Alternative names: Postcholecystectomy Syndrome
One of the biggest crimes in modern American medicine is the amount of unnecessary surgery preformed. Gallbladder surgery is the most common operation in North America. Every year, more than half a million people in the United States and more than 50,000 people in Canada undergo surgery to remove their gallbladders (cholecystectomy) because of gallstones. Many of these surgeries are unnecessary.
Some 7% of Americans harbor gallstones, and as we get older these stones become even more common – half of all women in the US over the age of 70 have gallstones. The huge prevalence of this disease has the potential for big medical business. Consider that at the turn of the century there were 800,000 hospitalizations, and $2 billion spent annually on gallbladder disease. With more honest consumer information all of these figures could be cut to a fraction of the present figures.
If it were true that doctors actually help people by removing symptomatic gallstones, then the medical business would be actively trying to eradicate the "gallstone plague" upon our society by setting up X-ray booths and surgical units on every street corner across the country. This action would cause well-deserved criticism, because the scientific research clearly and consistently shows that your risk of death and disability is much greater if you take a course of immediate surgery upon discovery of gallstones, rather than "watchful waiting", until some symptoms develop.
Patient surveys taken 2 to 24 months after both open and laparoscopic cholecystectomy indicate that 40-50% of patients have one or two symptoms that continue, such as abdominal discomfort from excess bowel gas or dull pain, although 80-90% regard the operation as highly successful. One of the most serious complications of gallbladder surgery is injury to the common bile duct. Because of limited visibility, this injury is more common with laparoscopy surgery than open surgery. (Major bile duct injuries occur in about 0.33-0.5% of laparoscopic operations, compared with about 0.06% in open procedures.)
Gallbladder patients just need to thin out their bile, clean up their diet and eliminate food allergens. Once a gallbladder has been removed, there are things you can do to reduce the consequences.
Reasons to Keep Your Gallbladder. Long-term consequences of removal of your gallbladder are related to the lack of a storage sack for bile acids. Bile is continuously synthesized by the liver. The purpose of the gallbladder is to store this greenish fluid between meals. When you eat, the gallbladder contracts, emptying its contents into the small intestine, where the bile mixes with the food. If there is no storage sack (gallbladder), then the bile constantly drips into the intestine, even when no food is present. In this concentrated form, the bile acids are very irritating to the linings of the intestine. In the short term, irritation of the large intestine by bile acids often causes diarrhea – and long-term the irritation can cause colon cancer. This is the reason why cancer of the right side of the colon is more common in people who have had their gallbladders removed.
Once a gallbladder is removed it is important to be on bile acid supplements. They need to be taken with every meal in which fat is consumed otherwise your fats will not be properly emulsified and absorbed.
If a change in your diet fails to relieve diarrhea, then the next step in treatment is to use bile acid sequestering agents, such as activated charcoal or doctor-prescribed cholestyramine (Questran) or colestipol (Colestid).
The long-term side-effects can be reduced or eliminated for people who have no gallbladder by eating a low-fat, high-fiber diet. Fat is the primary stimulus for bile acid production. On a low-fat diet much less bile acid is produced.
After removal of the gallbladder, a healthy low-fat, plant-food based (high-fiber) diet is very important.
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