Gallbladder Problem

[siftasam]

I won't mention the hospital that I attend quite regularly. It is I think very good, but it is private and expensive.

 

I am 76 years old. After a usual thorough examination of my lower abdomen I was told that everything was OK except my gallbladder. Doctors recommended that I have it removed although there is no cancer (thank God).

 This was a year ago and I agreed to the operation - but Co-Vid and associated concussion from a fall prevented it.

 

I honestly don't know whether to bother with this operation at my age. I feel no stomach or abdomen pain.

The hospital told me that the cost of the operation and 2/3 nights in a good private room with food would be around 300,000 baht.

 

I'm obviously not asking for expert medical opinion, but any thoughts and experiences would be welcome. Thank you.

 

[BritManToo]

At age 54 I was told I would die if I didn't have my gallbladder removed.

66 now, no stomach problems, still have a gallbladder.

 

If it don't hurt, leave it alone IMHO.

[scubascuba3]

Dr John McDougall doesn't recommend removal. Worth searching his YouTube videos or website and see what you make of it

[LS24]

I had my gall bladder removed due to gall stones. It got to the point where any time I ate anything with even small amounts of fat would cause me a few hours of intense pain and sweating and a trip to emergency to max out on pain killers. It was an easy decision for me.

 

The surgery required three small incisions in the abdomen. Felt ginger for a week or so but was up and walking next day and I think I only required an overnight stay in hospital.

 

**Warning - next part is not for squeamish**

But the part that some mightn't tell you about is the time it takes for your intestines to adopt. The pancreas constantly makes bile which is used to break down fats. Bile is stored in the gall bladder and is released when the stomache / intestines sense fats.

With no gall bladder, bile is constantly dripping into your intestines and if it has nothing to do or is not absorbed by other foods, becomes a severe irritant. For months after the surgery, I could not trust a fart and on a couple of occasions had almost instantaneous diarrhea. So seriously be prepared with a change of underwear, outwear and wet wipes until the body starts to accommodate for no gall bladder.

I still find that if I don't eat for more than about 8 hours, I will <deleted> straight bile. I've found that a lot more fibre and breads helped in the early days. You want foods that bulk up to absorb the bile. But once I dealt with that and the body settled down, there are no issues.

 

I needed the surgery because I was having attacks far too regularly and my gall bladder was heavily infected. My biggest stone was over an inch in diametre. But if you are feeling no ill effects and there is no cancer, you will need to toss up the aftereffects because for me and a few others I spoke to they were very real for a few months.

 

Good luck with it.

[jaywalker2]

Why is your doctor recommending you have it removed?

[Mentors65]

I recommend Phyathai 2 in Bangkok for this, from my own experience

[Sheryl]

It is impossible to respond to this without knowing the reason for the recommendation for surgery. If stones, need to know their size.

 

When asymptomatic gallstones are found  on the scan (common finding) the options are (1) expectant management (watch & wait) (2) surgery (3) drugs to dissolve the stones, though these take months to a year to work and often fail to.

 

Most often, expectant management is advised unless the stones are very large. About 80% of people with asymptomatioc stones will never develop a problem - but again, the size of the stone(s) are important. The larger the stone, the greater the risk that it might obstruct the common bile duct which can be very serious.

 

https://consultqd.clevelandclinic.org/gallstones-watch-and-wait-or-intervene/

 

With a price tag of 300K i assume they meant laparoscopic surgery. Open procedure would cost less but larger incision. You could also likely get laparoscopic at lower cost, and I recommend

Dr. NARONGSAK JONGSIRI at St Louis Hospital  https://www.saintlouis.or.th/en/FindDoctor

 

Suggest you bring medical records with you, and ask his opinion about surgery vs expectant management in your specific case.

 

[lopburi3]

Wife had removed laparoscopic surgery 3 years ago at age 79 (they mentioned cut off at age 80).  Cost was 200k at major Bangkok hospital and entered at 0820 and departed at 1220 next day (one night in ICU).  No post op issues but was having pain prior to operation.  

[siftasam]

Such tremendously helpful and knowledgeable responses! I thank you all. I'll surely reply as soon as I digest all the information.

[mstevens]

It's curious that a doctor would recommend the removal of your gallbladder when there is no pain and said to be no cancer. As LS24 says in the post above, there can be issues living without a gallbladder and diarrhea is one of them.

 

Do you have any digestive issues? Do you have trouble digesting fats? Pain after eating fat on your upper right abdomen, at all? If not, I wonder why they want to take your gallbladder.

 

There are a host of possible gallbladder (and related liver) issues. Do some research on TUDCA. It's a supplement that can help to clear sludge from the gallbladder. It would not hurt to take it. Seeking Health's specific Gallbladder Nutrients supplement is also very good, a supplement I took myself when I previously had issues digesting fats - which was related to bile production and bile flow. There are many gallbladder supplements but this one by Seeking Health is widely considered to be one of the best.

 

[lopburi3]

2 hours ago, mstevens said:

It's curious that a doctor would recommend the removal of your gallbladder when there is no pain and said to be no cancer.

I suspect there were stones that gave doctor a concern for the future but OP was happy with the no cancer and did not remember that?   OP also did not say if there may have been reasons for the lower abdomen exam or the relief with no cancer found.  But so far poster has not replied to such questions (which may because it was awhile ago and memory/reports not fresh/available.

[crouchpeter]

On 10/7/2022 at 11:06 AM, jaywalker2 said:

Why is your doctor recommending you have it removed?

Because it's a private hospital!

[lopburi3]

1 hour ago, crouchpeter said:

Because it's a private hospital!

Hospital doctors in private hospitals here almost all work for themselves.

[Chris.B]

I had my gall bladder removed a couple of years ago by Laproscopy. Cost me 165,000 Baht in a private hospital in Central Thailand.

 

[jaywalker2]

2 hours ago, crouchpeter said:

Because it's a private hospital!

I had a friend who was having vision problems and went to a famous private hospital in Bangkok (which I won't name but began with the letter B). They told him he needed immediate cataract surgery and pressed him to make an appointment for that afternoon.

 

Naturally, he was reluctant and instead went to the Eye Hospital for a second opinion.  They told him he just had dry eyes and prescribed eye drops, which fixed the problem.

[internationalism]

go to the governmental hospital for new tests and for second opinion.

Check their price for operation.

[Lorry]

11 hours ago, lopburi3 said:

Hospital doctors in private hospitals here almost all work for themselves.

If you mean to say that doctors in private hospitals have no financial incentives to overtreat patients, then you are very wrong. 

 

Good doctors will forego the money and not overtreat. My surgeon worked hard in order NOT to operate on me. He was successful (no surgery) and lost a lot of money.

But not all doctors are like this.

[siftasam]

A belated but very sincere thank you for all your replies.

The problem seems to be now out of my hands(?)

 

I felt soreness on my right side last week and thought at first it was a kidney infection/ UTI. I had a similar soreness 10 years ago that turned out to be very small kidney stones which thankfully 'passed'.

 

I went to a different hospital, had a blood test, a urine test and an X-ray.

The culprit is gallstones, so once again a doctor has advised that my gallbladder be removed.

 

I see no alternative since I'm told there's nothing can be done without surgery to stop or ameliorate the problem; so next week I'll check that this is possible now considering a problem I have (high PSA prostate level) and a problem I had last year (a DVT in my leg).

 

I'll read back over all your wonderful comments and recommendations and, I'm sure, I'll comment on them more.

Again, may I thank you all very much indeed!

[siftasam]

I won't rush into surgery just yet, but, as you suggest, talk more to the doctors/surgeon about possible 'management' and drugs and, particularly, about the size of the stones.

The soreness is not quite bad enough for me to take painkillers.

 

Thank you, 'Sheryl', for your so excellent and helpful post.  I'm taking careful note particularly of this:

 

'When asymptomatic gallstones are found  on the scan (common finding) the options are (1) expectant management (watch & wait) (2) surgery (3) drugs to dissolve the stones, though these take months to a year to work and often fail to.

 

Most often, expectant management is advised unless the stones are very large. About 80% of people with asymptomatic stones will never develop a problem...The larger the stone, the greater the risk that it might obstruct the common bile duct which can be very serious.'

 

And LS24 your experience is certainly a great thing to bear in mind - thanks!

 

The McDougall videos I will watch - thanks, 'scubascuba3'!

 

And the supplement recommendations from 'mstevens' - so helpful too.

[Sheryl]

1 hour ago, siftasam said:

 

I see no alternative since I'm told there's nothing can be done without surgery to stop or ameliorate the problem; so next week I'll check that this is possible now considering a problem I have (high PSA prostate level) and a problem I had last year (a DVT in my leg).

 

 

 

if you are on anticoagulants make sure to mention this to the surgeon.  Your prostate issue is not really a barrier but anticoagulation and history of DVT present some challenges.

 

Now that the gallstones are symptomatic, the situation is a bit different. Unless the symptoms are quite mild and the stones are small in size , surgery is probably indicated

 

Stone size is important and should be in the ultrasound report. The big danger is that larger stones can block the common bile duct creating a life-threatening situation.

[parafareno]

google apple cide vinegar and bile stones....many people found relief in it

[In Full Agreement]

On 10/7/2022 at 2:36 PM, lopburi3 said:

Wife had removed laparoscopic surgery 3 years ago at age 79 (they mentioned cut off at age 80).  Cost was 200k at major Bangkok hospital and entered at 0820 and departed at 1220 next day (one night in ICU).  No post op issues but was having pain prior to operation.  

 

How did the hospital manage her pain after surgery?     Was she given adequate pain medication?

 

[In Full Agreement]

On 10/26/2022 at 1:48 PM, jaywalker2 said:

 

Naturally, he was reluctant and instead went to the Eye Hospital for a second opinion.  They told him he just had dry eyes and prescribed eye drops, which fixed the problem.

 

I went to that private hospital on four occasions  complaining about painful dry eyes.       They  immediately shifted their focus to cataracts and in the end just said use over the counter eye drops.   Plus they said at that time I don't have glaucoma.

 

I'm no closer to knowing the cause of my condition than I was before I entered the hospital.

[lopburi3]

4 minutes ago, In Full Agreement said:

 

How did the hospital manage her pain after surgery?     Was she given adequate pain medication?

 

She had no pain and take home was 30 Tylenol and 4 Tylenol at hospital.  

[In Full Agreement]

13 minutes ago, lopburi3 said:

She had no pain and take home was 30 Tylenol and 4 Tylenol at hospital.  

 

Heck I had quite a bit of pain just from a hernia operation and before anyone says anything, a good mate experienced the same issue with his a month ago.

 

Good for you wife she got by with only Tylenol.       Doctors frequently drop the ball when it comes to pain mitigation.

[Sheryl]

1 hour ago, In Full Agreement said:

 

Heck I had quite a bit of pain just from a hernia operation and before anyone says anything, a good mate experienced the same issue with his a month ago.

 

Good for you wife she got by with only Tylenol.       Doctors frequently drop the ball when it comes to pain mitigation.

Laparoscopic procedures involve very, very small incision (band-aid sized) and much less pain, this is the advantage of them.

 

Pain will be more with an open approach.

[frantick]

Also note that an incisional hernia is a possibility when having gallbladder surgery; don't ask how I know. If you're not in constant pain, it's at least worth trying cider vinegar or a diet change. IMNPO (in my non professional opinion) 

[Sheryl]

57 minutes ago, frantick said:

Also note that an incisional hernia is a possibility when having gallbladder surgery; don't ask how I know. If you're not in constant pain, it's at least worth trying cider vinegar or a diet change. IMNPO (in my non professional opinion) 

An incisional hernia is possible after any open abdominal surgery but would be very, very unlikley with laparoscopic surgery.

 

Apple cider vinegar does not dissolve gallstones. Diet changes can reduce painful attacks (i.e. low fat intake will reduce need for gallbladder to express bile)  but not eliminate the stones he already has either.

[mstevens]

The surgical removal of your gallbladder is a big deal. Surgically, it's not a difficult procedure and is one of the most common operations performed and, I believe, the most common abdominal surgery. The concern is not so much the surgery itself, or the recovery time, but the after effects of living the rest of your life without a gallbladder.

 

A small percentage of people who have their gallbladder removed suffer life-long diarrhea. Basically, instead of the gallbladder releasing bile when you eat fats to assist with their digestion, your bile flow is "always on". Think of it as a small, but constant flow of bile. This causes upset in some people and life-long diarrhea. Estimates vary as to how many people this affects but I have read numbers ranging from 5 - 20%. It can cause "urgency" in others, including a friend of mine whose gallbladder was removed. He never knew that once his gallbladder was removed that he would forever need to be aware of where the nearest toilet is. He sometimes gets very short notice that he "has to go" i.e. get to the nearest toilet at Formula 1 speed!

 

Have you considered trying the Chanca Piedra supplement? It's known as the "stone-breaker" and can help to break down and dissolve gallstones (and kidney stones). Google it for more information. I don't know if it's available in Thailand but Lazada and Shoppee would be worth checking out. Failing that, it can be purchased from Amazon: https://www.amazon.com/Chanca-Piedra-800MG-Tablet-Gallbladder/dp/B071KR997R

 

Surgery is one option but do your research first, particularly in to the side effects of living without a gallbladder. Also, do some research in to Chanca Piedra. If it were me, I'd try that first (and if you do try it, I'd go with a high dose, like 1,600 mg).

 

Whatever you decide, good luck!

[lopburi3]

11 minutes ago, mstevens said:

Estimates vary as to how many people this affects but I have read numbers ranging from 5 - 20%

High estimate is 20% will have temporary issues but in almost all cases this resolves within weeks/months and is not lifetime.

https://www.stclair.org/services/mayo-clinic-health-information/faqs/FAQ-20058481