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Apr 04, 2006
Convalescence and recovery after gallbladder surgery
by MariAnne
 Since gallbladder surgery became one of the most common surgeries today, it is quite normal that many people want to learn more about it. Most of them do not know what a gallbladder is, and what its role in organism is. Even more, it would be very useful to understand which problems our unhealthy gallbladder could cause. The question is - should we choose gallbladder removal or alternative treatment? What are the benefits of gallbladder surgery and what are the consequents? There’re too many questions with too many different answers. Most of you would like to learn more about convalescence and recovery time after gallbladder surgery, so let’s start with some global facts.Gallbladder problemsGallbladder removal is one of the most common surgical operations. Thousands of people in Canada for example undergo surgery to remove their gallbladders because of gallstones. The great problem is that approximately 80% of all gallstones show no symptoms and may remain silent for years. Once symptoms arise, they persist and increase in frequency, where the most common triggers for gallbladder attacks are caffeine, chocolate, eggs, dairy products and greasy or deep fried foods. Symptoms may include right upper quadrant abdominal discomfort or sharp pain, gas and fullness after meal. The pain can also spread to patient's chest, shoulder, neck or back. In addition to these symptoms, stones expelled from the gallbladder during contraction may become lodged within the bile duct. It could also lead to infection of the bile duct or gallbladder. In conventional medicine there are different approaches to gallbladder problems and all carry unwanted risks. The most common treatment has as many as 10% of patients coming out of surgery with stones remaining in the bile ducts. Important is to know that the gallbladder is connected to the spleen by nerves and is also closely connected to the liver. Anyone with gallbladder problems or with gallbladder removed should avoid or minimize foods that weaken the liver or spleen. This is food such as white flour, white sugar, caffeine, chocolate and deep fried foods. According to Chinese medicine, cold foods, cold drinks, citrus fruits, tomato, banana and even salad should be avoided or minimized because they weaken the spleen and kidneys.What is gallbladder removal surgery?Alternative names for the same surgery are open cholecystectomy, laparoscopic cholecystectomy, or just cholecystectomy. Gallbladder removal is surgery to remove the gallbladder if it is inflamed or obstructed, especially if gallstones are causing pancreatitis, or if cancer is suspected. Gallbladder removal or cholecystectomy is done while the patient is under general anesthesia. This means patient is unconscious and pain-free. Gallbladder removal is most commonly performed through four small incisions, where the doctor is using a small video camera called the laparoscope. In laparoscopic surgery, the abdomen is inflated with carbon dioxide. It is done to provide more space for the surgeon to work, because the laparoscope is inserted through small incisions. The vessels and duct going to the gallbladder are identified, clipped, and cut, so the gallbladder is removed and the incisions are closed. In complicated cases, an open cholecystectomy may be performed. A larger incision is made just below the ribs on the right side of the abdomen.When is it done?Gallbladder removal is usually done to treat different gallbladder diseases, gallstones, infection or inflammation known as cholecystitis, gallbladder cancer and biliary dyskinesia which means abnormal gallbladder function.Risk factors for gallbladder surgeryThe risks for any anesthesia include reactions to medications, or problems breathing, as well as the gallbladder removal surgery itself. The risks specifically for this surgery include bleeding, infection, or injury to the common bile duct. However, most patients tolerate the procedure well, recover rapidly, and return to normal health without the gallbladder.Convalescence and recovery after gallbladder surgeryFor open gallbladder removal, most patients generally need about 2 weeks for recovery. For laparoscopic gallbladder surgery, patient's hospital stay is likely to be shorter, and patient will be at home within 24 hours, as well as recovery time is likely to be shorter. The outcome of cholecystectomy is usually good, and symptoms are relieved completely in about 90% of patients who undergo gallbladder removal. Each patient should allow about 3 weeks for recovery from open gallbladder removal. The laparoscopic gallbladder surgery requires a shorter hospital stay, and usually the patient is home within 24 hours, as well as much shorter recovery time. Injuries from a new procedure to remove gallbladders are lower than previously reported in the media. The higher injury rates that were previously reported were based on inaccurate inferences of bile duct injuries from hospital administrative records. Media reports had indicated the rate of bile duct injury from both laparoscopic and open surgical gallbladder removal has tripled from 0.3 per cent to 0.9 percent from 1991 to 1995.Laparoscopic cholecystectomy was introduced about eight years ago and has become the standard surgical treatment for problems with gallstones. Like the open surgical operation, the procedure removes the gallbladder and provides instant relief of symptoms. However, this one involves using a scope and trocar instead of making a large incision. The benefits of the new procedure include a shorter hospital stay, smaller incisions, and decreased need for drugs to relieve pain and faster convalescence. Alternative to gallbladder surgeryAn alternative to surgery and gallstone removal by chemical dissolution is so called gallbladder flush. This traditional European folk remedy recommends the use of olive oil and lemon juice to flush the gallstones. A major concern is that if the stones are too big, they may not easily come out or may even get stuck on the way out, which is not good. If your problem is gallstone, you should know that traditional Chinese medicine recommends the use of Gold Coin Grass. This plant is supposed to crush and soften the stones so that they will come out slowly. The problem is that this tends to take a relatively long time, but good thing is it does not cause any side effects.Problem with gallstonesWhen gallstones exist, the gallbladder cannot contract efficiently and only stones in the front area of the gallbladder can be pushed out in the first flush. Then stones from the back area would slowly move forward and may cause repeated problems. Flushing is process used to clean out all the stones, and it needs three to four repeats to have result. Basically the flush should be repeated until hardly any stone comes out even though patient had a good flush. The weaker is gallbladder's contraction, the more flushes will be needed in order to push out all of the stones. A good flush means that all the loose stones are out and patient should feel good for at least a few days. The remaining stones are packed ones, which should be allowed to loosen up and get ready to come out. The interval between good flushes should be 1-2 months, because repeating the flush too soon after a good flush may waste effort. It happens because the packed stones are not ready to come out yet. Once stones have been formed, the gallbladder tends to be sluggish.New stones may be formed again, therefore 1 to 2 flushes a year is recommended for maintenance. The actual problem if the gallbladder is loaded with stones, is that there is very limited space in the gallbladder to store the bile. The bile, which is produced in the liver, stays in the liver and leads to liver congestion, which could lead to more problems. When the liver is very congested, nutrients or herbs may not reach the gallbladder. This explains why some people with very congested liver cannot flush out their stones unless they decongest liver first. Another problem is that bile produced in the liver has to flow down to the gallbladder in order to push out stones with the help of gallbladder contraction, helped by lemon or grapefruit juice. If the liver is congested, bile flow is restricted, so as a result there is insufficient bile in the gallbladder to push the stones out. After gallbladder surgery is doneTo understand this article we have to know that the gallbladder stores, concentrates and secretes bile, which is produced in the liver. Most of people know the bile is necessary in the intestine for the digestion and absorption of fat, and it is also important for lubricating the intestinal wall. Once that gallbladder is removed, the bile lost its storage space and tends to accumulate in the liver, so the result is reduced bile flow. It happens because the liver does not contract to squirt the bile into the intestine like the healthy gallbladder does. The reduced bile flow usually causes problems such as indigestion, constipation or diarrhea. When the accumulated bile becomes congested in the liver, it weakens the liver functions. Problem is that it could even lead to depression, which is, according to Chinese medicine, a sign of blocked liver energy. The combined effects of liver congestion and intestinal sluggishness may also cause sleep disorder, insomnia, or bad breath in these patients. Furthermore, the reduced bile flow could weaken the spleen and pancreas. In some cases this side effect is so strong that even may result diabetes.Auto-immune diseases and allergies may also be the result of gallbladder removal. It happens because they are often caused by weak liver and spleen. Other health problems that may be experienced after gallbladder removal include itchy skin, arthritis or anemia, where allergy and arthritis are associated with weak liver and spleen. Itchy skin is usually caused by weak spleen if rashes, or inflammation, are involved. If there are no rashes, it may be caused by bilirubin, which is one of the major components in bile that is crystallizing under the skin. When excessive bilirubin is in the blood due to excessive bile carried to blood circulation from the liver, bilirubin may crystallize. This substance crystallizes because it has low solubility in blood. Excessive bile in blood is usually the result of stagnant bile flow caused by liver congestion or some kind of blockage, as it is already mentioned. In this process, it is important to understand that our red cells live about 100-120 days. The worn out cells are destroyed by the spleen or liver, so when the spleen and liver are healthy, the broken down products would be recycled to produce new red cells. Weak liver and weak spleen that have poor capability of recycling these broken down products may lead to anemia, which is blood disorder we all know. It is common problem that the liver is badly congested with stagnant bile, especially to people with their gallbladder removed. In these cases, the only relief is to stimulate their bile flow. Until now, a combination of taking Chinese Bitters in the morning and Coptis at night showed best results for patients who already had gallbladder surgery. This is supposed to help these patients to relieve symptoms related to gallbladder removal, such as sleep problems and difficulty with bowel movement. It is common for people who have their gallbladder surgically removed, to have gallstones in the liver. When the bile that is produced in the liver cannot be stored in the gallbladder anymore, it tends to get congested in the liver. When the bile is stagnant in the liver for too long, it becomes too concentrated, so then cholesterol and bile pigments may crystallize. This process leads to form stones in the liver, similar to what happens in the gallbladder. The fact is that gallstones are a national health issue which cannot be solved by simply removing peoples' gallbladders the moment they develop problems. Pale yellow diarrhea after gallbladder surgeryOne of most common post gallbladder surgery side effects is diarrhea. As mentioned before, the function of the gallbladder is to store bile, which contains digestive salts made by the liver. During meals, the gallbladder releases the stored bile salts into the intestine to help with digestion, and after food is digested and absorbed in the intestine, the bile salts are also reabsorbed and recycled. Following a cholecystectomy, the liver must make more bile salts, and more are released between meals. This is necessary because there is no place to store these substances. The problem is that increased amount of bile salts can sometimes overwhelm the intestines' capacity to absorb them. In this case, the unabsorbed bile salts can prompt the colon to secrete fluids, leading to diarrhea. This scenario is benign, and it does not get worse, but each patient should know it. Interestingly, some patients who tended to be constipated before their surgery are actually happy about this side effect, while certain medications, such as Questran, that bind the excess bile salts can be given to patients who experience severe diarrhea.However, if a pale yellow diarrhea occurred so soon after gallbladder surgery, other factors must also be considered. These include new medications that patient may be taking or an infection that may have been acquired in the hospital. If this happens, patient should discuss these symptoms with the doctor, who will do the appropriate diagnostic testing. There are also some other gastric symptoms are also common after cholecystectomy. Those symptoms are often lumped together under the term post-cholecystectomy syndrome. The most common symptoms reported by gallbladder patients, include right-sided abdominal pain, flatulence, bloating and nausea. The reason for these symptoms is unclear. Generally they have no relation to the surgical procedure. Often they were present before the operation and may have been the reason that diagnostic tests and diagnosis were done in the first place. They may have been mistaken for gallbladder symptoms, which leads to the operation, but since gallstones are so common, finding them does not necessarily mean that they are the cause of a patient's symptoms. That is why removal of the gallbladder may not eliminate the problems after all. In some cases, these are new symptoms and may indicate disease in another organ that must be investigated by your doctor. General effects of gallbladder surgeryThe gallbladder removal can be a shock to your system, but generally, there are no long term restrictions on your diet after gallbladder surgery. However, some patients do complain of increased gas or bloating after meals for up to several weeks after gallbladder surgery. In most cases these changes are temporary and will improve within a few weeks of having this kind of operation. If you have had very major surgery, with the removal of other organs such as the pancreas, then you may have problems digesting your food and you may not feel like eating much and eating small meals often may seem easier than having 3 large meals a day. Important is to take care about bowels after gallbladder surgery. The fact is that 20% of people who have their gallbladder removed will have diarrhea afterwards. Problem is that small bowel absorbs a lot of substances that should not be there in such amounts. That is why the extra bile passes into large bowel, or colon. The bile holds water in the large bowel, causing loose watery stools, so after the gallbladder has been taken out, patient's stools tend to stay in bowel for less time. This is the reason why patient has more frequent bowel motions after gallbladder surgery. Diarrhea will improve with time, but unfortunately, it can last for many years, which can make everyday life more difficult. Being continuously worried about having an accident with bowels when person is out is a big strain, but some things may help. People with this problem could eat a high fiber diet to absorb excess water and make bowel motions more bulky. It’s recommended to consult with your doctor which could prescribe the anti diarrhea medicine to slow down the excessive bowel movement. Some experts recommend avoiding foods that can make diarrhea worse such as caffeine in tea and coffee, dairy products, spicy and fatty foods. You could also try to wear a small pad in your pants, because it might help to prevent embarrassing moments in public and help you feel more confident. |
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