![]() ![]() Make your own healthy GERD Diet. Scientific information on making a diet for GERD and choosing foods to avoid acid reflux. Read about symptoms of acid reflux. Gallstones and gallbladder disease Description. An in-depth report on the causes, diagnosis, treatment, and prevention of gallstones. Want to know what to eat or avoid if you have gallbladder disease? Ask Joanne Larsen, registered dietitian and nutrition therapist. Pancreatitis Causes, Symptoms, Treatments, Tests. The pancreas is a large gland behind the stomach and next to the small intestine. ![]() The pancreas does two main things: It releases powerful digestive enzymes into the small intestine to aid the digestion of food. It releases the hormones insulin and glucagon into the bloodstream. ![]() These hormones help the body control how it uses food for energy. Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas. There are two forms of pancreatitis: acute and chronic. Acute pancreatitis. Acute pancreatitis is a sudden inflammation that lasts for a short time. It may range from mild discomfort to a severe, life- threatening illness. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys. Chronic pancreatitis. Chronic pancreatitis is long- lasting inflammation of the pancreas. ![]() ![]() It most often happens after an episode of acute pancreatitis. Heavy alcohol drinking is another big cause. Damage to the pancreas from heavy alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms. What Are the Symptoms of Pancreatitis? Symptoms of acute pancreatitis: Symptoms of chronic pancreatitis: The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. Patients frequently feel constant pain in the upper abdomen that radiates to the back. In some patients, the pain may be disabling. Other symptoms are weight loss caused by poor absorption (malabsorption) of food. This malabsorption happens because the gland is not releasing enough enzymes to break down food. Also, diabetes may develop if the insulin- producing cells of the pancreas are damaged. Continued. What Causes Pancreatitis? In most cases, acute pancreatitis is caused by gallstones or heavy alcohol use. An acute attack of pancreatitis usually lasts a few days. An acute attack of pancreatitis caused by gallstones may require removal of the gallbladder or. I had to write because your wifes problem sounds very familar. I had extreme pain after my gallbladder operation too. The surgeon droped my sac inside me and had to. What do you know about gallstones? Gallstones: one of the most important factors to be aware of is that very often they do not cause any symptoms. Noninvasive Breast Cancer. Noninvasive breast cancers include: Ductal carcinoma in situ (DCIS; also called intraductal carcinoma). DCIS consist of cancer cells in the. ![]() Other causes include medications, infections, trauma, metabolic disorders, and surgery. In up to 1. 5% of people with acute pancreatitis, the cause is unknown. In about 7. 0% of people, chronic pancreatitis is caused by long- time alcohol use. Other causes include gallstones, hereditary disorders of the pancreas, cystic fibrosis, high triglycerides, and certain medicines. ![]() In about 2. 0% to 3. What Are the Risk Factors for Pancreatitis? Pancreatitis can happen to anyone, but it is more common in people with certain risk factors. Risk factors of acute pancreatitis include: Gallstones. Heavy alcohol drinking. ![]() Acute pancreatitis may be the first sign of gallstones. Gallstones can block the pancreatic duct, which can cause acute pancreatitis. Risk factors for chronic pancreatitis include: Heavy alcohol drinking for a long time. Certain hereditary conditions, such as cystic fibrosis. Gallstones. Conditions such as high triglycerides and lupus. People with chronic pancreatitis are usually men between ages 3. How Is Pancreatitis Diagnosed? To diagnose acute pancreatitis, doctors measure levels in the blood of two digestive enzymes, amylase and lipase. High levels of these two enzymes strongly suggest acute pancreatitis. Doctors may also use other tests, such as: Pancreatic function test to find out if the pancreas is making the right amounts of digestive enzymes. Glucose tolerance test to measure damage to the cells in the pancreas that make insulin. Ultrasound, CT scan, and MRI, which make images of the pancreas so that problems may be seen. ERCP to look at the pancreatic and bile ducts using X- rays. Biopsy, in which a needle is inserted into the pancreas to remove a small tissue sample for study. In more advanced stages of the disease, doctors may use blood, urine, and stool tests to confirm the diagnosis. How Is Pancreatitis Treated? Treatment for acute pancreatitis. People with acute pancreatitis are typically treated with IV fluids and pain medications in the hospital. In some patients, the pancreatitis can be severe and they may need to be admitted to an intensive care unit (ICU). In the ICU, the patient is closely watched because pancreatitis can damage the heart, lungs, or kidneys. Some cases of severe pancreatitis can result in death of pancreatic tissue. In these cases, surgery may be necessary to remove the dead or damaged tissue if an infection develops. Continued. An acute attack of pancreatitis usually lasts a few days. An acute attack of pancreatitis caused by gallstones may require removal of the gallbladder or surgery of the bile duct. After the gallstones are removed and the inflammation goes away, the pancreas usually returns to normal. Treatment for chronic pancreatitis. Chronic pancreatitis can be difficult to treat. Doctors will try to relieve the patient's pain and improve the nutrition problems. Patients are generally given pancreatic enzymes and may need insulin. A low- fat diet may also help. Surgery may be done in some cases to help relieve abdominal pain, restore drainage of pancreatic enzymes or hormones, treat chronic pancreatitis caused by blockage of the pancreatic duct, or reduce the frequency of attacks. Patients must stop smoking and drinking alcoholic beverages, follow their doctor's and dietitian's dietary advice, and take the proper medications in order to have fewer and milder attacks of pancreatitis. Can Pancreatitis Be Prevented? Because most cases of pancreatitis are caused by alcohol abuse, prevention is directed at responsible drinking or no drinking at all. If heavy drinking is a concern, talk to your doctor or health care professional about a referral to an alcohol treatment center. Also, you may benefit from a support group such as Alcoholics Anonymous. Sources. SOURCES: Emedicine.. The disorder can occur a single time (acute), or can recur multiple times (chronic). Description. The gallbladder is a small, pear- shaped organ in the upper right hand corner of the abdomen. It is connected by a series of ducts (tube- like channels) to the liver, pancreas, and duodenum (first part of the small intestine). To aid in digestion, the liver produces a substance called bile, which is passed into the gallbladder. The gallbladder concentrates this bile, meaning that it reabsorbs some of the fluid from the bile to make it more potent. After a meal, bile is squeezed out of the gallbladder by strong muscular contractions, and passes through a duct into the duodenum. Due to the chemical makeup of bile, the contents of the duodenum are kept at an optimal p. H level for digestion. The bile also plays an important part in allowing fats within the small intestine to be absorbed. Causes and symptoms. In about 9. 5% of all cases of cholecystitis, the gallbladder contains gallstones. Gallstones are solid accumulations of the components of bile, particularly cholesterol, bile pigments, and calcium. These solids may occur when the components of bile are not in the correct proportion to each other. If the bile becomes overly concentrated, or if too much of one component is present, stones may form. When these stones block the duct leaving the gallbladder, bile accumulates within the gallbladder. The gallbladder continues to contract, but the bile cannot pass out of the gallbladder in the normal way. Back pressure on the gallbladder, chemical changes from the stagnating bile trapped within the gallbladder, and occasionally bacterial infection, result in damage to the gallbladder wall. As the gallbladder becomes swollen, some areas of the wall do not receive adequate blood flow, and lack of oxygen causes cells to die. When the stone blocks the flow of bile from the liver, certain normal byproducts of the liver's processing of red blood cells (called bilirubin) build up. The bilirubin is reabsorbed into the bloodstream, and over time this bilirubin is deposited in the skin and in the whites of the eyes. Because bilirubin contains a yellowish color, it causes a yellowish cast to the skin and eyes that is called jaundice. Gallstone formation is seen in twice as many women as men, particularly those between the ages of 2. Pregnant women, or those on birth control pills or estrogen replacement therapy have a greater risk of gallstones, as do Native Americans and Mexican Americans. People who are overweight, or who lose a large amount of weight quickly are also at greater risk for developing gallstones. Not all individuals with gallstones will go on to have cholecystitis, since many people never have any symptoms from their gallstones and never know they exist. However, the vast majority of people with cholecystitis will be found to have gallstones. Rare causes of cholecystitis include severe burns or injury, massive systemic infection, severe illness, diabetes, obstruction by a tumor of the duct leaving the gallbladder, and certain uncommon infections of the gallbladder (including bacteria and worms). Although there are rare reports of patients with chronic cholecystitis who never experience any pain, nearly 1. The pain may be crampy and episodic, or it may be constant. The pain is often described as pushing through to the right upper back and shoulder. Because deep breathing increases the pain, breathing becomes shallow. Fever is often present, and nausea and vomiting are nearly universal. Jaundice occurs when the duct leaving the liver is also obstructed, although it may take a number of days for it to become apparent. When bacterial infection sets in, the patient may begin to experience higher fever and shaking chills. Diagnosis. Diagnosis of cholecystitis involves a careful abdominal examination. The enlarged, tender gallbladder may be felt through the abdominal wall. Pressure in the upper right corner of the abdomen may cause the patient to stop breathing in, due to an increase in pain. This is called Murphy's sign. Physical examination may also reveal an increased heart rate and an increased rate of breathing. Blood tests will show an increase in the white blood count, as well as an increase in bilirubin. Ultrasound is used to look for gallstones and to measure the thickness of the gallbladder wall (a marker of inflammation and scarring). A scan of the liver and gallbladder, with careful attention to the system of ducts throughout (called the biliary tree) is also used to demonstrate obstruction of ducts. Rare complications of cholecystitis include: massive infection of the gallbladder, in which the gallbladder becomes filled with pus (called empyema)perforation of the gallbladder, in which the build- up of material within the gallbladder becomes so great that the wall of the organ bursts, with a resulting abdominal infection called peritonitisformation of abnormal connections between the gallbladder and other organs (the duodenum, large intestine, stomach), called fistulasobstruction of the intestine by a very large gallstone (called gallstone ileus)emphysema of the gallbladder, in which certain bacteria that produce gas infect the gallbladder, resulting in stretching of the gallbladder and disruption of its wall by gas. Treatment. Initial treatment of cholecystitis usually requires hospitalization. The patient is given fluids, salts, and sugars through a needle placed in a vein (intravenous or IV). No food or drink is given by mouth, and often a tube, called a nasogastric or NG tube, will need to be passed through the nose and down into the stomach to drain out the excess fluids. If infection is suspected, antibiotics are given. Ultimately, treatment almost always involves removal of the gallbladder, a surgery called cholecystectomy. While this is not usually recommended while the patient is acutely ill, patients with complications usually do require emergency surgery (immediately following diagnosis) because the death rate increases in these cases. Similarly, those patients who have cholecystitis with no gallstones have about a 5. Most patients, however, do best if surgery is performed after they have been stabilized with fluids, an NG tube, and antibiotics as necessary. When this is possible, gallbladder removal is done within five to six days of diagnosis. In patients who have other serious medical problems that may increase the risks of gallbladder removal surgery, the surgeon may decide to leave the gallbladder in place. In this case, the operation may involve removing obstructing gallstones and draining infected bile (called cholecystotomy). Both cholecystectomy and cholecystotomy may be performed via the classical open abdominal operation (laparotomy). The laparoscopic procedure can also be used to remove the gallbladder through one of the small incisions. Because of the smaller incisions, laparoscopic cholecystectomy is a procedure that is less painful and promotes faster healing. Prognosis. Hospital management of cholecystitis ends the symptoms for about 7. Of these patients, however, 2. Each attack of cholecystitis increases a patient's risk of developing life- threatening complications, requiring risky emergency surgery. Therefore, early removal of the gallbladder, rather than a . Cure is complete in those patients who undergo cholecystectomy. Prevention. Prevention of cholecystitis is probably best attempted by maintaining a reasonably ideal weight. Some studies have suggested that eating a diet high in fiber, vegetables, and fruit is also protective. Resources. Organizations. Digestive Disease National Coalition. Capitol Court NE, Suite 2. Washington, DC 2. Information Way, Bethesda, MD 2. Bile contains many different substances, including bile salts, cholesterol, and bilirubin. After a meal, the gallbladder pumps bile into the duodenum (the first part of the small intestine) to keep the intestine's contents at the appropriate p. H for digestion, and to help break down fats. Bilirubin — Produced when red blood cells break down. It is a yellowish color and when levels are abnormally high, it causes the yellowish tint to eyes and skin known as jaundice. Cholecystotomy — An operation during which the gallbladder is opened, gallstones are removed, and excess bile is drained. The gallbladder is not removed. Duct — A tube through which various substances can pass. These substances can travel through ducts to another organ or into the bloodstream. Gallbladder Disease - Ask the Dietitian? Dietitians often have their own private practice nutrition counseling services in addition to services provided in a clinic or hospital. Include your zip code or city / state, the type of service you want (individual consultation) and expertise in digestive disorders and gastrointestinal diseases / disorders. Thanks for the reply. Just don't overdo as your liver is working . Her doctor put her on a diet of clear liquids last week and she needs to remain on that for a couple more weeks (I am not sure how long after the surgery). My concern is that she will not get all of her nutrients. Plus, I know she is sick of gelatin and broth. What else can she have? Besides flavored gelatin and broth (chicken or beef), she can have apple juice, cranberry juice and tea. A clear liquid diet is low in calories and most vitamins and minerals. Since it is used for such a short time, I wouldn't worry. After your sister has her gallbladder removed, she will be started on clear liquids again, then full liquids (any food liquid at body temperature 9. F) and finally a regular diet. I was reading your Q& A on gallbladder and I wonder if you have the e- mail address of the husband who wrote that his wife was getting sick after gallbladder removal. I have the same problem and would like to see what they found out if anything. Thanks for your help, if you feel it would be wrong to send me their e- mail address please forward this to them. Hi. I do not keep viewers e- mail address due to the number of persons who write to me. Nor can I forward your letter to them. Sorry. I would suggest you go back and see your surgeon or another specialist. It is very unusual to have symptoms like below after surgery. My wife had her gallbladder removed last June as she had several gallstones. Soon after the operation, she would once in a while (2 to 3 hours after supper) experience a very painful burning sensation in her tummy. She would scream uncontrollably at the top of her lungs for several seconds and spit up part of her dinner. She would feel better after a 2 or 3 . I read the gallbladder topic Q and A you have and her situation sounds similar except that her gallbladder has been removed. She knows that she should not eat foods that are very fat or fried foods. Yesterday's supper did have stir- fried vegetables, but the overall meal was not particularly worse than other meals she has been eating without problems. Is there some randomness to be expected for the amount of fat ingested to trigger an . She doesn't remember her doctor mentioning spicy foods, but we will ask him about it the next we see him (my wife goes to him periodically regarding hormone - thyroid hormone replacement). Do you know if she needs to avoid spicy foods also? If so, would this be for both red and black pepper? You told the person in your Q& A too much fiber should be avoided. My wife does like to have fruit after dinner (she had an orange and a tangerine last night). As such she has had her gallbladder removed, should she avoid too much fiber also? I did give her a glass of Metamucil several weeks ago as she was constipated and this did not give her problems. We hope to avoid this situation again by watching what she eats, but if she does happen to break down and eat something marginally fatty or lightly fried, would Tums or Pepcid AC type products help her if taken early enough? I hope to see your reply either by email or posted in your web site. It is not normal for someone to experience a . This should not happen whether or not they have had their gallbladder removed. You do not specify whether it is in her stomach area above her belly button or in her intestinal area below her belly button. This could help her doctor locate the problem. Would not suggest you . You may disguise the symptoms and delay treatment with periodic periods of relief from such over the counter medicines. People who have had their gallbladder removed have varying tolerances to the very foods that previous to their surgery may have caused gallbladder attacks. These foods may have been high fat or fried foods as well as whole grain breads and cereals, nuts, seeds or gas producing vegetables (baked beans) from the cabbage family (broccoli, brussel sprouts, cabbage or cauliflower). This may include over the counter bulking agents like Metamucil. Spicy food seasoned with red or black pepper may cause some discomfort for persons with gallbladder disease but not necessarily. Symptoms may range from burping and gas to a feeling of fullness (like the food isn't going the direction it should). When this current problem is treated, your wife should be able to return to a normal diet if no other medical nutritional therapy is recommended. That means that she would be able to eat anything. If constipation were a reoccurring problem, I would suggest a high fiber diet if she were allowed a normal diet. Whole grain cereals and breads, fresh fruit (including edible peels) and fresh vegetables should be included in her daily menu. Perhaps she should see a Registered Dietitian to address all her health plans into one meal plan. Hello, I have a brother, 2. Southern California. My other brother and I are trying to help him out. He has been taken by ambulance numerous times to different hospitals that send him straight to county hospital. The county Doctor told him he needs his gallbladder out. He has no kidney stones, but has a lot of pain ,throws up everything, including blood and has blood coming out the other end. He also throws up lots of clear and yellow stuff. He has had this for awhile. My question is can a gallbladder burst like an appendix? Also, the past three times he has been to the county hospital, they give him morphine, keep him in for a few days, then tell him to go home and they will take his gallbladder out next time. This has happened three times. Any advice will be greatly appreciated. Thank You. Yes, a gallbladder can rupture like an appendix. A gallbladder attack is painful and the morphine will control the pain. The pain starts at the bottom of the breastbone like a heart attack and may radiate around to the back unlike a heart attack. Gallstones can get stuck in the opening of the duct to the intestines or cause pain as they are passing through. Sometimes doctors don't like to take out a gallbladder when it is inflamed as the risk of complications or infection could be greater. I would suggest your brother make an appointment to see a county doctor ASAP and schedule to have his gallbladder removed. Most states have medical coverage for persons who can't afford it or have a pre- existing illness not covered by insurance. You can advocate for him as he may not feel well enough to get adequate help until the pain is excessive. Be persistent with your advocacy for your brother! If the blood he is throwing up looks like coffee grounds, he may also have an ulcer in his stomach. If it is bright red blood, then it is coming from somewhere higher than the stomach, possibly the esophagus or lungs. The cause of bleeding should be determined. Bright red blood in the stool can come from hemorrhoids or a fissure in the end of the large colon. Blood loss higher in the intestines or iron supplements usually colors the stool black rather than bright red. The cause of blood in stool should be determined. Don't know what the yellow vomit is. Though bile is yellow, it is secreted into the intestines, not the stomach. Until he gets his gallbladder out, I would suggest he avoid any fat, fatty meats, fried foods, whole grains, seeds and skins as these foods need bile to be digested. Bile is produced by the liver and stored in the gallbladder until needed to break down these foods. One can live without a gallbladder because the liver produces bile and can be secreted directly into the intestines. Went to physician, then sonogram. The onset is almost exactly 2. For example, a meal of white chicken breast (no skin), baked potato chunks with very little cheese sauce, kale and a root beer float for desert was finished at 7: 3. PM. By 1. 0: 1. 0 PM, the pain described above occurred. This pain lasts for about 3 to 4 hours, during which time it is always constant although of varying intensity. It seems to radiate toward my back on the same side (right). No aspirin or other commercially available painkillers have any effect. I have used some PERCOCET and this seems to do the trick. Now. I saw a MD who suspected gallstones. I had a sonogram that showed nothing (all normal). Question: What the heck is going on?? Well rather than playing doctor whom is not my specialty or yours, I would suggest you get a second opinion. Chest pain is not something to wait around to go away. Actually symptoms of a gallbladder attack mimic a heart attack. Your description of food eaten, delay in pain after a meal and pain below the sternum with radiation around to the back describes common symptoms of gallstones. I would suggest that you go back to see your doctor rather that waiting out the pain. Newer tests are available to help diagnose the cause. The above meal contains baked potato skin, cheese sauce, kale and the ice cream portion of the root beer float, which would aggravate gallstones along with large portions of any of the other foods. Until the cause of the pain if found, I would suggest you follow a low fat, low fiber diet with 2. Also, avoid foods with seeds or skins, limit whole grains, fresh fruits and vegetables to the cooked version. Also, don't overeat at meals. Your liver produces bile, which is stored in the gallbladder until a meal. Bile is an emulsifies that pushes fat molecules apart to allow enzymes from the pancreas to break down fats prior to absorption. If you have gallstones, especially if they block the duct coming out of the gallbladder or going down to the intestinal tract, that could be the source of your pain, which will not be, relieved with aspirin or other painkillers.
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