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Borderline Gastroparesis -- Should my Gallbladder be Removed?
Here's my info:
* Diagnosed: Gallbladder Dyskinesia. No stones, HIDA/CCK set the EF at 19%. Note that neither an ERCP nor MRCP were done.
* Diagnosed: Very mild gastroparesis. 50% emptying time was expected at 70 minutes, mine took 80. Because it's such a low level gastroparesis, the doc said no medications are necessary. Managing with exercise, biofeedback, meditation, and a low-fat diet.
All pancreatic and liver functions were tested, everything look OK. Non-diabetic. Nothing odd in my immune system function. Late 20's, but no signs of demyelinating disease. Officially, it's idiopathic gastroparesis. Unofficially, a viral cause is suspected since symptomatic onset came after a bout with a prolonged flu.
Recommendation was to remove the gallbladder as this might help my gastric emptying. The gastroparesis symptoms (left-side stomach pain after eating, heartburn, bloating, nausea being by far the most common) do not show up whenever I take sufficient bile salts, so I'm beginning to suspect part of the reason for the gastroparesis is due to the biliary dyskinesia. However, I'm still reviewing this.
As per the gastroenterologist, I "stand a very good chance of improved gastric motility if the gallbladder is removed," though it might not resolve some of the symptoms, and is no guarantee that the gastric emptying will not again decrease.
For anyone who can analyze this information, what is your opinion on the matter? What do you suggest as a possible course of action from this point? I'm thinking an elimination diet to see whether the gastroparesis symptoms are exacerbated by anything in my current diet (maybe flouride?). I'm also introducing complementary medicine (acupuncture, specifically) into the mix.
Any thoughts are appreciated.
* Diagnosed: Gallbladder Dyskinesia. No stones, HIDA/CCK set the EF at 19%. Note that neither an ERCP nor MRCP were done.
* Diagnosed: Very mild gastroparesis. 50% emptying time was expected at 70 minutes, mine took 80. Because it's such a low level gastroparesis, the doc said no medications are necessary. Managing with exercise, biofeedback, meditation, and a low-fat diet.
All pancreatic and liver functions were tested, everything look OK. Non-diabetic. Nothing odd in my immune system function. Late 20's, but no signs of demyelinating disease. Officially, it's idiopathic gastroparesis. Unofficially, a viral cause is suspected since symptomatic onset came after a bout with a prolonged flu.
Recommendation was to remove the gallbladder as this might help my gastric emptying. The gastroparesis symptoms (left-side stomach pain after eating, heartburn, bloating, nausea being by far the most common) do not show up whenever I take sufficient bile salts, so I'm beginning to suspect part of the reason for the gastroparesis is due to the biliary dyskinesia. However, I'm still reviewing this.
As per the gastroenterologist, I "stand a very good chance of improved gastric motility if the gallbladder is removed," though it might not resolve some of the symptoms, and is no guarantee that the gastric emptying will not again decrease.
For anyone who can analyze this information, what is your opinion on the matter? What do you suggest as a possible course of action from this point? I'm thinking an elimination diet to see whether the gastroparesis symptoms are exacerbated by anything in my current diet (maybe flouride?). I'm also introducing complementary medicine (acupuncture, specifically) into the mix.
Any thoughts are appreciated.
You know, after your description of what happened with your husband, I'm actually wondering whether in my case it's something else. I'm not fatigued (I'm actually overtly energetic most of the time) and my skin is blotch free, so that part doesn't match. And, here's something more to add:
Recently my wife and I took a trip to Montana. During that trip, I almost didn't need my Prevacid medication (what I was on before Neksium): I ate all kinds of foods, including foods with gluten and fatty foods, and got almost no heartburn or bloating. (Well, except once when we went down to Cody, Wyoming and I ate WAY too much buffalo lasagna.) That made me think my issues might actually stem, at least partly, from stress. There I was under almost no stress at any point, and as soon as I returned home my symptoms started again, with a vengeance. Since all of this started AFTER I started getting panic attacks, I'm wondering if a good portion of this isn't psychological. (Talking to the doctor, he said that panic attacks do have an effect on autonomic functions, particularly in the digestive system, and suggested that I measure myself before and after my move. I'll be moving from a very large city where I know a few people to a smaller city where all of our family live.) Makes me wonder whether I should go on anxiety medications to test that theory out. Opinions?
Nevertheless, I plan on starting again going gluten free, since I've noticed I do better when I avoid most grains, including gluten-free grains like buckwheat or Irish oats, and instead eat more vegetables, fruits, nuts, and meat. I'm also wondering about the possibility of flouride sensitivity, since it's been shown that flouride can cause digestion slowdowns.
This brings me to my original question: to cut or not to cut. Based on the answers here, it seems the answer is "not to cut" just yet, since I don't really get pain from my gallbladder (ocassional bloating, very infrequently to the point of "pain"). I'll continue to seek other paths.
Any more opinion or information, however is appreciated, so if someone is reading this wants to chime in, I'm all eyes. I'll be updating this as I compile some more personal information.
Recently my wife and I took a trip to Montana. During that trip, I almost didn't need my Prevacid medication (what I was on before Neksium): I ate all kinds of foods, including foods with gluten and fatty foods, and got almost no heartburn or bloating. (Well, except once when we went down to Cody, Wyoming and I ate WAY too much buffalo lasagna.) That made me think my issues might actually stem, at least partly, from stress. There I was under almost no stress at any point, and as soon as I returned home my symptoms started again, with a vengeance. Since all of this started AFTER I started getting panic attacks, I'm wondering if a good portion of this isn't psychological. (Talking to the doctor, he said that panic attacks do have an effect on autonomic functions, particularly in the digestive system, and suggested that I measure myself before and after my move. I'll be moving from a very large city where I know a few people to a smaller city where all of our family live.) Makes me wonder whether I should go on anxiety medications to test that theory out. Opinions?
Nevertheless, I plan on starting again going gluten free, since I've noticed I do better when I avoid most grains, including gluten-free grains like buckwheat or Irish oats, and instead eat more vegetables, fruits, nuts, and meat. I'm also wondering about the possibility of flouride sensitivity, since it's been shown that flouride can cause digestion slowdowns.
This brings me to my original question: to cut or not to cut. Based on the answers here, it seems the answer is "not to cut" just yet, since I don't really get pain from my gallbladder (ocassional bloating, very infrequently to the point of "pain"). I'll continue to seek other paths.
Any more opinion or information, however is appreciated, so if someone is reading this wants to chime in, I'm all eyes. I'll be updating this as I compile some more personal information.
Gnorb, he's gluten-free, I'm not. We've kind of divided up the kitchen a bit and his side of the prep counter never gets 'touched' with anything gluten or with casein, since he's got cross-reactivity problems. We double wash things to make sure things are clean. So far so good. He's typically pretty good about not getting 'hit,' but if he misses something on labels we immedicately know it.
I do eat a lot of his gluten-free stuff, because it's good, but there are some things I do crave and we make sure those things are kept separate. The only thing I make sure to do is to completely clean the counter any time I use it, typically with chlorox or some other bleach product.
If we go to restaurants, he actually 'grills' the chef and asks for simple stuff - broiled or pan-fried stuff. Not on the grill because that could contaminate his food. Most chefs are pretty good about understanding the problem. I think in the last few years he's only gotten hit 2 times when someone really didn't understand the severity of the problem. We also use the dining guide to see if we can find gluten-free restaurants when we travel. And lately, we've been renting small condo's with kitchen facilities and doing a fair amount of our own cooking when I have to go to a conference and he accompanies me.
There are some things in restaurants you do have to watch out for - like french fries and the like. They could be floured to freeze them, or the oil could be contaminated. We've even found in the supermarket that we've got to be careful of shrimp - they're floured to freeze for shipping! UGH!
We've found that he has to be very cautious about cross-contamination - he's like the canary in the mine - very sensitive. We know immediately when he's been 'hit' - he goes downhill like a rock and just crashes. Then he needs about 12 hours of sleep, wakes up feeling drugged, and his head starts breaking out in blotches.
We've recently been ordering gluten-free oats from a company online and they're thankfully gluten-free. So we can make oatmeal cookies and all sorts of things with them, which has been wonderful. And with the products we've found at several companies, he really doesn't feel deprived at all. It was hard in the beginning, but now it just seems like 'everyday.'
And I've found some stuff from TreeHugginTreats that I steal from him! He's always complaining that there's a mouse in his 'bars.' Luscious.
Basically, we really didn't know he had a problem until about 5 years ago. Sure, he'd get tired at times - and it would be at strange times - and we couldn't figure it out. Every summer we'd head for Bonaire where I was teaching SCUBA diving to some local kids, and he's feel better for the time we were there. We couldn't figure out what was going on. We'd come back home, and things would slowly go downhill.
At first we thought it must be all the fruit he was eating down there????? But when we tried the same thing at home? No dice. Well, when we first started to go to Bonaire getting food was a little interesting.........the boat came in once a week and you'd race to the one supermarket in town and raid the shelves before everything was gone (about 2 hours later). So shopping was 'different.' I used to cook very simply down there and we used almost no bread, no flour - nothing fancy. Just basic stuff. Bought all the veggies from the local veggie boat. And you shopped almost every day for the veggies. They were fresh, so we ate a LOT of veggies, but mostly baked meat (chicken, goat, some red meat). We're not milk drinkers, so diary was almost non-existent. There was one small place on the island that made ice cream, so for a treat I'd get myself some at times, but not often. And my husband didn't like the flavors (changed according to whim) so he's skip it. I used oil to cook, didn't use almost any butter at all. Etc, etc, etc...........it finally dawned on us several years later that one big thing that was missing in our diet on the island was bread/flour/crackers etc. I approached my internist with the question about wheat, and he said no way. 'Your husband doesn't have the symptoms of that kind of problem' - which he didn't. But there wasn't anything else to explain it. I proposed it to him and he wasn't happy with the idea, but he thought he's cut out a bit and see what happened. Meanwhile, I started doing some research and found out about the studies done in Europe with Dr. Fine. I ordered the kit and presented it to my husband - who wasn't too happy. But he was even less happy when the tests came back positive! When we cleaned out the pantry he almost cried. And the first year he really went through a lot of 'mourning.' After that, when he started to feel better, he got angry - angry at all the hidden gluten. Angry at companies that don't label things correctly. Just plain angry.
But since he's been gluten-free things are so much better. His energy is back, his bowel habits have changed, and his skin don't blotch unless he gets hit. We recently switched his shampoo back to baby shampoo because we can't always rely on manufacturers being honest that they haven't changed their formula. Found out the hard way that they do it far too often.
Sorry, I'm babbling, but if gluten is a problem for you, you'll feel so much better when it's not a part of your diet anymore.
I do eat a lot of his gluten-free stuff, because it's good, but there are some things I do crave and we make sure those things are kept separate. The only thing I make sure to do is to completely clean the counter any time I use it, typically with chlorox or some other bleach product.
If we go to restaurants, he actually 'grills' the chef and asks for simple stuff - broiled or pan-fried stuff. Not on the grill because that could contaminate his food. Most chefs are pretty good about understanding the problem. I think in the last few years he's only gotten hit 2 times when someone really didn't understand the severity of the problem. We also use the dining guide to see if we can find gluten-free restaurants when we travel. And lately, we've been renting small condo's with kitchen facilities and doing a fair amount of our own cooking when I have to go to a conference and he accompanies me.
There are some things in restaurants you do have to watch out for - like french fries and the like. They could be floured to freeze them, or the oil could be contaminated. We've even found in the supermarket that we've got to be careful of shrimp - they're floured to freeze for shipping! UGH!
We've found that he has to be very cautious about cross-contamination - he's like the canary in the mine - very sensitive. We know immediately when he's been 'hit' - he goes downhill like a rock and just crashes. Then he needs about 12 hours of sleep, wakes up feeling drugged, and his head starts breaking out in blotches.
We've recently been ordering gluten-free oats from a company online and they're thankfully gluten-free. So we can make oatmeal cookies and all sorts of things with them, which has been wonderful. And with the products we've found at several companies, he really doesn't feel deprived at all. It was hard in the beginning, but now it just seems like 'everyday.'
And I've found some stuff from TreeHugginTreats that I steal from him! He's always complaining that there's a mouse in his 'bars.' Luscious.
Basically, we really didn't know he had a problem until about 5 years ago. Sure, he'd get tired at times - and it would be at strange times - and we couldn't figure it out. Every summer we'd head for Bonaire where I was teaching SCUBA diving to some local kids, and he's feel better for the time we were there. We couldn't figure out what was going on. We'd come back home, and things would slowly go downhill.
At first we thought it must be all the fruit he was eating down there????? But when we tried the same thing at home? No dice. Well, when we first started to go to Bonaire getting food was a little interesting.........the boat came in once a week and you'd race to the one supermarket in town and raid the shelves before everything was gone (about 2 hours later). So shopping was 'different.' I used to cook very simply down there and we used almost no bread, no flour - nothing fancy. Just basic stuff. Bought all the veggies from the local veggie boat. And you shopped almost every day for the veggies. They were fresh, so we ate a LOT of veggies, but mostly baked meat (chicken, goat, some red meat). We're not milk drinkers, so diary was almost non-existent. There was one small place on the island that made ice cream, so for a treat I'd get myself some at times, but not often. And my husband didn't like the flavors (changed according to whim) so he's skip it. I used oil to cook, didn't use almost any butter at all. Etc, etc, etc...........it finally dawned on us several years later that one big thing that was missing in our diet on the island was bread/flour/crackers etc. I approached my internist with the question about wheat, and he said no way. 'Your husband doesn't have the symptoms of that kind of problem' - which he didn't. But there wasn't anything else to explain it. I proposed it to him and he wasn't happy with the idea, but he thought he's cut out a bit and see what happened. Meanwhile, I started doing some research and found out about the studies done in Europe with Dr. Fine. I ordered the kit and presented it to my husband - who wasn't too happy. But he was even less happy when the tests came back positive! When we cleaned out the pantry he almost cried. And the first year he really went through a lot of 'mourning.' After that, when he started to feel better, he got angry - angry at all the hidden gluten. Angry at companies that don't label things correctly. Just plain angry.
But since he's been gluten-free things are so much better. His energy is back, his bowel habits have changed, and his skin don't blotch unless he gets hit. We recently switched his shampoo back to baby shampoo because we can't always rely on manufacturers being honest that they haven't changed their formula. Found out the hard way that they do it far too often.
Sorry, I'm babbling, but if gluten is a problem for you, you'll feel so much better when it's not a part of your diet anymore.
You know, I've been considering going gluten free again, since I do remember feeling well as I did that. But the good feeling went away after I suddenly became completely resistant to Prevacid, so I wasn't convinced that gluten free was the way to go. Still, I may give it another try very soon: I'm in the process of moving from one city to another and trying to work with my diet right now, especially because of all the traveling, which makes it almost impossible to watch out for cross contamination.
I was checked for evidences of being celiac during an EGD. Doc says he found absolutely no evidence to show that this might have been the case. Still, I won't discount the possibility.
Two questions about your husband's diet: how "gluten free" is he/are you both? Is he to the level of being completely free of any possibility of cross contamination? (I've heard of people having to stop kissing their spouses because of possible cross contamination that way, so basically my wife would have to go gluten free as well, at least in the house.) Or is he simply avoiding all obvious gluten without much concern for cross contamination? (eg, Can he still go to restaurants and be OK ordering gluten-free meals from restaurants that don't observe being completely gluten-free?)
I certainly wouldn't mind hearing more about your husband's story. I could certainly learn a fair amount from it.
I was checked for evidences of being celiac during an EGD. Doc says he found absolutely no evidence to show that this might have been the case. Still, I won't discount the possibility.
Two questions about your husband's diet: how "gluten free" is he/are you both? Is he to the level of being completely free of any possibility of cross contamination? (I've heard of people having to stop kissing their spouses because of possible cross contamination that way, so basically my wife would have to go gluten free as well, at least in the house.) Or is he simply avoiding all obvious gluten without much concern for cross contamination? (eg, Can he still go to restaurants and be OK ordering gluten-free meals from restaurants that don't observe being completely gluten-free?)
I certainly wouldn't mind hearing more about your husband's story. I could certainly learn a fair amount from it.
Gnorb, I don't know if I've asked this before, but have you ever tried gluten-free? It's not a do all and end all, but in some 'silent' celiacs, it can change there GB functioning and a lot of other things in their digestive systems without showing any of the 'typical, overt' symptoms. My husband had slow stomach emptying. We never had it measured, but food seemed to 'sit' in his gut. He had 'mildish' constipation and a few other things we never could figure out. Once we tried the gluten-free (later tested via the fecal antibody test and found to be positive) things changed quite a bit.
H. Pylori was checked for ;-). My gastritis was caused by acid hanging out in my stomach too long. (Slowed gastric emptying + the fatty diet of the time.)
I've had SOME pain in the gallbladder region, but a grand total of thrice in about 7 months. Bloating is upper abdominal. No diarrhea, although when this all first started I was doing #2 up to 5 times per day. (It's back down to a more regular--to me--2 and 3 times per day.) No bile reflux was spotted during my EGD, just GERD, esophageal inflammation due to acid, and some esophageal irritation. No bitter taste in my mouth with the reflux, though the very rare but occasional "vurp" isn't something I particularly enjoy.
The bile salts, I guess, help me digest fats in foods faster and therefore help increase the speed of the digestion. That's just a guess, though.
I'm planning on trying out some pre-biotics and enzymes to see whether this helps the condition as well.
Currently I'm taking the following:
1) Neksium (not "Nexium" -- bought it through an online pharmacy, from Canada. Recommendation came from PharmacyChecker.com, recommended by the AARP). 40mg/1xDay
2) Orange peel extract. 1 every 2 days.
3) Vitamin B complex to supplement whatever might not be getting absorbed. Also, sublingual B-12.
4) Triphala. (2 or 3/day)
5) A few chinese herbs recommended by my acupuncturist for stomach/spleen strength (I can't remember the name now. Little black pills.)
6) Viamin D3 (Have stopped it temporarily as I ran out.)
7) Alpha Lipoic Acid (Have stopped it temporarily as I ran out.)
8) Calcium/Magnesium/Zinc supplement.
9) DGL before meals to help protect the stomach lining.
10) And, of course, Bile Salts
I also drink a fair amount of high-antioxidant juices (acai, pomegranite) and teas (rooibos, mostly; nothing with caffeine).
Of all these, Bile salts have made the most immediate difference. Others have helped, but slowly over time. However, I was recommended to use too many bile salts as they might keep the gallbladder weak if it begins to re-strengthen.
Finally, I've been losing weight, mostly due to not being able to eat, 36 lbs in the past year. (6'1, from 284lbs to 248lbs) Doc says weightloss may help by making the muscles less reactive and therefore giving them time to strengthen. However, he still recommends gallbladder removal. My PCP doesn't agree, and I'm... still investigating.
What I'd like to know is some of the possible side-effects given my gastroparesis and GERD.
I've had SOME pain in the gallbladder region, but a grand total of thrice in about 7 months. Bloating is upper abdominal. No diarrhea, although when this all first started I was doing #2 up to 5 times per day. (It's back down to a more regular--to me--2 and 3 times per day.) No bile reflux was spotted during my EGD, just GERD, esophageal inflammation due to acid, and some esophageal irritation. No bitter taste in my mouth with the reflux, though the very rare but occasional "vurp" isn't something I particularly enjoy.
The bile salts, I guess, help me digest fats in foods faster and therefore help increase the speed of the digestion. That's just a guess, though.
I'm planning on trying out some pre-biotics and enzymes to see whether this helps the condition as well.
Currently I'm taking the following:
1) Neksium (not "Nexium" -- bought it through an online pharmacy, from Canada. Recommendation came from PharmacyChecker.com, recommended by the AARP). 40mg/1xDay
2) Orange peel extract. 1 every 2 days.
3) Vitamin B complex to supplement whatever might not be getting absorbed. Also, sublingual B-12.
4) Triphala. (2 or 3/day)
5) A few chinese herbs recommended by my acupuncturist for stomach/spleen strength (I can't remember the name now. Little black pills.)
6) Viamin D3 (Have stopped it temporarily as I ran out.)
7) Alpha Lipoic Acid (Have stopped it temporarily as I ran out.)
8) Calcium/Magnesium/Zinc supplement.
9) DGL before meals to help protect the stomach lining.
10) And, of course, Bile Salts
I also drink a fair amount of high-antioxidant juices (acai, pomegranite) and teas (rooibos, mostly; nothing with caffeine).
Of all these, Bile salts have made the most immediate difference. Others have helped, but slowly over time. However, I was recommended to use too many bile salts as they might keep the gallbladder weak if it begins to re-strengthen.
Finally, I've been losing weight, mostly due to not being able to eat, 36 lbs in the past year. (6'1, from 284lbs to 248lbs) Doc says weightloss may help by making the muscles less reactive and therefore giving them time to strengthen. However, he still recommends gallbladder removal. My PCP doesn't agree, and I'm... still investigating.
What I'd like to know is some of the possible side-effects given my gastroparesis and GERD.
1 Comments
I had my gallbladder out in 2012, no choice it was only functioning at 18% and I had stones. I was just diagnosed with borderline gastroparesis. I have a hital hernia, gastritis and acid reflux. No one can tell me why this happened. I exercise often and now am just miserable. I have had a dry mouth since July of this year. I do everything right, I don’t drink, smoke and eat healthy. I actually think this is all related. The acid coming up and causing my dry mouth. I retired 7-17 to take care of my mom with dimentia she is 93 now and I am in worse health than here. I am so exhausted I just want to cry. I take Xanax and tramadol. Now I read these meds might be bad. I don’t know even if I answered anything for you because I am just so confused I can’t think straight. Wanted to get my story out there as my therapist said to join a group. Sad!
No right sided pain? This is expected in either gallbladder or biliary duct issues. The consequence of gb/duct disorder can be biliary reflux from the duodenum into the stomach what can trigger GERD: In this case, I assume you would maybe feel some bitter (bile) taste with your heartburn. Well, but you say bile salts help you in UPPER (?) abdominal bloating, you mean in GERD in general?
Lower abdominal bloating (?) in your case could be caused by unabsorbed fats (bacteria in colon ferment them and produce gas). Well, this goes with some diarrhea...Bile salts help to digest fats, so they help to lessen bloating.
I won't mention H. pylori this time...:))) .
About elimination diets, can you say, do you have only upper abd. bloating (with burping) or lower abd. bloating (with gas), or both...
Beside bile salts, any other medication?
Lower abdominal bloating (?) in your case could be caused by unabsorbed fats (bacteria in colon ferment them and produce gas). Well, this goes with some diarrhea...Bile salts help to digest fats, so they help to lessen bloating.
I won't mention H. pylori this time...:))) .
About elimination diets, can you say, do you have only upper abd. bloating (with burping) or lower abd. bloating (with gas), or both...
Beside bile salts, any other medication?
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