Abdominal Pain after fatty foods-Post gallbladder removal

[olsonkl]

I am a 33 year old female, and I just had my second child 6 months ago.  I had my first painful attack of severe epigastric pain (presumed to be a gallbladder) attack about 2 months ago (which was 4 months after my birth of my second child). At the time of the attack, I went to the ER where I had sonogram and blood work taken.  However everything seemed normal.  Upon leaving ER, tentatively diagnosed with Gastritis, however GI cocktail did not stop the pain.  Since this time, I went to see a gasteroenterologist, he tentatively diagnosed me with gallbladder problems and ordered a CCK HIDA scan.  The HIDA scan an revealed a gallbladder ejection fraction of 22%.  Based on the ejection fraction, the Dr indicated my gallbladder was bad and instructed me to contact a surgeon to have it removed.  I had my gallbladder removed a couple of weeks later.  Prior to my surgery, I did not have any more episodes of pain.  However, I did note I was unable to properly digest fats, symptoms included:  Nausea, gurgling of stomach & diarrhea.  Therefore, remained on a minimal fat diet until surgery was performed.  Pathology from my cholecystectomy indicated my gallbladder had chronic inflammation of the gallbladder and think yellow-green bile. After the surgery my ability to digest fats properly seemed to get worse.  My symptoms included a more severe case of a gurgling of stomach and severe diarrhea after ingestion of fatty substances.  In order to get around this problem, I resorted to elimination of fats from my diet, although I still had a few problems with diarrhea and GI indigestion.  My doctor also prescribed Colestid and Metamucil, and this seemed to also help, but the problem did not go away if I ate very fatty foods.  I have had an MRI and an ERCP (where they were specifically looking for a choledochal cyst).  It turns out I do not have a choledochal cyst, but I am not sure they were looking for other problems that are related to my other GI issues.  Now, about 2 months post gallbladder surgery and 2 weeks after the ERCP, I had my second episode of severe epigastric pain after eating the chicken (not the skin) from fried chicken.  I again went to the ER where they ran blood tests and gave my the GI cocktail, again nothing worked (but pain meds) and did not see anything unusual in my bloodwork.  My question to you is, what else could be causing this epigastric pain?  Is it possible it could be pancreatitis or IBS?  Would this have been evident in the ERCP, even if they were not specifically looking for it?   (I think they may have only been focused on the bile duct)  What is causing this fat indigestion?  Is this normal post gallbladder surgery, what else could it be?  Can you suggest any addition tests I could have done to rule out other problems?  Thank you in advance for your help!!!

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are several considerations.  The first would be the other causes of dyspepsia including ulcers, or inflammation of the stomach and esophagus.  Another consideration would be Sphincter of Oddi dysfunction - which can manifest after a cholecystectomy.  

I would consider an upper endoscopy to look for the other causes (i.e. ulcers or inflammation) of your stomach discomfort.  A test for H Pylori would also be recommended.

If those tests come back negative, I would inquire whether the ERCP include Sphincter of Oddi manometry - this would be a test to evaluate whether any dysfunction was present.  

To answer your questions, pancreatitis and IBS would not necessarily be evident on ERCP.  Pain may be present post surgery, but not for this long period of time.  

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.

Thanks,
Kevin, M.D.

[jepcap]

Hey, I feel for you.  I had my gallbladder out at 24, five years ago and I have been living with your symptoms since then. Almost immediately after any meal that I eat, especially when I eat out I have severe cramps and episodes of diarrhea.  My GI Doctor also put me on Colostid and things have gotten a little better, but then sometimes that medicine can make me constipated.  My GI doctor told me this isn't something that is ever going to go away.  He told me to watch my caloric intake (not necessarily fat) and start excersising more.  It's unfortunate that at the time of having our Gallbladders removed that the Doctor's neglected to say you'll have these issues.  They told me I'd be fine and I didn't really need it in the first place.  Now I'm going through Liver work up, blood tests, ultrasounds and he wants to do a liver biopsy.  

My thoughts to you, is to keep pressing your Doctor's for information and Don't ignore your body.  It's definately a Catch 22.... do you want severe pain in your back and abdomen from the gallbladder or do you want severe episodes of diarrhea for the rest of your life.  I never really got all the information needed or the choice either.

Best wishes to you.

[purplekat]

I am curious, are all of these problems created BECAUSE your gallbladder has been removed, or did they exist before your gallbladder was removed, but the condition was just exaserbated.  I have also had similar problems to what you describe and my GI doc says it has nothing to do with my gallbladder being removed (which I find hard to believe).

Jepcap- Are you still undergoing these tests for your liver?  Do they believe it is something inherently wrong with your liver or just the lack of the presence of your gallbladder?  

I am relatively new to this and this is so depressing to think of it as a lifelong problem.

[purplekat]

Jepcap-
One more question, this is the first time I have heard of caloric intake instead of just fats?  Also I did not know exercise would help?  Have you seen that a direct relationship exists?  What types of foods have you found good/bad?

[browniee]

Hello everyone,
I've been having gall bladder attacks since December of last year. I've done about 3, or 4 gall bladder flushes (olive oil, lemon juice, apple juice, grapefruit juice), and I've passed some stones. I've had one sonogram done back in April, and when I had another one done yesterday, I had about the same amount or more stones (gall bladder is about 1/3 full). I have made an appointment for surgery, but I still think there's something else I can do besides having one of my organs cut out. I am also well aware of the side effects (loose bowels, gas...etc...) that can follow having the gall bladder removed. Does anybody have any ideas about what I can do besides surgery? Has anyone here ever gone to a natural/alternative health care doctor?For those who opted for surgery, do you regret your decision? HELP!!!!!!!!!!!

[KathyS]

Browniee and others -- I had a lap chole in July of last year.  I had the same symptoms mentioned above, cramping and sudden "explosive" diahhrea shortly after eating, especially following a meal higher in fat than my normal.  I also had to watch what I ate and modify my diet, cutting down on things such as ice cream, rich sauces, etc.  Fortunately, this passed after about five months.  I slowly regained the ability to eat and drink the same types of food as I did before the surgery.  Maybe in time some of those who posted above as having these symptoms will see that the symptoms dimenish also.  Browniee, as far as the surgery itself, I have to say it was very easy.  I spent one night in the hospital (only because my gallbladder removal was deemed an "emergency" and was performed in the late afternoon) and I was back at work just two days after that.  I was lucky to have had a laproscopic procedure.  Good luck with your decision and I hope you fare well and don't experience these other gastric complications.  Remember that it's usually the people with poor results and complications that come here for advice and support ... few of those with excellent surgical outcomes feel the need to post about it.  Take care!

[browniee]

Has anyone tried using supplements to help dissolve or relieve some of their symptoms (before gall bladder surgery)? I've read that peppermint oil tablets, milk thistle, lecithin, vitamin E and C are supposed to help. Has anyone tried using any of these supplements? If so, did they work?

[KenteMan]

I have been having gall bladder pains since early March.  it took these doctors 2 months to determine the problem.  I had been having dull-mild pains in my right upper abdominal area as well as chest pains (directly in the center of my chest).  I had several tests perfomed (scans, ultrasound) and a HIDA scan, which came back with an ejection fraction of 18%.  Gallstones were never found, just sludge.  After this, the doctor told me to have my gall bladder removed.

Note that throughout this process, I never had diarrhea or any serious episodes, just this nusiance of these dull-mild pains.  I decided to visit an alternative medicine doctor.  She determined that my digestive system is inflammed and I needed to change my diet to get the inflammation down.  Removing the gall problem was not the solution, since it does not appear to be the problem.  I know for years I had too much sugar in my diet, as well as breads and dairy.  However, as I exercised frequently, I got away with this, save for the past few years when my frequency of exercise decreased.

Basically the doctor put me on the Atkins diet, except I can eat rice and some fruits (all except bananas, grapes), all meats except pork, and any vegetables.  Sugar, dairy and wheat/oat/corn products are a no-no.  The only fluid I can drink is water, which I must drink a gallon daily.  I also take various supplements (Vitamin, Pryxidol?, chlorcaps and pancreas tablets) with each meal.  I have been on this diet for exactly 30 days as of today and the gall bladder pain is nearly gone.  I still have the chest pains but not as frequent.  After removing the sugar from my diet, I lost 10 lbs in SEVEN days.

Please note I am of normal build (5'11, 200 lb) and have no history of health problem prior to this.  My advice to anyone is to explore alternative medicine methods anytime they talk about cutting you open, especially if the illness is not life-threatening.  Alternative medicine looks at the function of the ENTIRE body, and not just one episode.  I think we all can agree it is a lot easier to change one's diet, versus having to adjust to the loss of an organ. Less painful too.

I have a follow up visit with the dr in 4 weeks so I will keep you posted.  I am also visiting a GI specialist who also disagreed with the other doctors who insisted my bladder be removed.  He wants to see how my whole system is functioing as well, given I do not exhibit the classic systems of a person with gall bladder functions.

Sorry for the long post, but I hate to see peoiple go through unnecessary procedures.  Good luck to all

[purplekat]

Thank you for your advise, I only wish I would have known what I know now before I had the surgery.  I hope your posting is helpful to others!

[dn]

i am 27 years old.  i just had my gallbladder removed last september.  at that time i had just turned 27.  i suffered with what i thought was just intergestion.  this went on for about a year to a year and a half.  as the time went by, it got worse.  the night of my last attack, right before my surgery, once again i just thought i needed maalox.  in porevious attacks the maalox would work.  this night nothing worked.  in the same night, 3 hours apart, i tried maalox, tums, digel, rolaids, liquid maalox, and one other one.  nothing worked.  then i knew that something was wrong.  years ago my dad had his gallbladder removed.  this was the time before the laser.  i knew what he went through.  the first thing that came to my mind was the i was having gallbladder attacks.  i went to the doctor.  he sent me for an ultrasound and sure enough, i had gallstones.  i had quite a few.  two weeks later i had my surgery,  i had it done my laser as a smae day surgery.  there was nothing to it.  this was my first surgery.  i still have my tonsils, have never broken a bone in my whole life, and i have never had stitches.  i was afraid, but, after it was all done, there was nothing to it.  i was up and moving around right after i woke up from surgery.  it felt like i just did too many sit ups. there was nothing to it.  if you have trouble with gallbaldder attacks the best thing to do is to get it taken out.  i read about all the treatments that you can do besides the surgery (the ones that are supposed to just clean it out).  that is such bull.  there is a bad catch to doing that.  i talked to a friend of mine.  a friend of his left his go and they started to poison his entire system.  he had to get an emergency surgery because his gallbladder was so inflammed and infected, gang green started to set in.  that is not good.  if that happens and if one of the stones does happen to get loose into your system, you are in even bigger trouble.  overall the best thing is to just get the gallbladder taken out.  there is nothing to it.

[marlow]

I don't think I'd put my experience of having the gallbladder removed as 'nothing to it'. From my pain first starting, I was admitted to hospital six months later, having visited my doctor 7 times & him precribing antacid pills telling me i just had acid.
I had my gallbladder removed and was fitted with a drain to drain the fluid from the site. This stopped working within hours of surgery.  After 4 days of crying in pain, the surgeon visited me on the ward and instructed the consultant to get me for a scan URGENT. Upon returning to the ward I was told the fluid was all in my stomach & if it wasn;t gotten out straight away, I would be dead by the end of the day.  Straight back to theatre I went.
I was in hospital for 15 days from start to finish and 4 years later I am still in pain and have constant diarhea. I have been for yet another ultrasound scan this morning and will let you know when I get the results. I just wonder, if the drain had worked properly, would I be in this state now????? Any ideas????

[Kare 1]

I had gallbladder surgery 1 month ago and I am still in pain.  and very bloated, I have dairrha every other day.  I feel nausea all the time.  what can I do

[weid]

I had gall bladder surgery 6 years ago and I still have the diarrhea and terrible stomach cramps after eating.  I have had every test possible run and the doctors say there is nothing wrong.  I hate living this way.  It interferes with everything I do.  I wish someone would have warned me before I had the surgery.

[krisg]

well, I had my gallbladder out 5 years ago.  I had stones and was having some discomfort and running a fever.  Within hours after the surgery I was having an attack of pain in the upper gastric area which prevented me from talking and breathing, and caused me to vomit for a couple of hours. (very painful just following surgery.)  I was told it was only gas.  Had a 2 day hospital stay.  I complained of these attacks (mostly at night) to the dr. and they diagnosed me with severe acid reflux.  I was already on prevacid 2x a day.  Finally was hospitalized with a severe attack 2 years later with elevated liver enzymes.  2 months later, they sent me to another dr. Still no answers.  Well, after another 3 years of agony I finally was diagnosed with Sphincter of Oddi dysfunction.  Bile duct was narrowed and scarred and full of mucus.  Had a sphincterotomy in feb 03.  Was doing better until last month. Back to the drawing board, so to speak!  My advise for diarreah is to get anti-spasm med.s.  There are a few different ones and I personally think they work great for the bowel problem after gallbladder surgery.  As for my SOD, I think it is something that is always going to give me pain for the rest of my life.  I'm just trying very hard to come to terms with that now.
Good luck to all who have this surgery.

[gardenmaniac]

Haven't visited this site much since Jan '03 following my 19 year old daughter's gallbladder surgery. Wanted to maintain contact with those that were so helpful to me, but with the change in format to allow the "dr" to respond to everyone questions first, they limited the questions/new comments to only 2 per day..sorry...but most people posting here have already been to too many doctors with no accurate diagnosis.

Anyway...in response to the surgery or no surgery debate..let me first say that my daughter had no stones & no sludge in her gallbaldder. She had 2 EGD's including biopsies of her small intestine and a bile sample taken from her gallbladder. She had a small bowel follow though series done and 2 HIDA scans at 2 different hospitals. She saw 2 family doctors, 2 gastroenterologists and one surgeon. The first HIDA said 32% ejection fraction, the 2nd one 6 weeks later said 8%. The surgeon informed us that with no obvious problem with the GB that the surgery success rate is not as good as if you have stones, etc. We agonized over what the right thing to do was. It seemed that the people that posted here still had problems folling GB surgery & then the problem was worse. I just know that by the time my daughter finally had her surgery ( a year and a half from the first doc visit) she was unable to eat anything with pain. Who wants to live like that?  

It has now been 9 months since her surgery. she is a junior in college & IS better...but does have part of her digestive system gone...& she still has reactions sometimes to things she eats. Stress plays a major role in her digestive system. ( Hmm.. college=stress) She would tell you that she is glad that she had the surgery, but would have been happier if it hadn't stopped working in the first place. since we don't really know why it quit, something else could rear it's ugly head in the future.

The best part of this site is all of the contributors...those that found solutions and those that haven't yet. There is nothing like being able to talk to someone who has been there, done that. Best of luck to those of you still searching for answers.

[browniee]

Hello everyone!
I've had gallbladder pains since December of last year. I opted not to have surgery, and so far, I am doing much better. I started taking digestive enzymes a long time ago, and lately, I added some herbs and vitamins that support the gallbladder and liver. A couple months ago, I had SEVERE gallstone attacks once a week to 3-4 days a week, but lately, I've only had one every few weeks. I feel much better. So far, I'm glad that I haven't had surgery.

[krisg]

thank you,  thank you,  thank you !!!
You said it the best.  There's nothing like having other
people in this world to relate with.  Best luck with
your daughter.

[bethban00]

I had gallbladder surgery 6 weeks ago.  Have had no negative effects since then.  I was very ill with high fever, chills, severe pain, and an elevated liver count when I arrived at ER.  I am so sorry to hear of all of you still having symtoms, but for me removal of the gallbladder was a life saving decision. I hope that you all find relief from your pain and/or symtoms.

[sade]

Hi everyone.  I am just baffled by how many people have the very same symptoms post gallbladder removal and do not have the answers they need in order to feel better.  I too have had my gallbladder removed... when I was 21.  It was weird-- I didn't have any "attacks" or pain, I just couldn't evacuate any food for a period of 2 months.

Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out.  Sure enough, the scan and tests prescribed revealed a diseased gallbladder....

4 years later, food digestion is still strange.  I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal.  There is not a day that goes by that I don't have discomfort after eating.

As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier.  High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).  

Maybe these things will help... and I wish you all better health.

[sade]

Hi everyone.  I am just baffled by how many people have the very same symptoms post gallbladder removal and do not have the answers they need in order to feel better.  I too have had my gallbladder removed... when I was 21.  It was weird-- I didn't have any "attacks" or pain, I just couldn't evacuate any food for a period of 2 months.

Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out.  Sure enough, the scan and tests prescribed revealed a diseased gallbladder....

4 years later, food digestion is still strange.  I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal.  There is not a day that goes by that I don't have discomfort after eating.

As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier.  High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).  

Maybe these things will help... and I wish you all better health.

[sade]

Hi everyone.  I am just baffled by how many people have the very same symptoms post gallbladder removal and do not have the answers they need in order to feel better.  I too have had my gallbladder removed... when I was 21.  It was weird-- I didn't have any "attacks" or pain, I just couldn't evacuate any food for a period of 2 months.

Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out.  Sure enough, the scan and tests prescribed revealed a diseased gallbladder....

4 years later, food digestion is still strange.  I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal.  There is not a day that goes by that I don't have discomfort after eating.

As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier.  High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).  

Maybe these things will help... and I wish you all better health.

[sade]

Hi everyone.  I am just baffled by how many people have the very same symptoms post gallbladder removal and do not have the answers they need in order to feel better.  I too have had my gallbladder removed... when I was 21.  It was weird-- I didn't have any "attacks" or pain, I just couldn't evacuate any food for a period of 2 months.

Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out.  Sure enough, the scan and tests prescribed revealed a diseased gallbladder....

4 years later, food digestion is still strange.  I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal.  There is not a day that goes by that I don't have discomfort after eating.

As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier.  High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).  

Maybe these things will help... and I wish you all better health.

[sade]

Hi everyone.  I am just baffled by how many people have the very same symptoms post gallbladder removal and do not have the answers they need in order to feel better.  I too have had my gallbladder removed... when I was 21.  It was weird-- I didn't have any "attacks" or pain, I just couldn't evacuate any food for a period of 2 months.

Anyway, I was treated for everything but the gallbladder then finally, on a whim, the doctor mentioned having my gallbladder checked out.  Sure enough, the scan and tests prescribed revealed a diseased gallbladder....

4 years later, food digestion is still strange.  I have gone from craving and only eating potatoes to craving FAT to feeling bloated after almost every meal.  There is not a day that goes by that I don't have discomfort after eating.

As of this summer, undergoing a lot of stress, my stomach became agitated and lead me to begin a new diet. One thing that has helped me is eating every couple of hours and very small meals. Luna bars are my favorite and are gluten free, dairy free which make digestion easier.  High water consumption and eating low amounts of carbohydrates helps, also...low fat. I also have been trying to put back the "good" bacteria in my stomach (acidophilus & metagreens-oasis product).  

Maybe these things will help... and I wish you all better health.

[NoGall]

Hello everyone, I came by this site researching doing the Atkins diet without a gallbladder.  

I had my gallbladder out in '96 after years of chronic problems that had made life really awful for me.  I was 23 at the time, and I had terrible pains in my shoulders which at the time I thought was bursitis.  I had gotten cortisone shots and was considering surgery, I was nearly disabled.  I had no idea that the problem was related to my gallbladder.  In fact, at the time I didn't even know what a gallbladder was!  I started having random episodes of stomach pain.  It wasn't always after eating.  I associated it with drinking diet drinks sweetened with aspartame, for lack of a better theory.  I was on a diet at the time called Nutri-System and had lost 20 pounds.  I had always been forty-odd pounds overweight and since high school had always been on some crash diet.  The stomach pain came and went, as did the shoulder and upper back pain, and I just dealt with it and thought I would have to deal with it the rest of my life.  Then I got married and the stomach pain got worse.  I remember one night we ate fondue and I thought I was going to die!  I still didn't see a doctor about it since I thought it was just a result of being overweight and eating the wrong things; and I was tired of being told to lose weight when I had tried and tried and couldn't.  My doctor finally did do some tests to see if I had ulcers, and it turned out that I had a hiatal hernia, and I thought that explained it.  I was given lots of tagamet and cimetidine (prescription antacids) and thought that would take care of the problem.  But it didn't.  It got worse.  One day I was in so much pain I thought maybe I had pancreatitis or something.  I read on the internet that people can die from that so I went to the ER.  They did an ultrasound and found a big fat gallstone about the size of a robin's egg lodged into my gallbladder.  I didn't hesitate to get my gallbladder out.  It was infected, and my liver was affected by it.  I should have had it out long before.  

The procedure was laproscopic, and I had very little pain afterwards.  For about two weeks my muscles were sore, but I recovered well and I have not had any problems since then.  I have been taking a supplement that contains ox bile (I know it sounds gross!) I got from a nutritionist.  Basically, he explained that the gallbladder provids an extra squirt on demand of bile when you need it, which is when you eat fat.  I'm supposed to take the supplement with each meal.  I did it for awhile, but I don't like taking supplements in general and so I don't always take it.  But I'm still okay.  I don't really notice any digestive issues, and all my shoulder and upper back pain is gone.  

I've discovered the Atkins diet, which I think I actually have a prayer of staying on, but I was curious as to whether not having a gallbladder would slow down weight loss.  Has anyone else noticed this?  If the fat just goes "right on through" then the body might think it's not getting enough fat and it seems like that would skew the carb/fat ratio Atkins talks about.  Maybe eating small amounts of fat throughout the day might help?

I don't regret having my gallbladder out at all, in fact I regret not having it out sooner.  Actually, what I regret the most is the misinformation I got when younger about low fat dieting.  There were times when I ate absolutely NO FAT for WEEKS and did not lose weight-- in fact I gained some!  Although I felt like I was STARVING TO DEATH!  If I were more paranoid I would think the whole lowfat diet thing was a plot invented by skinny people to torment those of us unfortunate enough to be genetically predisposed to putting on pounds.

So far, I've been on Atkins for 3 weeks, and I've only lost 8 lbs.  I'm just wondering if it's been slow because of my gallbladder.