GALLBLADDER PAIN - VERY NASTY

I'm not telling you anything, if you have experienced gallbladder pain. It comes on abruptly, rapidly gets to a severe intensity and then holds on, with minor wavering, for far too long!

You are most likely to feel it in the right upper quadrant of your tummy, and in your back at the same level.

Lots of people have gallstones without knowing anything about it. It is doubtful whether they cause any symptoms apart from bad pain¹. They usually turn up when one is having an ultrasound for some other reason.

They may never cause gallbladder pain. You can leave them right where they are and take them to your grave. The yearly risk of getting pain from them is 1-4%.


gall stones


CHOLECYSTITIS - GALL BLADDER PAIN AND INFLAMMATION

Attacks of gall bladder pain often last for hours.

During this time, the neck of the gall bladder is clamping down on the stone, which may be too big for it to discharge down the bile duct.

The lining of the gall bladder may become abraded by the pressure and friction.

Bile is extremely irritant on our flesh, and will readily cause marked inflammation of the gallbladder wall, when this happens.

As well as the biliary colic, one now gets pain and fever from the inflammation. The swelling may obstruct the main bile passage, and bile then builds up in the blood producing jaundice. The whites of ones' eyes then go yellow.
One is usually vomiting with it.

No germs are involved in the early stages of cholecystitis, and if a surgeon operates now, it is very easy because the swelling helps separate things.

Very soon, the inflamed tissues become too friable to operate safely, and surgery then is put off for weeks until you have recovered.

Having your gall bladder out is vastly more comfortable since the widespread use of endoscopic (keyhole) surgery.

Removing this organ, while not ideal, has little long term ill effect in the majority of people.

Once you start having episodes of gallbladder pain from stones, it is only a matter of time before you have cholecystitis.


AVOIDING GALLSTONES = AVOIDING GALLBLADDER PAIN

Eat chewy food, and take your time about it.

Note that I didn't say eat less. People who live in glass houses can't throw stones.

The advice above will result in you eating less, but not feeling hard done by.

You can make chewy vegetables taste any way you want, with tomato, peanut, tahini, honey, butter, basil, garlic, pepper etc.

Gall stones contain cholesterol but don't have anything to do with your serum total cholesterol, nor with the cholesterol content of your diet.

They do correlate with high triglycerides and low HDL in your blood, which in turn correlate with diet and exercise.


Once you have gallbladder pain, you may still have non surgical options.

Small gallstones do pass, so the gallbladder cleanses often advised may possibly work sometimes. I have never seen a definitely proven case myself.

Extracorporeal shock wave therapy is used, as is chenodeoxycholic (bile) acid. I have no experience of these treatments.


POST CHOLECYSTECTOMY SYNDROME

This is when you still have pains after having your gallbladder removed.
Not gallbladder pain now, but what?

Your doctor will probably have a test done to ensure no stones were left in the passage below the gallbladder. This will probably be a CT cholangiogram - x-rays after a special dye is injected to outline the passage.

Endoscopic retrograde cholangiopancreatography can be used to diagnose stones left in this "common bile duct." This uses a gastroscope, through your stomach into the small intestine, and up the passage where the bile comes into the duodenum.

The stones are then removed at the same time.



Any scar may generate pain. You can test for this possibility yourself.

Find something small, smooth and hard, such as the rounded top end of a biro. Press firmly as you run this along all of your scars, to see if there are tender spots. They are obvious and quite discrete.

I treat these spots by injecting local anesthetic into the tender scar. This hurts, but can immediately relieve someones' pain.

This is called neural therapy.

In the modality called "kinesiology" there is a method for correcting such problems from scars.

Google kinesiology scars and find the healthandgoodness.com site on this subject - some very interesting examples.



Bile is now draining continually into the upper small bowel, instead of just when you are digesting fatty foods.
This puts one at risk of it passing backwards into your stomach, (duodenogastric reflux or DGR,) which can cause gastritis.

Bile and duodenal contents can have bad effects in the long run, on both the stomach and the gullet. Long-term exposure can cause dysplasia, intestinal metaplasia, ulcers and malignancy in the stomach, and Barrett's esophagus and various forms of esophageal malignancy.



The passage carrying bile from the liver to the intestine may be damaged at operation, with narrowing and obstruction. This is very uncommon fortunately.


Investigations of gallbladder function

The first investigation is usually an upper abdominal ultrasound examinaion. This may show gallstones, thickened gallbladder wall or even a polyp (a grape-like thickening of the wall, protruding into the gallbladder.)

If this shows nothing amiss, but your doctor is still very suspicious of your gallbladder, he may order a HIDA scan. HIDA stands for hepatobiliary iminodiacetic acid, used to outline your gallbladder.

Technetium-99m-Labeled iminodiacetic acid is excreted in your bile, and shows the intra-hepatic bile ducts, common bile duct and gallbladder...

x


This test may be combined with something to make your gallbladder contract, and the proportion of its contents expelled (ejection fraction), can be calculated.



Back to home pain page from gallbladder pain page

Is it gallbladder pain or pylorospasm?

Cholangitis

This is (usually bacterial) infection in the main bile passage, usually due to blockage somewhere. As elsewhere in our body "stasis is the basis" - materials held up and stagnant, grow germs.

The blockage may be from stones, a tumor, blood clots, a narrowing that may occur after a surgical procedure, swelling of the pancreas, or from parasite invasion.

The symptoms are the same as in cholecystitis, but here always with evidence of obstructed bile flow. The urine may be dark, bowel actions pale and the eyes yellow.

Blood tests will show damage to the liver cells as well. Liver enzyme values will be at least 1.5 to 2 times above the high cutoff point (mean plus 2 standard deviations.) This is the top end of the "reference range."

If you see figures for any of your blood tests, there will be your result and then in brackets the RR or reference range. This is not a "normal range" but 95% of a reference population who were probably far from in ideal health.

Sam Queen of the Health Realities Institute has worked out better ranges for a lot of the commonly used blood tests, which are sometimes widely different to the regular ranges.

Cholangitis is usually treated in hospital with intravenous antibiotics, as it is a serious infection.

Notes and references

1. Just to prove me ignorant, a chap came in recently (Dec '10) and related how his chronic right shoulder and arm pain had totally resolved after his recent laparoscopic cholecystectomy for gall stones.

W. H. Price (did not find evidence for) Gall-bladder Dyspepsia Br Med J. 1963 July 20; 2(5350): 138–141. This article can be read in full at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1872305/?page=1



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