Gallstones: What you need to know

I’ve always had a history of stomach problems. For a time, we always dismissed it as a chronic constipation due to my lack of interest in anything green and fiber-y, unless it was actual dollar bills. There were times I would be rushed to the emergency room of which I was discharged after a few hours. One time during a trip in Malaysia, an ambulance had to pick me up from the hotel – something to cross out the bucket list, I guess. Whatever my stomach pain was, which eventually would end up me sweating bullets, pale skin and cold to the touch, vomiting, and tired, as soon as the episode has passed, I would crawl into bed and forget everything about it and continue with my routine.

Bad irresponsible patient.

I’ve neglected it and didn’t raise the flag whatsoever not until in 2007 when the pain was different, terribly unbearable and I had to return to the bathroom more than three times. I vomited so much that all I could spew was just bile and water that I just drank. I knew something was off and we had to run to the emergency room again. I was brought to the small timid hospital called Malvar Hospital along Commonwealth Avenue. Like any government owned hospital in the Philippines, the building was old, patients looked really bad, it looked under manned and the only thing you see new is the consumables. It was scary but when in pain, all that mattered to you was someone to tend to you right away. It was there when the over 35-year-old emergency room surgeon suspected I had something more than what seems to be constipation. The lack of full response expected after jabbing two syringes of painkillers into my arm meant something more. I was quickly scanned and lo and behold, I had gallstones.

Though he wanted to operate on me immediately, we opted not to do it right away because we were unprepared for it – not only financially but emotionally and mentally. We didn’t know what gallstones were, we were unsure how the operation is going to be done, and hell we didn’t know what’s next after that.

What are gallstones?

Gallstones are not the same as kidney stones, hence the obvious name difference (sorry for the sarcasm but I had a rather bad experience with a know-it-all on this debate). It is found in the gallbladder located under your liver. Kidney stones are found in the kidneys that are located at the back. The purpose of a gallbladder is to store the bile, a substance secreted by your liver to help in digestion. It is a small sac that expands and contracts to control the flow of bile while your body processes your food – especially the fatty ones. Bile is the yellow, greenish to brownish color you see when you vomit. It is smelly and bitter in taste. Now when bile has been stored for quite some time in the gallbladder, and it is just too thick, it forms into crystals called the gallstones.

Little green sac below the liver is called the gallbladder
Little green sac below the liver is called the gallbladder

Are gallstones dangerous?

Gallstones are not dangerous itself. There are patients out there with gallstones who do not experience any pain whatsoever for years! It becomes dangerous when it clogs up the ducts that is connected to your gallbladder blocking the flow of enzymes causing the pain in the upper right abdominal area and sometimes would reverberate to the back. Another cause of the pain is when the gallbladder contracts, its walls are rubbed on to the stones causing it to be traumatized hence also causing the pain.

Please note self-diagnosing is not advisable. Though these are the common pain symptoms reported, other symptoms of gallstones can appear in not farting as much, stools, yellowing of the skin, etc. Please check with your doctor.

What causes the gallstone formation?

Previously it is believed that gallstone patients possess the 4 F’s – fat, female, over forty, and fecund age.

With the change of lifestyle, diet, and other factors, this scene has changed. Gallstone formation can be influenced by:

  1. the genes,
  2. poor diet especially those who fancy fatty food and those who crash diets or irregularly eat their meals,
  3.  diabetes,
  4. medication such as cholesterol lowering,
  5. change in estrogen hormones in women (yes, including the contraceptive pill), and/or
  6. age.

In one of my consultations with my surgeon, we were surprised to learn that he just came from an operation with a 13-year-old boy for gallstones. According to the doctor, the kid was obese and had fries used to pacify him since he was a toddler! Something to ponder for parents out there.

How to treat gallstones?

When you’re diagnosed to have gallstones, it’s time to change your diet. No fatty food. The reason to this is it causes the gallbladder to contract to expel the bile causing the pain mentioned above. Anything fried, meat, and dairy is a no no. Though protein is important, fish and white meat on chicken is exempted as long as it is not fried.

Unfortunately, I had not really undergone any treatment to remove the gallstones in the form of medication that I can say it actually worked. There was a small gel type tablet that I had to take three three times a day. Total of 9. It was tiring and expensive too as one tablet was PhP 35 (SGD 1). There was even a “home remedy” which I had to take a lot of apples, castor oil, some kind of salt, and lemon that makes you want to gag at the sight of it. Did they work? Again, I can’t say it really worked or not and the reason is I only tried it for such a short time before I ran into complications. I slipped in my no fat diet and ate some steamed beef which got me into a slippery slope of having jaundice.

SIDE NOTE: Jaundice is not only present for some newborns. It can also occur in adults. This is when your skin, eyes or even tongue turn yellow. Another sign is when your urine is very dark in color that it seems like tea is poured into the bowl. It can also have fever along with it. Jaundice is a telltale sign of the body saying “hey, the ducts around your liver is clogged do something”, roughly saying that is.

The permanent treatment of gallstones is to remove the gallstones and the gallbladder itself. It can be done by two modes of surgical operation – having a one big cut (open cholecystectomy), or 4-5 1 cm cuts on your belly (laparoscopic cholecystectomy). To have an open cholecystectomy is good as doctors may immediately see your gallbladder and other organs around it. Though it seems a direct approach, this would leave a huge cut that may take long to heal. On the other hand, the laparoscopy will leave small cuts where doctors may insert little hands in and using a small controller, like in game consoles, to navigate around. Having small cuts is good for those who doesn’t want massive scarring (especially with those who have the keloid gene) but it just limits the view. Both administers general anesthesia.

Life without a gallbladder

Initially, you’ll have really soft bowels after the operation but it will stabilize. There will be soreness around the operated area and laughing will be painful. It’s also a bitch for those who live in cool areas or have the occasional gassy discomfort in prolonged exposure to cooling machines such as air conditioners or an electric fan. For some reason for me, I had an initial distaste for oily food this proves how amazing the body can adjust without being fully aware.

But in general, life without a gallbladder is peachy for those who love to eat. You can eat again anything you want with no immediate consequences. Having your gallbladder removed is almost the same as having your appendix removed only it has an ugly caravan trailing behind if left unmanaged for a long time.

Since the bile controller is out of the picture, bile is continuously flowing. It means that when you need it to process fatty food, it won’t put out as much as what is actually needed. Since fat breakdown is not the same as what it used to, expect that fat can be absorbed into your body easily rather than expelled in time. Note that fatty liver, obesity, diabetes, and high blood pressure is closer than you think.

It is a must that you have to reclaim your life with proper diet and a lot of fiber to help process what you eat. Exercise doesn’t hurt as well but if you are a bit on the heavy side, do take it slow at first before going commando.

I hope this post enlightens you and makes you more conscious about your health. Don’t ignore any body pain. Always take note of anything and inform your doctor.

If you have any other ideas on gallstones, feel free to share!

Sincerely,

Toni
Gallbladder-less since 2007

PS: Special thanks to Dr. Reginita Uy of Chong Hua Hospital for some quick reference check I had to do.

 

One Reply to “Gallstones: What you need to know”

  1. Welcome to the club! I have a lot of friends who are gall-bladder less in the last 2 years or so. Now, watch out what you eat. 😉

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