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<\/figure><\/div>\n\n\n\nBy Ross Simafranca, M.D. What is a gallbladder? The gallbladder (GB) is a small balloon…<\/p>\n","protected":false},"author":1,"featured_media":3877,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":"","_links_to":"","_links_to_target":""},"categories":[38,26],"tags":[],"featured_image_urls":{"full":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,false],"thumbnail":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=150%2C150&ssl=1",150,150,true],"medium":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"medium_large":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"large":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"1536x1536":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"2048x2048":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"ultp_layout_landscape_large":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"ultp_layout_landscape":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"ultp_layout_portrait":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"ultp_layout_square":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"covernews-slider-full":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"covernews-slider-center":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"covernews-featured":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1",221,198,true],"covernews-medium":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true],"covernews-medium-square":["https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?resize=221%2C198&ssl=1",221,198,true]},"author_info":{"info":["admin"]},"category_info":"Ask A Doctor<\/a> Columns<\/a>","tag_info":"Columns","comment_count":"0","jetpack_featured_media_url":"https:\/\/i0.wp.com\/thefilipinochronicle.com\/backup\/wp-content\/uploads\/2020\/09\/image.png?fit=221%2C198&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/posts\/3876"}],"collection":[{"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/comments?post=3876"}],"version-history":[{"count":1,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/posts\/3876\/revisions"}],"predecessor-version":[{"id":3878,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/posts\/3876\/revisions\/3878"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/media\/3877"}],"wp:attachment":[{"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/media?parent=3876"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/categories?post=3876"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thefilipinochronicle.com\/backup\/wp-json\/wp\/v2\/tags?post=3876"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
What is a gallbladder?<\/strong>
<\/em>The gallbladder (GB) is a small balloon located under the right side of the liver, right underneath the rib cage. It is a storage tank for bile, which is a fluid that the liver makes to help digest fats. Bile is transported from the liver and GB through a tube called the common bile duct (CBD).\u00a0 The CBD empties into the small intestine where it mixes with food to aid in digestion.There is a muscle at the end of the CBD that closes off when we are not eating.\u00a0This forces the bile to then back up into the gallbladder for storage. When we eat, the signals of digestion relax the muscle, allowing the bile to enter into the intestine, as well as squeezes the gallbladder for emptying.
What are gallstones?<\/strong><\/em>
Bile is made up of a few different components.\u00a0 When there is an over abundance of a certain component, usually cholesterol, they tend to clump together forming what is called GB sludge and then progressing further to form gallstones.\u00a0 Gallstones are rocks that can vary in size from tiny grains of sand to golf balls.\u00a0
How do I get gallstones?<\/strong><\/em>
A few risk factors that seem to be associated with developing gallstones include: female, obesity (likely due to high levels of fats in the blood), pregnancy (likely from hormonal changes), rapid changes in weight, and age (the risk of developing gallstones increases with age; by age 75, 35% of women and 20% of men have gallstones).
What types of symptoms do people with gallstones have?<\/strong><\/em>
Not all people with gallstones will have problems. However, the usual presentation is upper abdominal right sided pain, sometimes traveling to the back. Many patients also complain of nausea or vomiting. They feel bloated and have no appetite.\u00a0 If the GB inflammation progresses, they may begin to have a fever or chills.\u00a0 These symptoms usually start within a few hours of eating a fatty meal.
This is because when the gallbladder is squeezed for digestion of fatty foods, the stones can cause irritation of the gallbladder, or the stones can get stuck. The stones can get stuck in the GB, on the way out through the tube, or get stuck in the tube.\u00a0 Sometimes the stones get stuck in the tube that drains the pancreas, and patients can present with pancreatitis. Symptoms of pancreatitis include severe back pain or yellowing of the eyes or skin called jaundice.
Many times, the stone unplugs itself from blocking the GB and flow is reestablished and the symptoms resolve over a few hours or so.\u00a0 This is called biliary colic.\u00a0 Unfortunately, the stones don’t just disappear.\u00a0 If you’ve experienced a painful episode once; it is highly likely that you’ll experience another, and another, and another.\u00a0\u00a0
What is the treatment for gallstones?<\/strong><\/em>
If symptomatic, then the entire gallbladder should be removed surgically. A cholecystectomy<\/em> is mostly done using a laparoscopic approach, in which small incisions and a camera are used to remove the gallbladder.\u00a0 If we are unable to do it that way for whatever reason, then a larger incision (\u2018open\u2019 approach) in the right upper abdomen under the ribs is required.
If you\u2019ve developed gallstones but have never had symptoms before, it would probably be fine to hold off on surgery but close monitoring is highly recommended.\u00a0 I would also suggest eating a low fat, high fiber diet and continue to maintain a routine exercise schedule.
Unfortunately, many patients have fallen victim to various non-surgical cures advertised on the internet claiming that the stones can be dissolved if only you drink a certain dietary blend of liquids.\u00a0 I recommend caution in trying these homemade remedies, not because they\u2019re dangerous; but primarily because they just don\u2019t work. In fact, in my practice, some patients try these alternative therapies, with no changes in follow-up GB ultrasounds. They usually end up having surgery for symptoms.
How long is surgery and what is the recovery like?<\/strong><\/em>
Symptomatic patients who have delayed surgery and whether or not the gallbladder is actively inflamed plays a role in the difficulty of surgery.\u00a0 Each time a patient has a painful episode, the GB gets thicker and scarred which can make surgery much more challenging.\u00a0 On average, a laparoscopic cholecystectomy takes about 30-90 minutes.
Most outpatients go home the same day with prescriptions for pain medicine, stool softener, and maybe even a medicine for nausea.\u00a0For those patients who are actively in pain, being seen in the ER with maybe fever\/chills, having an elevated infection count on their blood test, evidence of acute inflammation on some imaging test, and those needing to have emergency surgery, postoperative hospitalization may be needed.
How long will I have to be out of work?<\/strong><\/em>
Most patients can expect to be out of work anywhere from 2-4 weeks depending on how active their job is.\u00a0 I usually recommend no heavy lifting >10-15lbs, no strenuous exercise\/activity, and no swimming\/bathing for 2-3 weeks.\u00a0 The incisions need time to heal and doing too much too early will likely cause more pain and increase the risk of complications.
Are there any risks and side effects of having\u00a0gallbladder surgery?<\/strong><\/em>
Any surgery has risks including bleeding, pain, scars, injury to other nearby structures, and need for further surgery or procedures.\u00a0 For the most part, those risks are minor and quite rare and shouldn’t be the reason to delay or not have surgery altogether.\u00a0 Gallstones can develop into a life-threatening condition and shouldn’t be taken lightly.\u00a0
Many patients ask if there are any dietary restrictions after the surgery.\u00a0 Most patients actually see little change in their bowel movements.\u00a0 However, some do develop loose stools after eating oily\/fatty foods.\u00a0Everyone reacts differently though.\u00a0 Some patients can have ice cream while others can’t.\u00a0 It all sort of depends on how each person’s body reacts.\u00a0 I encourage patients to avoid spicy or fatty foods at least for about 2 weeks and then to slowly introduce in small amounts different types of foods and see how their body responds.
What are the risks if I don\u2019t have surgery?<\/strong><\/em>
We strongly recommend having surgery for symptomatic gallstones.\u00a0 If there is a delay, it is important to know the possibilities of what could happen.\u00a0 Usually, symptoms get worse over time.\u00a0 Pain increases in severity.\u00a0 Episodes may begin to last longer than usual and they may occur more frequently.\u00a0 As mentioned before, each episode of inflammation causes scarring of the GB to some degree.\u00a0 This could make things much more difficult during surgery thereby increasing the chance of open surgery which also increases the risk of having complications and possibly more procedures. Therefore, it is much safer to have surgery when the GB is not acutely inflamed.\u00a0 Waiting until a GB infection and having to have emergency surgery increases the risk of complications. Lastly, repeated bouts of GB inflammation increase the risk of developing GB cancer, which carries with it an extremely poor prognosis.\u00a0
DR. ROSS SIMAFRANCA<\/strong> is a general surgeon practicing in West Oahu since 2007.\u00a0 He finished his medical degree at UH -JABSOM and general surgery residency at UH Department of Surgery. \u00a0\u00a0He currently serves on the Philippine Medical Association of Hawaii Board of Governors. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"