes pancreatitis), and it's dying.
Well, if it's dying, get it out because when it does die it will cause gangrene which is a big thing to worry about. (You'll die.)
If it's pain, having it removed ends the pain usually. (Then again, no one knows if that pain would have continued, or for how long.)
BUT if it is gallstones, go for the alternative they never mention unless the patient becomes like me. Gallstones are simply an excess of bile that solidifies in the gallbladder over time. (The majority of people have some by the time they're middle-aged. Matter of fact, they usually hit if you are "female, fertile, forties, and fat." I had just taken off my fat the year before. Go figure. Although, oddly enough most of the people I know who had it removed are men. Most autopsies prove gallstones, and yet that was never the person's complaint or cause.) Sure enough, GIs can take them out without cutting.
Since you made me google a bunch of words you used, I'm going to do it to you. (lol) Same concept as an ERCP, except they can do something at the front of the camera, so it's called an MRCP. They can remove the gallstones by putting you into a light sleep, (or heavy sleep, since they stopped trusting the light sleep when I started living on pain pills), putting a camera down through your mouth all the way, (if you've ever had an endoscopy, THAT camera), to your gallbladder and sucking the stones out. Or picking them out. Never learned which. I slept through them. (lol)
No idea of the safety issues for that, but I know others who are 1%ers from gallbladder removal, but have never met anyone who got hurt from an endoscopy. Sounds like you're heavy into understanding the medical words, so feel free to investigate on that one.
The one thing you should not do yet is to panic. Find out why they want it out, and if it works fine, ask for Plan B. They may pretend not to understand, but you can always say something like, "You know after someone has their gallbladder out, but they're still in incredible pain four months later, so you decide it's worth pursuing, and then look for straggling gallstones through an MRCP? Yeah. Like that."
Considering I was never given that option pre-operation, no idea if it will work. But ever since I was a young middle-ager with a gallbladder, I really wish I knew that was a choice.
And, I hope my homespun humor relaxed you a bit. If anything could go wrong in life, it has happened to me or my husband. Between the two of us, the only thing we haven't been through — thankfully — is murder. Think of what else could go wrong — medically or criminally, and yeah. Probably lived through it.
A couple of our biggest, medically, were both becoming disabled within three years of each other and his heart attack was so bad it took seven months to recover. When he saw doctors for follow-ups afterwards more than one called him "the Miracle Man." (I'll skip where we were targeted criminally.)
Including the part where I became a 1%er in chronic pain from my gallbladder removal, I still think that part only rates as a C for average. Far worse can happen. And, thank God, far better does too. (Hubby and I are happily married 43 years later, so "far better.")
Please. Deliberately work this out, but don't let it work you over. I hope I helped in a different way than you asked.
Welcome to Mayo Connect!
There are quite a few of us with gallbladder problems.
Many of us have had it removed and still experience symptoms- especially after eating fatty foods.
There are also many who feel great afterwards.
Another group will wait and see.
I agree that you should discuss this with your medical care team.
As long as you don’t experience severe pain or illness you wouldn’t have to rush to the ER but contact your doctor.
Surgery is usually recommended when gallbladder disease is diagnosed when the patient is a good candidate for surgery instead of waiting until there is an acute emergency and the patient is not such a good candidate for surgery.
By the way, my husband developed acute pancreatitis secondary gallstones 6 months ago. He had the surgery and has done very well- except once when he ate a lot of buttercream cake!
I checked my eyes daily for jaundice. I check my skin daily for jaundice. I log my meals. I take my temp 3 times a day. Sometimes I have little twinges of pain or discomfort and it terrifies me because that was my first ever visit to the hospital and I absolutely don't want to go back and be in that position again. I know it's probably just my anxiety and I'm following the diet and just waiting for these doctors appointments. It's still spooky. So thank you for your reassuring and kind words! I appreciate you
Thank you for your kind words. In 2021 I went gluten free after periods of horrific pain and bloating. I look back at old photos of me and wonder why no one ever told me how sick I looked. I've been doing great on my gluten free diet and in fact a lot of my other chronic illnesses have improved because of this. I want to meet with my hematologist, gastroenterologist and PCP before the surgical consult just to make sure my liver is trending in the right direction and discuss non surgical options. I've heard that people get drains placed to drain their gallbladder or stents to make sure that it's draining correctly into the body. I was told that they do endoscopic procedures where they put a camera down the throat and go into the gallbladder to remove gallstones but the way the surgeon describe it to me when she first came into my room with her team of what I like to call vultures (bc they all looked at me with these wide eyes and terrifying smiles like I was meat) and explain to me that the only reason that they put the endoscopic camera in is to remove the gallstones in the bile ducts they'd never just go in and clear out the gallbladder. I'd like to find out why because it seems like if I only have four stones that were less than 3 mm each visualized in my MRI, why are there not other options to remove those stones? Is it possible that they'll come back despite following a low fat gluten-free diet if I change my lifestyle again and do really well because I'm 32 and was assigned female at birth, and overweight despite losing a ton going gluten free I still need to fix that. I'd fit into the female, fat, fertile. I'm on birth control but they didn't feel that was an issue. Pernicious anemia is weird in that I clot really well and also very poorly. I think it would be important to get a panel done before anybody cuts into my body just to make sure I'm not going to bleed to death or throw a clot. I too think I fit into the 99% but I would like to just make sure I've never had surgery in my life. I have never needed to the hospitalized and so every time I feel a little bit of discomfort where my gallbladder is or in my back or in my shoulder based on my other health issues who knows if it's my muscles doing their usual thing or if it's my gallbladder deciding to murder me again. I'm trying my best to just breathe and make it to these doctors appointments. Thank you for your kind words!