Weight Loss After Gallbladder Removal: Know the Facts

Weight Loss After Gallbladder Surgery Forum: Know the Facts

Gallstone Removal Weight Loss Forum: Know the Facts

Gallstones are small stones made up of bile (a fat soluble liquid) and digestive enzymes. They form when bile from your liver passes through tiny holes in your gall bladder. These gallstones usually pass out with normal bile flow, but they may block the intestine or cause other problems if not removed promptly.

There are several types of gallstones. Smaller ones called non-albumin type gallstones are harmless and do not need to be removed; however, large albumin type stones (gallstones) must be removed because they can cause pain and difficulty swallowing. Most people have one or two small gallstones that can easily be passed out with normal bile flow, but some people develop larger stone sizes which require removal.

The most common causes of gallstones are high cholesterol levels, diabetes mellitus, obesity and alcohol consumption. There is no cure for gallstones, but there are many treatments available such as diet changes and medications. Some people with gallstones will eventually lose them all naturally without treatment. Others may benefit from surgical procedures to remove their stones.

What Causes Gall Stones?

The gallbladder is a small organ that is located just under the liver. It stores and concentrates bile until it is needed for digestion. The body makes bile, a fluid that contains among other things, cholesterol. When food is digested, bile is released into the small intestine to help digest the fat in the food. Normally, the amount of bile released from your gallbladder is just enough to digest the meal you have eaten. Any leftover bile is reabsorbed by the gallbladder. If you eat a high fat meal, your body can easily get overloaded with bile. Your body keeps the amount of bile released into the small intestine in check, but when you eat a high-fat meal, there is a larger than normal amount of bile released into the small intestine. If the small intestine is overloaded with bile, some of it will crystallize and turn into gallstones.

Gallstones form when bile components (cholesterol and bilirubin) become crystals and these crystals come together to form a stone.

If the stones are small enough, they can pass out of the gallbladder and out of the body in the bile. These types of stones do not cause problems and most people never know they have them.

Larger stones (called obstructive or symptomatic gallstones) can block the passageway from the gallbladder to the intestine. When this occurs, bile continues to build up in the gallbladder and more small stones are formed. This can lead to a serious and painful condition called gallstone disease. Itching, pain in the upper-right part of the abdomen, nausea and vomiting often accompany gallstone disease.

Who Gets Gallstones?

Almost anyone can develop gallstones, but certain people are at greater risk than others. These include:

People who have had their gallbladder removed (especially if they had it removed years before). This happens because the gallbladder acts as a reservoir to keep bile stored and concentrated until it is needed. When the gallbladder is not present, bile will flow continuously into the intestine, and there is a greater chance of stones forming.

Pregnant women.

People who have had major surgery.

People with other diseases (especially diabetes and cirrhosis of the liver).

People who have kidney failure or other conditions that affect how the body breaks down cholesterol.

People with a history of blood transfusions.

Binge drinkers.

Obese people.

Diabetic patients who are not taking the proper medication to control their blood sugar levels (or who are not following the advice of their doctors).

How Are Gallstones Diagnosed?

If you have the symptoms of gallstones (see above), a doctor will do a physical exam and ask you about your medical history. Based on this information, they may decide to do blood and urine tests. If they think you have gallstones, they will refer you to a surgeon or a specialist for further testing.

Before the procedures listed below, you may need to stop eating (at midnight) and drinking (six hours before the procedure).

The first test a surgeon may do is an ultrasound of the gallbladder. A small device that produces sound waves is pressed against your skin. The sound waves bounce off the layers of your gallbladder and create a pattern known as a sonogram. A technician will look at this pattern to see if they see stones or other problems.

The second test is a CT Scan. This is a more detailed X-ray of the gallbladder. A dye (called contrast agent) may be injected into your arm or given through an intravenous line (IV). The CT Scan will allow the doctor to see the inside of the gallbladder and other parts of the biliary system.

A third test is a HIDA Scan. Radioactive iodine is injected into a vein and travels through the rest of your body. When the thyroid gland absorbs the iodine, it becomes hot or radioactive. Certain tissues (like the gallbladder) concentrate iodine, so the iodine shows up brightly on a HIDA Scan.

The fourth test is an ultrasound guided percutaneous aspiration. A thin needle is inserted into the part of the liver that drains into the gallbladder (called the porta hepatis). When the needle is inserted, any stones in the gallbladder will move toward the needle. A syringe is attached to the needle and the stones are slowly drained out.

The surgeon checks the syringe to see if there are any stones or other problems. Sometimes doctors use this procedure to break up large stones before removing them with an instrument called a stone grabber.

The fifth test is a ERCP (Endoscopic Retrograde CholangioPancreatography). A long, flexible tube with a camera at the tip and other tools is threaded through the mouth into the duodenum (the first part of the small intestine). The bile and pancreatic ducts are cleaned out. The camera can also let the doctor see inside the gallbladder and take samples of tissue for biopsy.

Treatment Options

Not all people who have gallstones need treatment right away. If you have no symptoms, watchful waiting is an option. This means close monitoring by your doctor and getting any tests they think are necessary. If you are having symptoms, however, treatment will probably be suggested.

Your treatment will depend on how many stones are in the gallbladder and other factors such as your age and general health.

Treatments include:

Eating a low-fat diet. This can help decrease the number of gallstones in your gallbladder.

Taking medication. These drugs help break up gallstones so they can be passed with the stool or eliminated from the body in urine.

Losing weight if you are overweight or maintaining a healthy weight if you are at an ideal weight already. Excess weight increases the chance of gallstones forming.

Surgery to remove the gallbladder. This is the most common treatment for gallstones. There are two types of surgery:

Open surgery (also called an open cholecystectomy). The surgeon makes a 5- to 10-inch incision in your upper belly area to locate and remove the gallbladder.

Laparoscopic surgery. Two or more small incisions are made in the belly button and into the abdomen. A narrow video camera is placed through the incisions to show the surgeon. Surgical instruments are then passed through the ports to remove the gallbladder.

The choice of which surgery to have is a joint decision between you and your surgeon based on your health, the number of stones and other factors.

If you need to have your gallbladder removed, you might wonder if you should get a new “insurance policy.