What to Eat After You Have Your Gallbladder Removed – Health Essentials from Cleveland Clinic

Surgeons remove more than 600,000 gallbladders each year to help eliminate pain associated with it. Often times, surgery is done because of gallstones, which are hard deposits of digestive fluid in the gallbladder. As people age, gallstones become more common.

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If you have your gallbladder removed, you’ll
likely experience changes in your digestion and will need to carefully watch
your diet.

The gallbladder, which is a pear-shaped
organ on your right side beneath your liver, isn’t necessary. However, it does
help you digest fatty foods. It also stores, concentrates and secretes the bile
your liver makes.

After surgery, your liver will still make enough bile, but you might have difficulty processing fatty foods – at least for a while. More than half of patients who have their gallbladder removed have trouble digesting fat.

Laura Jeffers, MEd, RD, LD, shares five tips to avoid discomfort after gallbladder removal:

1. Add foods back into your diet gradually

For the first few days after surgery,
stick with clear liquids, broths and gelatin. After that, gradually add
more solid foods back into your diet.

2. Avoid fried food and stick with smaller portions

Avoid fried foods, high-fat foods, foods with strong odors and gas-causing foods. You should also stick to small, frequent meals.  

3. Skip high-fat foods to help avoid discomfort

Eating the wrong food after gallbladder
surgery can induce pain, bloating and diarrhea. To side-step this
gastrointestinal discomfort, avoid eating high-fat or spicy foods, including:

• French fries and potato chips.
• High-fat meats, such as bologna, sausage and ground beef.
• High-fat dairy, such as cheese, ice cream and whole milk.
• Pizza.
• Lard and butter.
• Creamy soups and sauces.
• Meat gravies.
• Chocolate.
• Oils, such as coconut and palm oil.
• Chicken or turkey skin.
• Spicy foods.

Typically, fat calories should total no more than 30% of your daily intake. That means if you eat about 1,800 calories each day, you should consume no more than 60 grams of fat.

Be sure to read food labels carefully. Look for foods that offer no more than 3 grams of fat per serving.

4. Take it slowly as you reintroduce high-fiber foods

Consider adding these gas-producing foods back into your diet slowly:

• Whole-grain bread.
• Nuts.
• Legumes.
• Seeds.
• Brussels sprouts.
• Broccoli.
• Cauliflower.
• Cabbage.
• Cereal.

Slowly add small amounts of foods back into your diet. Re-introducing things too quickly can lead to diarrhea, cramping and bloating.

5. Keep a food journal

It’s a good idea to keep a food journal
after surgery. This will help you keep track of what you eat and what the
impact was. Doing so will help you know what you can and cannot eat
comfortably.

Most people can return to a regular
diet within a month after surgery. However, talk to your doctor if you
experience these symptoms:

• Persistent, worsening or severe abdominal pain.
• Severe nausea or vomiting.
• Jaundice.
• No bowel movements for more than three days post-surgery.
• Inability to pass gas more than three days post-surgery.
• Diarrhea that lasts more than three days post-surgery.

After surgery, doing these things should help you feel more comfortable. As time goes on, take note of your tolerance for high-fiber foods and fats, especially healthy fats.

10 Side Effects of Having Gallbladder Removed

When the gallstones are big enough it can lead to bile build-up inside the gallbladder. Eventually, this can lead to gallbladder becoming infected and inflated. This is known as acute cholecystitis. To prevent such infection, one should get rid of gallstones right away. 

A cholecystectomy or removal of the gallbladder is a common operation for gallbladder pain from gallstones. However, the risk of complications depends on your overall health, type of surgery and the reason for your gallstones removal. There are several side-effects of traditional surgery for gallbladder removal.

Also Read: Why to choose laparoscopic surgery over open surgery?

Here are Top 10 Side-Effects of Gallbladder Removal

1. Difficulty in digesting food

   After the gallbladder removal, the body takes time to adjust to the missing organ. Therefore, the bile flows in a small amount directly into the small intestine. This can lead to temporary diarrhea.

   In some cases, the gallstones remain in the common bile duct even after the surgery. This can block the flow of bile into the small intestine and result in nausea, vomiting, bloating or fever. Thus, check with your doctor to stop this from getting worse.

2. Wound infection

   There is one large incision in open surgery or small incisions in laparoscopic surgery. After the surgery, these wounds are usually closed with dissolvable stitches or glue.

   The nearby organs may be injured when the instruments are inserted in the abdomen. Even the contact area is more. In addition to this, sometimes you may notice bruising around the wound. If you experience unusual pain after the surgery, call the doctor right away.

   Antibiotics are not for everyday consumption except for high-risk patients. Hence, keep the site clean to avoid infection.

3. Pain that gets worse

   It is normal to get sore after surgery and experience tenderness at the incision site. But the pain should not worsen. If the pain is getting worse then it is the sign of infection. When you touch the incision, if it pains, it again indicates infection.

4. Blood clot

   Some people are at risk of developing blood clots. This is known as deep vein thrombosis (DVT) and develops in leg veins. This can be serious as the clot can travel anywhere in the body blocking the flow of blood to the lungs.

5. Bile duct injury or bile leakage

   Bile duct can get cut, burned or damaged during the surgery. As a result of the injury, the bile duct is unable to perform its functions properly. The bile might leak into the abdomen or the damage can block the normal flow of the fluid from the liver.

6. Bulging of organ or tissue (Hernia)

   This problem may arise months or even years after the gallbladder removal surgery. There may be protrusion of tissues through the weak area around the incision area. Though it is not so common, hernia needs another surgery to get repaired.

7. Diarrhea and fever

   Indigestion can cause diarrhea which often worsens by excess fat and low fiber content in the diet. Fever after the surgery indicates that the body is struggling with an infection. Consult a doctor if you face a similar issue.

8. Damage to the bowel or blood vessel

   Constipation is common which hampers normal bowel habits. Constipation can be due to decreased activity, anesthesia or pain relief medicines. Make sure you increase the fiber content and fluid intake in your diet.

9. Heart problem

   Those who have already been through heart surgery or who is a heart patient puts the physical stress on the patient. This added stress or tension can complicate this problem both during and after gallstones removal surgery. Gallstones and heart disease share some common symptoms – obesity, cholesterol level or diabetes.

10. PCS if stones remain in the bile duct

    PCS stands for the post-cholecystectomy syndrome, which develops if the gallstones remain in the bile duct. There are chances that it occurs if the bile leaks into the stomach. PCS symptoms are same as that of gallstones which include abdominal pain, diarrhea and heartburn.

Also Read: Gallbladder Removal Complications

Recovery After Gallbladder Surgery

Unless there are no complications after the gallbladder removal, the recovery should go smoothly. 

After the surgery, the doctor will keep you in the hospital for three to five days if undergo an open surgery. For laparoscopic cholecystectomy, patient can go back home on the same day of the surgery.

Here are some pointers you should keep in mind-

• Try not to physically strain yourself for at least two weeks.
• You should know how to clean the wounds and look out for infection.
• Consume only liquid or bland diet for first few days.
• Drink liquids throughout the day.
• Limit highly salty, sweety, spicy or fatty foods for a couple of weeks.
• Increase your fiber intake for proper digestion but limit the consumption of nuts, seeds, whole grains, Brussels sprouts, cauliflower, cabbage, etc.

Sometimes during the recovery period, patients can develop some symptoms that should not be ignored. Here are some symptoms-

• Pain that doesn’t cure over time
• Abdominal pain that develops again
• Intense nausea or vomiting
• Unable to pass gas or stools
• Diarrhea
• Jaundice

Advantages of Laparoscopic Gallbladder removal

There are benefits of laparoscopic treatment over traditional surgery:

• Difficulty in digestion is just a temporary problem
• Risk of wound infection is negligible as the incisions made to perform the surgery are very small.
• Post-surgery complications are negligible
• Recovery is quick if you follow the diet instructions and exercises
• The surgery is performed by experts with great precision
• Patient can go home within 48 hours after the surgery

Dietary changes after the gallbladder removal surgery

Here are a few dietary changes to avoid discomfort after gallbladder removal:

• Add food into your diet gradually: For the first few days after surgery, stick to a liquid diet. After that, gradually add more solids to your food routine.
• Go for a low-fat and smaller portion of meals: Avoid fried foods, high-fat foods, and take small frequent meals.

Eating the wrong things after gallbladder surgery can induce pain, bloating and diarrhea. Consider reintroducing high-fiber food gradually- nuts, legumes, broccoli, cabbage, cauliflower and cereals. Immediately including such a diet can lead to diarrhea, cramping and bloating. 

Also Read: Gallbladder Surgery Recovery Tips

Conclusion

Most patients feel better within a week after surgery and can resume normal activities like walking, driving or some duties at work. However, they are not allowed to lift heavy weights, until you an affirmation from the doctor. You should talk with your doctor about any medical advice dealing with the complications after gallbladder removal surgery.

At Pristyn Care clinics, doctors are specialized in performing laparoscopic gallbladder removal surgery. Don’t wait anymore and give us a call today!

Gallbladder – gallstones and surgery

The gallbladder is a small sac that holds bile, a digestive juice produced by the liver that is used in the breakdown of dietary fats. The gallbladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gallbladder to squeeze its bile concentrate into the small intestine.

Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually in a mixture that forms in the gallbladder. They are a common disorder of the digestive system, and affect around 15 per cent of people aged 50 years and over.

Some things that may cause gallstones to form include the crystallisation of excess cholesterol in bile and the failure of the gallbladder to empty completely.

In most cases, gallstones don’t cause any problems. However, you might need prompt treatment if stones block ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).

Surgeons may remove your gallbladder (called a cholecystectomy) if gallstones (or other types of gallbladder disease) are causing problems. Techniques include laparoscopic (‘keyhole’) cholecystectomy or open surgery. The gallbladder is not a vital organ, so your body can cope quite well without it.

Symptoms of gallstones

In approximately 70 per cent of cases, gallstones cause no symptoms. The symptoms of gallstones may include:

• pain in the abdomen and back. Pain is generally infrequent, but severe
• increase in abdominal pain after eating a fatty meal
• jaundice
• fever and pain, if the gallbladder or bile duct becomes infected.

Types of gallstones

There are three main types of gallstones being:

• mixed stones – the most common type. They are made up of cholesterol and salts. Mixed stones tend to develop in batches
• cholesterol stones – made up mainly of cholesterol, a fat-like substance that is crucial to many metabolic processes. Cholesterol stones can grow large enough to block bile ducts
• pigment stones – bile is greenish-brown in colour, due to particular pigments. Gallstones made from bile pigment are usually small, but numerous.

Causes and risk factors for gallstones

Gallstones are more common in women than in men. They are also more common in overweight people and people with a family history of gallstones.

There is no single cause of gallstones. In some people, the liver produces too much cholesterol. This can result in the formation of cholesterol crystals in bile that grow into stones. In other people, gallstones form because of changes in other components of bile or because the gallbladder does not empty normally.

Diagnosis of gallstones

Doctors diagnose gallstones by using a number of tests, including:

• general tests – such as physical examination and x-rays
• ultrasound – soundwaves form a picture that shows the presence of gallstones
• endoscope test – endoscopic retrograde cholangiopancreatography (ERCP). A thin tube is passed through the oesophagus and injects dye into the bowel to improve the quality of x-ray pictures
• hepatobiliary iminodiacetic acid (HIDA) scan – a special type of nuclear scan that assesses how well the gallbladder functions
• magnetic resonance cholangiopancreatography (MRCP) – a form of the body-imaging technique magnetic resonance imaging (MRI). The person’s liver, biliary and pancreatic system is imaged using an MRI unit. The image is similar to an ERCP test.

Complications of gallstones

If gallstones cause no symptoms, you rarely need any treatment.

Complications that may require prompt medical treatment include:

• biliary colic – a gallstone can move from the body of the gallbladder into its neck (cystic duct), leading to obstruction. Symptoms include severe pain and fever
• inflammation of the gallbladder (cholecystitis) – a gallstone blocks the gallbladder duct, leading to infection and inflammation of the gallbladder. Symptoms include severe abdominal pain, nausea and vomiting
• jaundice – if a gallstone blocks a bile duct leading to the bowel, trapped bile enters the person’s bloodstream instead of the digestive system. The bile pigments cause a yellowing of the person’s skin and eyes. Their urine may also turn orange or brown
• pancreatitis – inflammation of the pancreas, caused by a blocked bile duct low down near the pancreas. Pancreatic enzymes irritate and burn the pancreas and leak out into the abdominal cavity
• cholangitis – inflammation of the bile ducts, which occurs when a bile duct becomes blocked by a gallstone and the bile becomes infected. This causes pain, fever, jaundice and rigors (shaking)
• infection of the liver
• cancer of the gallbladder (occurs rarely).

Treatment for gallstones

Gallstones that cause no symptoms, generally don’t need any medical treatment. In certain cases (such as abdominal surgery for other conditions), doctors may remove your gallbladder if you are at high risk of complications of gallstones.

Treatment depends on the size and location of the gallstones, but may include:

• dietary modifications – such as limiting or eliminating fatty foods and dairy products
• lithotripsy – a special machine generates soundwaves to shatter the gallstones. This treatment is used in certain centres only, for the minority of people with small and soft stones
• medications – some medications can dissolve gallstones, but this treatment is only rarely given, due to side effects and a variable success rate
• surgery.

Surgical removal of the gallbladder or gallstones

Around 80 per cent of people with gallstone symptoms will need surgery. Surgeons may remove your entire gallbladder (cholecystectomy), or just the stones from bile ducts.

Techniques to remove the gallbladder include:

• laparoscopic cholecystectomy – ‘keyhole’ surgery. The surgeon makes a number of small incisions (cuts) through the skin, allowing access for a range of instruments. The surgeon removes the gallbladder through one of the incisions
• open surgery (laparotomy) – the surgeon reaches the gallbladder through a wider abdominal incision. You might need open surgery if you have scarring from prior operations or a bleeding disorder.

Medical factors to consider before cholecystectomy

Before the operation, you need to discuss some things with your doctor or surgeon, including:

• your medical history, since some pre-existing conditions may influence decisions on surgery and anaesthetic
• any medications you take on a regular basis, including over-the-counter preparations
• any bad reactions or side effects from any medications.

Laparoscopic cholecystectomy

The general procedure includes:

• The surgeon makes a number of small incisions into your abdomen, so that slender instruments can reach into the abdominal cavity.
• A tube blowing a gentle stream of carbon dioxide gas is inserted. This separates the abdominal wall from the underlying organs.
• The surgeon views the gallbladder on a TV monitor by using a tiny camera attached to the laparoscope.
• Special x-rays (cholangiograms) during the operation can check for gallstones wedged in the bile ducts.
• The ducts and artery that service the gallbladder are clipped shut. These clips are permanent.
• The gallbladder is cut free using either laser or electrocautery
• The gallbladder, along with its load of gallstones, is pulled out of the body through one of the abdominal incisions.
• The instruments and the carbon dioxide gas are removed from the abdominal cavity. The incisions are sutured (closed up) and covered with dressings.

Open gallbladder surgery

The general procedure is the same as for laparoscopic surgery, except that the surgeon reaches the gallbladder through a large, single incision in the abdominal wall. Sometimes, an operation that starts out as a laparoscopic cholecystectomy turns into open surgery if the surgeon encounters unexpected difficulties, such as not being able to see the gallbladder properly.

Immediately after gallbladder surgery

After a gallbladder operation, you can expect to:

• feel mild pain in your shoulder from the carbon dioxide gas
• receive pain-relieving medications
• be encouraged to cough regularly to clear your lungs from the general anaesthetic
• be encouraged to walk around as soon as you feel able
• stay overnight in hospital, if you had a laparoscopic cholecystectomy
• stay up to eight days in hospital, if you had open surgery.

Complications after gallbladder surgery

All surgery carries some degree of risk. Possible complications of cholecystectomy include:

• internal bleeding
• infection
• injury to nearby digestive organs
• injury to the bile duct
• leakage of bile into the abdominal cavity
• injury to blood vessels.

Self-care after gallbladder surgery

Be guided by your doctor, but general self-care suggestions include:

• Rest as much as you can for around three to five days.
• Avoid heavy lifting and physical exertion.
• Expect your digestive system to take a few days to settle down. Common short-term problems include bloating, abdominal pains and changes to toilet habits.

Most people recover within one week of laparoscopic surgery.

Long-term outlook after gall bladder surgery

You will need to see your doctor between seven and 10 days after surgery to make sure all is well. Some rare complications may have to be followed up with another operation.

Where to get help

Things to remember

• Gallstones are small stones made from cholesterol, bile pigment and calcium salts, which form in a person’s gall bladder.
• Medical treatment isn’t necessary unless the gallstones cause symptoms.
• Treatment options include surgery and shattering the stones with soundwaves.

Life After Gallbladder Removal: Rockwall Surgical Specialists: General Surgery

The gallbladder is a pear-shaped organ that’s about 4 inches long. It sits just below your liver in the upper right quadrant of your abdomen. Your gallbladder is not a vital organ, meaning you can live well without it. It does serve a purpose, though: to concentrate, store, and release bile made by your liver to help you digest fatty foods.

If you’re experiencing the pain and other symptoms that a faulty gallbladder can cause, you may be looking forward to gallbladder removal (cholecystectomy) and relief from your discomfort. And you aren’t alone. Surgeons in the United States remove about 600,000 unhealthy gallbladders annually, mostly due to gallstones.

You can expect to live a perfectly normal life after gallbladder surgery but may experience temporary side effects related to the way your digestive system processes fatty foods. These symptoms may include loose stools or diarrhea, bloating, cramping, and excess gas in response to meals or certain foods. Fortunately, these problems usually last 30 days or less and only affect about half of the people who undergo gallbladder removal.

At Rockwall Surgical Specialists, our surgeons have significant experience and expertise in gallbladder removal. Read on for their advice about what you can do to ease digestive ailments after a cholecystectomy.

Take a break after surgery

Whenever possible, our surgeons prefer the robotic-assisted laparoscopic technique for gallbladder removal because it’s a minimally invasive procedure. Compared to traditional open surgery, the laparoscopic method offers fewer risks of complications during and after surgery and greatly speeds your recovery time.

In fact, most of our patients who’ve undergone a laparoscopic procedure can return home the same day as their surgery. But don’t expect to return to your normal activities right away. Give your body a day or two to rest.

Pamper your stomach as well for two to three days with a diet that’s easy to digest. Start with clear liquids, broth, and gelatin, and then add solid foods gradually.

Reach for smaller portions, and skip the deep-fried menu

As your system gets used to processing fats without the aid of a gallbladder, large meals and high-fat foods can cause pain and bloating. Smaller, low-fat meals spread throughout your day — six is a good number — are easier for your digestive system to handle.

Foods to avoid in the weeks following gallbladder surgery include:

• High-fat meats, such as bologna, sausage, and hamburger
• Cheese, ice cream, whole milk, and other high-fat dairy products
• Pizza
• Cream soups or sauces and meat gravies
• Chocolate
• Chicken or turkey skin

We also recommend you avoid heavily spiced foods during your initial recovery phase because they’re more difficult to digest. Rather than deep-frying your foods, reduce the fat and add flavor by stir-frying skinless chicken breast or lean steak in a pan with a teaspoon of olive oil.

Introduce gas-producing foods slowly

High-fiber foods are an important part of a healthy diet but may add to the gassiness and cramping that can occur after a cholecystectomy. We don’t recommend you stop eating fiber, but we do suggest you introduce it slowly into your postsurgical diet over a couple of weeks.

Foods high in fiber that are natural gas producers include:

• Whole-grain bread
• Nuts and seeds
• Legumes
• Brussels sprouts, broccoli, cauliflower, and cabbage
• Some breakfast cereals, such as bran flakes

Remember that the digestive side effects following a cholecystectomy should resolve within one to four weeks of your procedure. If you have persistent symptoms beyond 30 days, it’s time to see your doctor.

If you’d like further details about what to expect during a cholecystectomy and what life is like after gallbladder removal, schedule a consultation today with one of our expert surgeons at Rockwall Surgical Specialists.

Gallbladder Problems Kansas City | In2GREAT Functional Medicine

GALLBLADDER PROBLEMS: SYMPTOMS AND NATURAL SOLUTIONS

It is estimated that approximately 700,000 gallbladders are removed each year. It is now rivaling hysterectomies in the number of procedures performed each year. The surgical removal of the gallbladder is a cholecystectomy. The frequency of this surgery is up from 500,000, on average, the years prior to the laparoscopic technique being introduced in the 1990’s. It appears since the surgical technique became faster, less expensive, and less invasive, the frequency went up. There is no evidence that anything occurred within American culture after the 1990’s to merit increased removal of the gallbladder. Even though the gallbladder is not a vital organ, there is concern it is being removed too often and too quickly. Just because you do not need an organ to survive (vital) does not mean that it is indispensable.

We are huge fans of gallbladders and think everyone should keep theirs whenever possible. Not unlike “The Little Engine That Could”, when the gallbladder is struggling to do the job it needs to do, there are ways to support it in order to, in most cases, avoid surgery and restore it back to healthy function. The gallbladder may be small, but it is mighty.

What is the Gallbladder

Your gallbladder is a pear-shaped organ under your liver. It stores the bile that your liver produces. Bile is continually secreted from the liver into the gallbladder where it is concentrated and stored, like a reservoir. This concentration of bile that occurs in the gallbladder is crucial for adequate fat digestions. Bile is then reabsorbed into the bloodstream to aid in digestion and deliver nutrients to the body. When your body needs bile to digest foods, the gallbladder squeezes bile through the bile ducts into your small intestine to break down fat from meals.

If there is build up of the things that make up bile like cholesterol, bile salts, and bilirubin, the excess hardens into gallstones. The liver is partially responsible for managing what goes into the gallbladder, so a healthy liver and gallbladder go together. Your gallbladder is responsible for:

Symptoms of Gallbladder Issues

• Nausea/vomiting
• Fatty or greasy stools
• Dry hair, eyes, brittle nails, itchy skin, skin rashes
• Diarrhea, bloating, cramping, excessive gas
• Pain between shoulders on right side and/or upper-right quadrant pain
• SIBO (small intestinal bacterial overgrowth)
• Abdominal pain
• Headache/migraines
• Chemical sensitivities (perfume, cologne, tobacco smoke)
• Hypothyroid
• Weight loss resistance

Causes and Risks of Gallbladder Complications

Potential causes of gallbladder issues include long-term low fat dieting, vegetarian/vegan diet, hypothyroid, high estrogen levels, impaired digestion, imbalance of gut bacteria and pro-inflammatory foods, and chronic infections (especially viral). Gallstones tend to run in families and women are more likely to experience gallbladder problems in part because of the effects of high estrogen on bile production. It is increasingly common for pregnant women to experience gallbladder attacks during and after pregnancy. This is due to high estrogen levels during and after pregnancy. Because of birth control, hormone disrupting chemicals, and general modern lifestyle contributing to hormone imbalances, many women spend years in an estrogen dominant state contributing to the development of gallbladder/liver issues.

Conventional Treatment of Gallbladder Issues

This is a pretty simple explanation. Surgically remove the gallbladder and follow a low fat diet for the rest of your life. There is essentially no real treatment for a sludgy gallbladder (biliary stasis). In all other organ related cases, surgical options are on the table AFTER all other available treatments have failed. However, with the gallbladder, it is removed at the first hint of an issue. This propensity towards surgery first with gallbladders can cause long term side effects that are often dismissed by surgeons. Additionally, after surgery, there is no liver and/or digestion support given and it is estimated that over 50+% of people who have gallbladder removed do not see any improvements in their digestive issues.

Side Effects of Gallbladder Removal

There are over 44 reported side effects from gallbladder removal.The top six reported side effects after surgery include:

1. Pain in Upper right quadrant of abdominal region or right shoulder pain
2. Nausea or Vomiting or Abdominal Cramping
3. Sporadic fever
4. Changes in bowel habit – especially diarrhea and light or chalky stools
5. Fatigue
6. Change in urine color – becomes more dark

These symptoms come from a variety of issues that occur when you don’t have your gallbladder. When you don’t have a gallbladder, the liver continues to make bile, but there’s no longer a place to store it, or concentrate it. Bile then slowly trickles into the intestines so if you eat a fatty meal,there’s not enough bile available to digest the fat since bile is the primary method of proper fat digestion. Fat malabsorption can be the cause of diarrhea, bloating, nausea and even heartburn.

Poor digestion of fats isn’t a small thing when it comes to your overall health and long-term health. Without a gallbladder you may not be able to digest essential fatty acids like omega 3 and omega 6 fats. These are both crucial to adequate hormone and brain function and are key players in managing inflammation. Fat soluble vitamins are dependant on good fat digestion to be absorbed so without a gallbladder, you may not absorb vitamins D, E, A, and K very well. Some phytonutrients like lycopene, lutein and carotenoids are fat soluble so absorption is impaired without a gallbladder. Even if you take extra of these nutrients, without enough bile you still will not absorb them well.

If you have had your gallbladder removed and suffer from dry, brittle hair, dry skin, dry eye, premature aging of skin, weak nails, low mood, anxiety, depression or impaired cognitive function, these could be signs you are not digesting fats adequately because of your gallbladder removal. Some of these symptoms could also be related to thyroid function which can also be inhibited by gallbladder removal. The gallbladder is also a key player in conversion of T4 to active T3 which is the main thyroid hormone.

Functional Medicine Treatment

A functional medicine approach to a healthy gallbladder includes taking care of the liver too. It supports the liver and bile secretion for life after gallbladder removal when it has already been removed. It is important to note that your gallbladder problem didn’t just happen spontaneously overnight even though the pain associated with a gallbladder attack can happen very suddenly. It started with an unhealthy liver and a poorly functioning digestive system which was likely developing for years. An unhealthy liver will not make quality bile and inadequate bile will not effectively digest fats, remove toxins, and increase risk for developing stones.

3 Essential Supplements after Gallbladder Removal

• Vitamin D3– since fat soluble vitamins are challenging for the body and vitamin D is so critical in a multitude of body functions, supplementing is key, especially in winter months
• Ox Bile– taking ox bile daily in rotating doses supports the body’s bile production and helps to replicate the intended function of the gallbladder
• Digestive Enzymes– bile is essential for proper breakdown of foods as they enter the intestines and digestive enzymes can support this process- especially lipase which aids in fat digestion

These three supplements will help support the very basic needs of the body after gallbladder removal, but it is important to work with your functional medicine practitioner to be sure your detoxification, digestion and absorption are optimized after gallbladder removal to prevent nutrient deficiencies and chronic disease- including autoimmune disease.

It is not uncommon for symptoms related to gallbladder removal to take time appear as deficiencies take time to develop. Don’t wait for poor digestion, essential fatty acid deficiencies and consequences of low vitamin D to set in before supporting your body if you have already had your gallbladder removed.

In the event you are experiencing gallbladder issues or gallstones and are considering gallbladder removal, be sure to work with a functional medicine practitioner to support your liver and gallbladder to remove gallstones without surgical intervention. Even a simple 3 day cleanse of bone broth, green apples and vegetables with appropriately designed supplement plan can stimulate better liver and gallbladder function. Some practitioners will use more aggressive one-day cleanses that often show good results in removing gallstones completely and therefore avoiding surgery.

Final Thoughts

Your gallbladder is important and should not be given up to surgery without a fight. Just because an organ is not vital to your survival does not mean it isn’t vital to your health. Daily habits that support a healthy liver and gallbladder can prevent issues from developing. If gallbladder issues do arise, there are treatment options instead of surgery. If surgery does need to occur or already has occurred, be encouraged- there are ways to support your liver in ways that can prevent ongoing issues. We have seen first hand patients who have been suffering from chronic health issues related thyroid, essential fatty acid deficiency and nutrient malabsorption trace the start of their hair loss, fatigue, diarrhea, cramping, bloating, and mood disorders back to a few months after their gallbladder removal. Don’t let this be you. We know it is not always possible to avoid gallbladder removal, but your long-term health does not have to suffer because of it.

in2GREAT Integrative Health is your solution to getting to the root cause of your condition. Our functional medicine practitioners focus on inflammation causing triggers that lead to chronic degenerative disease. See our Overland Park providers for your digestive needs.

Fecal Incontinence after Gallbladder Surgery

Gallbladder surgery is one of the most common surgical procedures performed in the U.S. today, with more than 700,000 procedures taking place each year. While the vast majority of patients experience no postoperative complications or changes, a small percentage may develop symptoms of fecal incontinence after gallbladder surgery which can range from occasional minor bowel leakage to more significant loss of bowel control. Symptoms can develop soon after surgery; other times, they may not appear until months afterward or longer.

What Is A Gallbladder?

The gallbladder is a small four-inch organ that is located under the liver in the upper-right section of one’s abdomen. The gallbladder concentrates and stores bile, a digestive fluid produced by the liver. 

What Does Your Gallbladder Do?

Your gallbladder acts as a reservoir for bile, a digestive acid produced by your liver. During digestion, your gallbladder delivers bile to the small intestine, through a small duct known as the common bile duct, in varying amounts depending on the food that’s being digested. This helps digest fats more effectively. 

What is Gallbladder Surgery?

Gallbladder surgery, also known as a cholecystectomy, is a common surgery that can be performed both as an outpatient or inpatient. The surgery most normally includes inserting a small camera and special surgical tools through small incisions to peer inside one’s abdomen and remove the gallbladder.

Why Is Gallbladder Removal Necessary?

Gallbladder removal is most commonly necessary to treat gallstones and any issues that they may cause. A doctor may recommend gallbladder removal if you are experiencing one of the following:

• Pancreas inflammation due to gallstones
• Gallstones in the gallbladder or bile duct
• Gallbladder inflammation

Gallbladder Removal Side Effects

Incontinence or other side effects can be a concern for some after they have undergone gallbladder removal. Below we have listed a number of side effects in bowel movements after gallbladder removal that one may experience.

Bowel Incontinence After Gallbladder Removal

Once the gallbladder is removed, some may notice an increase in mucus in their stool after the gallbladder removal. This is due to an increased amount of bile being delivered directly to the small intestine. This bile can act as a laxative resulting in increased bowel movements or bowel leakage after gallbladder surgery due to looser stools that are harder for your body to control. These symptoms resolve by themselves over time, but other times, they may persist.

Yellow Diarrhea or Smelly Bowels After Gallbladder Removal

Some people may experience yellow diarrhea or smelly poop after gallbladder removal. The larger amounts of bile reaching the colon may cause irritation resulting in diarrhea with a yellow hue. The increased amounts of bile salt can also make one’s bowel movements have a more potent smell as well. As your body adjusts after the gallbladder removal, these usually go away in a few weeks. If it continues to persist, consulting your doctor would be recommended.

Urinary Incontinence After Gallbladder Surgery

Some people report experiencing urinary incontinence after gallbladder removal. However, the reason for this was stress, aptly known as stress urinary incontinence, from the procedure. This is a common type of urinary incontinence and consulting your doctor about treatment plans is recommended.

Gallbladder Surgery Recovery and Incontinence Treatment Options

The first step towards successful recovery from gallbladder surgery and any resulting incontinence issues is reaching out to a physician for a consultation to help put you on the path leading to a happier, more confident life.

For many, changing one’s behavior can help treat these incontinence issues. Some examples of such changes are listed below:

• Diet Modification – Changing what one eats to increase fiber intake and fluid consumption.
• Increase Bowel Habits – Making sure one drinks plenty of liquids, gets proper exercise, and allowing their body regular bowel movements can help.
• Physical Therapy – In some cases, attending physical therapy can help treat fecal incontinence.

Other non-invasive procedures to help with incontinence resulting from gallbladder removal are:

• Medications – It is recommended one speaks with a physician about medications that can help with their unique situation.
• Biofeedback Therapy – This therapy is a painless, personalized method to help the patient learn how to control their muscles.

Fecal incontinence can cause significant embarrassment, anxiety and even depression, but the good news is, today there are lots of treatments that can be used to control symptoms,.

Studies have shown many people with fecal incontinence are too embarrassed to speak to their doctor about their symptoms. As a result, they live with unnecessary shame and inconvenience. If you suffer from fecal incontinence, remember: your doctor has heard it all before.

Make an appointment with an Incontinence Institute physician today for an evaluation so you can start leading a happier, more confident life.

No Gallbladder? You Need Bile Salts!

Are you suffering from gas, bloating, abdominal pain or yellowing of the skin?  Have you had your gallbladder removed, also known as a cholecystectomy?  If so, you may be dealing with bile or bile salts deficiency.  Bile dysfunction can alter the health of your liver, the gallbladder, colon and your skin.  But what exactly are bile salts?  Why are they so important?  I will attempt to take a very complicated subject and make it simple.

Bile is a liquid produced by the liver that helps to break down fats of our diet.  Bile contains bile salts and other substances like cholesterol, bilirubin, phospholipids as well as water and electrolytes.  Unfortunately, over a third of all people who have their gallbladder taken out never fix the symptoms of gallbladder disease.  In fact, those who have had their gallbladder removed end up suffering from new symptoms which include vitamin deficiencies and fat malabsorption.  If you have had your gallbladder removed you are no longer producing bile salts which help to eliminate cholesterol and toxic compounds and play a role in cholesterol regulation.  If you still have your gallbladder bile salts help to promote gallbladder and liver function by reducing inflammation of the bile ducts and help normalize blood flow.  They also help relieve gas and bloating that can be caused by gallbladder problems.  If you have a bile salt insufficiency, taking a supplement of bile salts may also help to improve cystic fibrosis of the liver as well as fatty liver disease and cirrhosis.  Bile salts also help digest and dissolve gallstones which are composed mostly of cholesterol and particles.  Bile salts also help to prevent the formation of gallstones by breaking down fats before crystallization.    Bile salts also are crucial to our health because they make it easier for our bodies to absorb and digest fat soluble nutrients like Vitamin A, E, D, K, even minerals like magnesium, iron and calcium.  If we do not have enough bile salts in our body, we can develop nutrient deficiencies because they are simply not being properly absorbed.  Bile salts also affect gut bacteria, they help control blood sugar and they also trigger the release of glutathione and eliminate bilirubin.  If you are deficient in bile salts, you obviously create vitamin deficiencies and also symptoms of heartburn, bloating, abdominal tightness, digestive issues, gallstones, jaundice, hormone imbalances, low cholesterol and liver damage.  Bile salts deficiencies are not just created by the removal of the gallbladder, but can also be caused by gene mutation, improper bile flow or pancreatic insufficiency.  So, the clear solution would be to restore the bile salts through supplementation.  Bile salts, in particular, eliminate bilirubin from the body which is very important to do so. 

According to research at Northwestern University, Department of Surgery, it indicated that too much bilirubin in the skin and mucus membranes can lead to jaundice which creates yellowing of the eyes and skin.  It also makes your urine darker and your stools may have a lighter color. 

So, how would one increase their bile salt intake?  Well, you may benefit from a bile salts supplement.  When you have a bile salts deficiency there just are not enough functioning bile salts to absorb and initiate a breakdown of fats so they can accumulate in the intestines and cause a list of symptoms.  Bile salt supplements should be taken with a meal so they can aid in the absorption and digestion of fats and fat-soluble vitamins.  I start patients with a lower dose, monitor how they feel after they eat and I usually pick a supplement that contains more cholic acid which is a more water-soluble bile acid. 

Most bile salt supplements are usually made from ox or bovine bile.  It is also recommended to take bile salt supplements with taurine which can also help restore healthy bile formation.  I also recommend betaine which is an amino acid created by choline that works in combination with glycine, another amino acid.  It assists with the process of digesting fats along with the bile salts.  It also promotes liver detoxification and removes toxins and chemicals so they do not accumulate and damage the liver.  It is also important to stay hydrated to improve bile function, especially considering that 85% of bile is made up of water.  Finally, it is important to supplement with bile salts, especially considering it is a subject that is rarely discussed, especially after one has had a gallbladder removed.  And now considering all the benefits of bile salts in those that still have their gallbladder, one cannot avoid the benefit and the need for bile salt supplementation. 

Purchase Bile Salts here!

Cholacol

Until next time, stay healthy!

90,000 When to run to the gastroenterologist ?! – Euromed clinic

– Elena Evgenievna, with what complaints do patients most often apply?

– Most common: abdominal pain and heartburn.
There are many causes of abdominal pain: from functional disorders associated with stress to serious illness.

Often worried about pain in the right hypochondrium due to dysfunction of the biliary tract, a feeling of discomfort in the epigastric region due to gastritis.In spring and autumn, peptic ulcer disease is often exacerbated.
The situation can aggravate against the background of stress and inaccuracies in nutrition. Moreover, as a rule, these two factors are interrelated: a stressful state for many is a trigger for eating disorders: someone’s appetite increases or, conversely, disappears, and a person eats irregularly or overeats, reduces control over the quality of food, etc. All this inevitably leads to problems with the gastrointestinal tract.

Heartburn is not a separate disease, but a symptom: a burning sensation behind the breastbone.In fact, it is a chemical burn with the acidic contents of the stomach when it is thrown into the esophagus, where the environment is more often alkaline. This leads to damage to the esophageal mucosa with hydrochloric acid and, which breaks down proteins, the enzyme pepsin. Sometimes with reflux disease, there is no heartburn, but there is a feeling of a lump in the throat, difficulty swallowing, chest pain, which are confused with angina pectoris. All this significantly reduces the patient’s quality of life. It is possible and necessary to treat this disease. Frequent reflux of acid from the stomach into the esophagus, especially with an admixture of bile from the duodenum, can even lead to oncological diseases of the esophagus.
Treatment is usually long, since the situation has been developing for years, and it will not be possible to change it instantly. In addition to medication, changes in lifestyle and dietary habits are required. With the help of drugs, we can reduce the amount of acidic products produced, which will lead to the fact that less of it will be thrown into the esophagus, respectively, less heartburn is manifested. There are also a number of drugs that adsorb acid and remove it. These are quick action tools.They help get rid of heartburn for 30-40 minutes. Usually these drugs are actively promoted in advertising and they will be offered by the pharmacist in the pharmacy. The patient, however, must, of course, be guided by the doctor’s recommendations

Food for reflux disease should be in small portions so that the volume eaten does not exceed the volume of the stomach, and for better control of appetite – frequent: 4-5 times a day. Food must be thoroughly chewed to crush it as much as possible and release more saliva, which, having an alkaline reaction, neutralizes the acid.

For reflux disease, boiled, baked, stewed vegetables, liquid cereals, pasta, lean meats, poultry, seafood, eggs, cottage cheese, stale bread and crackers, jelly, mousses, jelly, mashed soups, dairy products are recommended.
Increase acid formation in the stomach and therefore are not recommended: smoked meats, fatty, spicy, salty, mushrooms, raw vegetables, sour fruits and juices, carbonated drinks, black bread, buns, fast food, strong tea and coffee

– Leads to heartburn nutritional error or is its appearance due to genetics?

– Both.
Genetically determined by the feature of the sphincters between the esophagus and the stomach. A fairly common problem is connective tissue dysplasia, that is, its increased elasticity, resulting in flat feet, varicose veins, “unstable vertebrae”, weakness of many sphincters, including the gastroesophageal and esophageal opening of the diaphragm. That is, they do not close tightly enough, and food easily enters the stomach from the esophagus.

The number of parietal cells in the stomach is also genetically determined, which determines the quantity and quality of hydrochloric acid produced by them.
Heartburn in pregnant women

Pregnant women often complain of heartburn. This is due to two main points. Firstly, in the process of the growth of the baby and the enlargement of the uterus, intra-abdominal pressure increases, the load on the stomach and intestines increases, which can provoke the reflux of acid and bile into the esophagus. By the way, this often leads to constipation in pregnant women. Secondly, pregnant women have a special hormonal background aimed at reducing the tone of the uterus and, at the same time, the esophageal sphincters relax, as a result of which acid reflux can occur.
If you have such problems – do not have to endure and wait that “after childbirth it will pass by itself” … Immediately contact a gastroenterologist. The doctor will select the treatment: there are drugs that are approved for use during pregnancy. You will also discuss with your gastroenterologist how to change your diet and lifestyle in order to get rid of this problem.
Ideally, contact a gastroenterologist at the stage of pregnancy planning – this way you can avoid many problems with the gastrointestinal tract that arise during this period in a woman’s life.

– One of the most common diagnoses is gastritis. What is the reason and how is it treated?

– Gastritis is an inflammation of the stomach lining. This diagnosis, indeed, is very often made, and often – without proper reason. This diagnosis is made morphologically, that is, after the morphologist describes the existing inflammatory changes as a result of a biopsy of the gastric mucosa. Then it’s gastritis. Only on the basis of complaints can a competent doctor write in the diagnosis only “functional dyspepsia syndrome”.
Complaints with gastritis are quite diverse: it can be pain, a feeling of a full stomach even with a small amount of food eaten, belching, vomiting, etc. individually.

Myth

Probably everyone has heard the opinion: “if you eat dry food, you will get gastritis.” In fact, it is not! The food should just be without additional liquid, it does not need to be washed down with water, tea, coffee, etc.The liquid dilutes the acidic contents in the stomach and impairs the quality of food digestion. But there is really no need to eat “on the run” – the most important thing for a good digestion process is to chew food thoroughly! A large amount of saliva released when chewing is necessary for the assimilation of food.
What provokes gastritis? Stress, systematic violation of the diet, violation of the frequency of nutrition, abuse of semi-finished products, concentrates, spices, sour, spicy, peppery, salty, smoked, fried, too hot, too cold or otherwise thermally, chemically or mechanically irritating food, carbonated drinks, coffee , alcohol, smoking; lack of thorough chewing of food.

In addition, gastritis is often caused by the bacterium Helicobacter pylori. This bacterium needs acid-free conditions to exist, for this it “envelops” itself with a cloud of urease – an enzyme that creates an alkaline environment. All this damages the mucous membrane up to its atrophy, and can also lead to the development of gastric and duodenal ulcers, significantly increasing the risk of developing stomach cancer. 95% of stomach ulcers and 85% of duodenal ulcers worldwide are associated with Helicobacter pylori infection.Other causes of damage to the mucous membrane of the stomach and duodenum is the frequent use of non-steroidal anti-inflammatory drugs.
In the treatment of gastritis and peptic ulcer, drugs are used that reduce the acid production of the gastric mucosa, improve its healing, and if Helicobacter pylori is detected, a course of antibiotic therapy is used. The patient must be prescribed a gentle diet.
All these activities are prescribed only by a doctor. Self-medication can be not only ineffective, but also harmful to the patient.

– Is stress also one of the reasons for the development of irritable bowel syndrome (IBS)?

– Yes, the classic triad for making this diagnosis: stress, pain, stool disorder (diarrhea, constipation or their alternation). The very name of the disease contains its essence: the intestine is irritated, the sensitivity is increased.

The peculiarity of this disease is that the patient has no visible lesion of the intestinal mucosa. No examinations can establish what actually happens to the human body, and the disease is clearly manifested.
The mechanism of the onset of symptoms is associated with the characteristics of the intestines. The intestine has its own nervous system, which is part of the autonomic nervous system. In stressful situations, malfunctions of the entire nervous system of the body begin, the brain gives the wrong signals to the intestines, and the intestine incorrectly informs the brain about the processes taking place in it. As a result, intestinal motility is impaired, the threshold of pain sensitivity decreases, and even minor discomfort causes severe bouts of pain.

In addition to stress and a low pain threshold, the risk of developing IBS is increased by eating disorders, a sedentary lifestyle, hormonal disruptions (for example, in pregnant women), and a genetic predisposition. IBS can also develop after some infectious bowel disease.
The main difficulty in IBS is that the symptoms are very unpleasant, and the correction must be carried out, first of all, of the psychoemotional state, which is quite difficult without the help of a competent psychologist. At the same time, there is still a problem that often patients do not even admit to themselves that they need psychological help.
When making this diagnosis, it is very important to show an onset of susceptibility. However, in our time it is always important, even in young patients, but especially in older people. IBS more often appears in young people, so if similar symptoms are observed in mature patients, first of all, the doctor should exclude cancer.

– For antibiotic therapy, doctors often advise taking probiotics or prebiotics. Is it really necessary?

– Antibiotics affect the intestinal flora, this is undeniable.Often, against the background of antibiotic therapy, the patient develops dysbiosis (“dysbiosis”), that is, a qualitative and / or quantitative change in the ratio of microorganisms that live in the intestine. Dysbiosis is manifested by a violation of the stool, flatulence (excessive gas formation), the presence of inflammation on the mucous membrane. As a prophylaxis for the development of this unpleasant condition, it is recommended to take pro- and prebiotics.
Probiotics are medicines or biologically active food supplements that contain live microorganisms that are representatives of the normal human microflora.They are designed to restore the disturbed balance of microorganisms inhabiting various mucous membranes of a person, and therefore are used for the treatment and prevention of immunodeficiency, dysbiosis and related diseases. Probiotics stimulate the immune system at all levels, as proven by numerous clinical studies.

Prebiotics are food ingredients that are not digested by human enzymes and are not absorbed in the upper sections of the gastrointestinal tract. They stimulate the growth and vital activity of beneficial microflora: by breaking down to fatty acids, they increase acidity in the colon, inhibiting the growth of opportunistic microflora, which also creates favorable conditions for the development of normal microflora.
Prebiotics are found in dairy products, cornflakes, cereals, bread, onions, chicory, garlic, beans, peas, artichokes, asparagus, bananas, and many other foods. They also exist in the form of dietary supplements.

It is believed that probiotics in tablet and liquid forms are less effective, since they cannot always pass through the highly acidic environment of the stomach, which is aggressive to bacteria, bile. And only capsules are designed to dissolve in the colon – where bacteria should live.
Not so long ago, symbiotics also appeared on the market – combination preparations that combine pre- and probiotics. Today they are considered to have the most advanced mechanism of action.
I recommend choosing drugs that normalize the microflora together with a doctor – because it is quite difficult for a non-specialist to understand all the variety of existing means, and it is unlikely that it will be possible for a non-specialist to understand what is suitable in each specific case.

– Why are constipation dangerous?

– Constipation is a condition characterized not only by a decrease in the frequency of bowel movements: less than 3 times a week, but also by the appearance of dense, dry feces or the absence of a feeling of complete emptying of the bowel or emptying of the bowel with tension or the use of additional techniques by patients for bowel emptying.
Prolonged constipation causes:
chronic intoxication (poisoning), which leads to sleep disturbance, unmotivated fatigue, increased fatigue and, finally, to depression, deterioration of the skin, hair;
the formation of intestinal diverticula (wall protrusions), which can cause abdominal pain, and when an infection joins, inflammation of the intestinal mucosa (diverticulitis) and the need for intensive antibiotic therapy or surgical treatment if intestinal obstruction occurs;
varicose hemorrhoidal veins, chronic anal fissures;
colon cancer.
It is necessary to start solving the problem of constipation not with self-medication, but with a visit to a gastroenterologist. There are many reasons for constipation. These can be very serious diseases. Only a competent specialist can understand this. Solving constipation on your own can make your condition much worse.

– Can a delicate problem like flatulence be treated?

– Flatulence (increased gas production) is associated with fermentation. There can be many reasons: insufficient bile secretion, insufficiently concentrated bile, disturbances in the secretion of pancreatic juice – as a rule, problems with the sphincter of Oddi.All this leads to a change in the intestinal bacterial flora. As a result, flatulence develops. This is a common problem, but it can be solved. Although I will not say that it is always simple and fast. The main thing is to find the root cause, since flatulence can be a symptom of various diseases.

– Sometimes a person suffers from bad breath or bad taste in the mouth. Is this a symptom of some kind of disease?
– Halitosis – bad breath – can occur for various reasons.First of all, I would recommend going to the dentist and checking the condition of the teeth and oral cavity. ENT diseases are in second place. If everything is in order in these areas, then, indeed, halitosis can be a consequence of digestive problems.
As for the taste in the mouth, it can be a symptom of certain diseases. But here everything is very individual: the taste can be sweet, bitter, sour, metallic, etc. It can be constant or appear only after eating or, conversely, on an empty stomach, etc.Therefore, we must look and look for the reason.

– Often, patients who have performed an ultrasound of the abdominal organs find out that they have a kinked gallbladder – how serious is it?

– Deformities of the gallbladder – kinks, membranes, etc. increase the risk of bile stagnation. The gallbladder should normally be emptied almost completely after every meal. Because this gallbladder has to work harder to contract, some patients may experience pain.After its contraction, part of the bile can remain behind the bend and “stagnate”, which can lead to the formation of stones. For patients with deformity of the gallbladder, I recommend monitoring their condition: see a doctor, do an ultrasound of the abdominal organs once a year to see the state of the bile and gallbladder. If an ultrasound diagnostic doctor notes that bile is “viscous”, “heterogeneous”, “inhomogeneous”, etc., it is important to immediately consult a gastroenterologist and undergo a course of therapy to prevent the formation of stones.It is especially important to take the prevention of gallstones seriously if any of your close relatives have these problems.

– What methods of preventing gastrointestinal diseases can be used? Maybe you need to take medications or do tyubazhi?

– No prophylactic drugs should be used without a doctor’s prescription. All medications have side effects and are not recommended to be taken without indications.
To carry out a tubazh (a procedure that is the intake of choleretic agents for the simultaneous emptying of the gallbladder), certain indications and contraindications are also required.More often, the doctor prescribes this procedure in combination with other therapeutic measures, selects drugs, etc.

The best prevention of gastrointestinal diseases is proper nutrition: in small portions, with thorough chewing food until gruel. You need to take food at least 4-5 times a day, be sure to have breakfast within an hour after a night’s sleep. The volume of water drunk per day must be at least 1.5 liters.

Try to minimize the amount of food that provokes the development of diseases.We have already listed them above: fast food, pickles, smoked meats, fried, spicy, etc. Add physical activity: Sedentary lifestyles have been proven to contribute to gastrointestinal problems, while abdominal exercise, brisk walking, and yoga have been shown to be beneficial to bowel function.
Organize your lifestyle so that you stay healthy for a long time – and you will protect your body from many unpleasant problems.

How to live after removal of the gallbladder / Health / Nezavisimaya gazeta

The first year and a half are the most difficult even in a psychological sense

One of the main conditions for recovery from gallbladder surgery is proper diet.Pexels Photos

The operation to remove the gallbladder is called cholecystectomy in medicine. This is the most common abdominal surgery after the appendix is ​​removed. Most often, cholecystectomy is resorted to in case of dysfunction of the gallbladder as a consequence of cholelithiasis. In this case, the formed stones or sand impede the outflow of bile from the bladder, which is often accompanied by severe pain and fraught with serious complications.

If therapeutic methods are powerless, surgery is indicated. Currently, it is mainly performed by the laparoscopic method using a special device inserted through a puncture in the abdominal wall. Performing this low-traumatic operation, the surgeon dispenses with traditional incisions, which makes it possible to shorten the patient’s stay in the hospital. After removal of the gallbladder, the body gradually adapts to the new conditions of digestion.

It is known that bile is produced by liver cells and enters the gallbladder.Here, as a result of chemical changes, its concentration increases, it thickens, becomes more viscous. After eating, bile from the gallbladder is directed through the ducts into the duodenum and promotes the digestion and absorption of fats. But what if the bubble is removed? In this case, bile enters the intestine immediately. This can lead to complications.

The fact is that in the absence of a gallbladder, the concentration of bile is lowered, it becomes chemically less aggressive.As a result, favorable conditions are created for the activation of pathogenic microorganisms. Against this background, the operated person may, for example, experience duodenitis (inflammation of the duodenum), duodeno-gastric reflux (throwing food from the duodenum back into the stomach), gastritis (inflammation of the gastric mucosa) or other diseases of the digestive system.

Fortunately, the body’s compensatory capabilities are great, and such complications after removal of the gallbladder are not so common.In addition, diet plays an important role in their prevention – the main therapeutic factor contributing to recovery. One of its main requirements is that food should be taken in small portions, five to six times a day. This is necessary so that bile, which is released into the intestines only after eating, does not stagnate in the biliary tract.

What should be the diet for people who have undergone surgery? First of all, it is necessary to exclude from it spicy, fried, smoked, canned food and various spices.Dishes from fatty meats and fish, coarse bread, pastries with cream, alcoholic and carbonated drinks, coffee, strong tea are contraindicated. The list of prohibited foods also includes sour berries and fruits, peas, beans, onions, and garlic. Cold food contributes to cramps in the gastrointestinal tract, so another requirement is that the food must be warm.

It should be especially emphasized that preference should be given to steamed foods, as well as boiled and stewed foods.This will avoid unwanted irritation of the mucous membranes of the digestive organs and will help them to more easily and quickly adapt to new conditions. As for the menu, let’s say it’s good to cook an omelet, rice or oatmeal for breakfast. The morning menu can also include low-fat cheeses, low-fat cottage cheese and sour cream, vegetable puree, boiled vegetables, and from drinks – weak tea.

For lunch, vegetable, cereal or milk soups are recommended from the first courses, and from the second – steam cutlets, roll or meatballs made from low-fat varieties of beef, fish or chicken.Vegetable puree, buckwheat porridge, pasta are allowed as a side dish for the second courses. As for the bread, it should only be white and yesterday’s baked goods. And for dessert – compote, jelly or fresh fruit, but always sweet. In the afternoon snack menu, it is advisable to include kefir with a bun or with low-fat cookies. And for dinner, cook buckwheat porridge, cottage cheese casserole or stewed vegetables.

During the year after surgery, heavy physical activity is contraindicated, especially associated with the tension of the abdominal muscles.This can lead to the formation of a postoperative hernia. But morning exercises, light exercise are useful, since they activate the work of the digestive system and facilitate the passage of bile. It is possible to start them in agreement with the doctor one and a half to two months after the operation. Of course, if you feel good. Walking is also recommended to help combat bile congestion.

Removal of gallstones with preservation of the gallbladder

Cholelithiasis – now there is an opportunity to preserve the gallbladder!

Gallstone disease (GSD) is a disease in which stones form in the gallbladder or rarely in the bile ducts.The stones are composed of bile components precipitated, in particular cholesterol, bilirubinates and calcium. There is also a protein in the form of mucin. The stones are single and multiple – it is believed that this depends on the ability of bile to form calculi (lithogenicity). There are several theories for the development of gallstone disease – stagnation of bile in the gallbladder and an increase in the concentration of cholesterol, bilirubinates and calcium salts in bile due to metabolic disorders. There is also an inflammatory theory of the development of gallstone disease and hereditary.Cholesterol is insoluble in water, but in bile it is present in the form of micelles, surrounded by molecules of chenodeoxycholic and ursodeoxycholic acid and lecithin. File micelle Until recently, the solution to gallstone disease, unfortunately, was mainly limited to the only method of treatment – surgical removal of the gallbladder – cholecystectomy operation, which is recognized as the “gold standard” in the treatment of cholelithiasis. However, one of the main disadvantages of this operation is the loss of the gallbladder as an organ with important functions for digestion.When a functioning gallbladder is removed, almost 40% of patients develop a “new” disease, which is combined into a clinical symptom complex called “postcholecystectomy syndrome”

Other methods of treating gallstone disease, which have brought some variety to the range of therapeutic measures, are extracorporeal lithotripsy, oral and contact chemical litholysis. Scientific publications on extracorporeal lithotripsy for cholelithiasis mainly come from one scientific center in China, the method is not devoid of side effects, there are many contraindications to its use, and for more than 15 years of testing it has not yet found widespread use.Contact chemical litholysis – dissolution of gallstones in the bladder by puncturing the bladder and injecting a drug into its cavity – methyl tertiary butyl ether MTBE file – is currently not used due to toxicity. Medicamental litholysis – the use of ursodeoxycholic acid preparations – in very rare cases, with prolonged use, allows to reduce or completely dissolve calculi.

Laparoscopic cholecystolithotomy is an operation that removes calculi and preserves a functioning gallbladder.The good results of 10 years of experience in performing these operations in the absence of contraindications allow us to confidently recommend this type of surgical treatment to patients with cholelithiasis. Candidate of medical sciences, surgeon of the highest category Shkatov D.A. deals with the treatment of this category of patients.

Directory of diseases

Surgical tactics for these complications can change radically in the direction of expanding the scope of surgical intervention. Which will require endoscopic sanitation of the bile ducts, or an open cavity operation, with possible external drainage of the bile ducts for a long time.

“Gold standard”

Cholecystectomy – an operation to remove the gallbladder. With cholecystectomy, the pathologically altered gallbladder is removed completely together with calculi by surgical intervention.

According to foreign and domestic literature, in 90–95% of patients, cholecystectomy completely cures the symptoms that were observed before the operation.

Laparoscopic cholecystectomy is the “gold standard” in the treatment of chronic calculous cholecystitis and often in the treatment of acute cholecystitis.It is performed using special instruments through 3-4 punctures in the abdominal wall with a diameter of 5-10 mm. Special tubes (trocars) are inserted into these punctures, carbon dioxide is injected into the abdominal cavity with the help of an insufflator (pump) – carboxyperitoneum is applied. The injected gas creates space for the tools to work. Through trocars, with the help of a video camera and special clamps and electrodes, the anatomical elements of the gallbladder – the cystic artery and the cystic duct are isolated, special metal brackets (clips) are placed on them and crossed.Modern video systems provide excellent image quality and visualization of structures, far superior to those of open operations. The gallbladder is separated from the liver and removed through one of the punctures of the abdominal wall.

The advantages of laparoscopic cholecystectomy are low trauma, which affects the absence of pain in the postoperative wound, a quick recovery period after surgery, reduced hospital stay (1-2 days), quick recovery and return to daily activities and work.

Unfortunately, in 1–5% of cases, it is impossible to perform cholecystectomy from the laparoscopic approach. Most often this is due to anatomical abnormalities of the biliary tract, pronounced inflammatory or adhesions, the development of intraoperative complications. In such cases, a transition to an open operation (conversion) is performed.

Open cholecystectomy is performed from the upper midline laparotomy or oblique subcostal incisions such as the Kocher and Fedorov approaches, which provide wide access to the gallbladder, bile ducts and other abdominal organs.With such approaches, all methods of intraoperative revision of the extrahepatic bile ducts are feasible, including measurement of their width, probing of the ducts, intraoperative cholangiography, intraoperative ultrasound examination, and intraoperative endoscopic examination of the bile ducts.

Everyone should know this

Many people ask the question: how can you live without a gallbladder? A healthy gallbladder is indeed an essential organ for digestion.During the entry of food from the stomach into the duodenum, the gallbladder contracts and from it bile enters the intestines, where it is involved in digestion. However, the pathologically altered gallbladder does not function normally, but, on the contrary, causes more problems: pain syndrome, maintenance of a chronic reservoir of infection, dysfunction of both the liver and pancreas. Therefore, cholecystectomy, performed according to indications, improves the patient’s condition and does not affect the digestive function.

The overall risk of mortality due to cholecystectomy varies within 0.14–0.15%, depending on the age, physical condition of the patients and the form of gallstone disease.

Postoperative period

In the first month after the operation, the functions and general condition of the body are restored. Careful adherence to medical recommendations is the key to a full recovery of health. The main areas of rehabilitation are exercise compliance, diet, medication and wound care.

People with a removed gallbladder in the first month need to follow a diet for a while, while the body adapts to changes in the functioning of the biliary system. During this period, it is possible (but not necessary) to loosen the stool or to increase it up to 2-3 times a day. In 4-6 months after the operation, a person can lead a normal life, practically without restrictions. However, in some patients who have had the disease for a long time and with complications, some of the symptoms cannot be eliminated by cholecystectomy, and they require further treatment.

Drug treatment

After laparoscopic cholecystectomy, minimal medical treatment is usually required. Pain after surgery is usually mild, but some patients require analgesics for 2-3 days. These are usually non-steroidal anti-inflammatory drugs such as ketorol. In some patients, it is possible to use antispasmodics for 7-10 days. Taking ursodeoxycholic acid preparations (Ursosan) can improve the fluidity of bile and reduce the risk of micro-calculus formation in the biliary tract.Taking medications should be performed strictly as directed by the attending physician in an individual dosage.

Care of postoperative wounds

In the hospital, special stickers will be applied to the postoperative wounds located at the places where the instruments are inserted. Showers can be taken from 48 hours after surgery. Getting water on the seams is not contraindicated, however, you should not wash the wounds with gels or soap and rub with a washcloth. After taking a shower, wounds should be lubricated with 5% iodine solution.Wounds can be treated with an open method, without bandages. Bathing or swimming in pools and ponds is prohibited until the stitches are removed and for 5 days after the stitches are removed.

Sutures after laparoscopic cholecystectomy are removed 7-8 days after surgery. This is an outpatient procedure, the stitches are removed by a doctor or a dressing nurse, and the procedure is painless.

Diet

Dieting is required up to 1 month after laparoscopic cholecystectomy.It is recommended to exclude alcohol, easily digestible carbohydrates, fatty, spicy, fried, spicy foods, regular meals 4-6 times a day. New foods should be introduced into the diet gradually, 1 month after the operation, it is possible to remove dietary restrictions on the recommendation of a gastroenterologist.

Possible complications of cholecystectomy

Any operation can be accompanied by undesirable effects and complications. Complications are possible after any technology of cholecystectomy.

It can be subcutaneous hemorrhages that go away on their own within 7-10 days. No special treatment is required. The incidence of wound infection is 1–2%, and wound suppuration is a rare complication, but it may require surgery under local anesthesia, followed by dressings and antibiotics. In 0.3% of patients, hernias may develop at puncture sites. This complication is most often associated with the peculiarities of the patient’s connective tissue and may require surgical correction in the long term.Very rarely, complications from the abdominal cavity are possible, which may require repeated interventions or minimally invasive punctures under the guidance of ultrasound. The incidence of such complications does not exceed 0.001%. It can be intra-abdominal bleeding, hematomas, purulent complications in the abdominal cavity.

Damage to the bile ducts is one of the most severe complications in all types of cholecystectomy, including laparoscopic. In traditional open surgery, the incidence of severe bile duct injuries was 1 in 1500 operations.In the first years of mastering laparoscopic technology, the frequency of this complication increased 3 times – up to 1 in 500 operations, however, with the growth of surgeons’ experience and the development of laparoscopic technology, it stabilized at the level of 1 in 1000 operations. A well-known Russian expert on this problem, Eduard Izrailevich Galperin, wrote in 2004: “Neither the duration of the disease, nor the nature of the operation (urgent or planned), nor the diameter of the duct, and even the surgeon’s professional experience do not affect the possibility of damage to the ducts… “The occurrence of such a complication may require repeated surgery and a long period of rehabilitation.

Venous thrombosis and pulmonary embolism are life-threatening complications of any surgery. That is why much attention is paid to the prevention of these complications. Depending on the degree of risk determined by your attending physician, preventive measures will be prescribed: elastic compression of the lower extremities and the introduction of low molecular weight heparins.

Any surgical intervention carries a certain risk of complications, however, refusal of the operation or delay in its implementation also carries the risk of developing serious diseases or complications. Performing cholecystectomy in a planned manner, with untreated forms of the disease, carries a much lower risk of unwanted deviations from the normal course of the operation and the postoperative period. The responsibility of the patient for strict adherence to the regimen and recommendations of doctors is also of great importance.

Rehabilitation after cholecystectomy

The majority of patients, after surgical treatment, completely get rid of the symptoms that worried them, and after 1 month after the operation, they return to normal life. If the cholecystectomy is performed on time, before the onset of concomitant pathology from other organs of the digestive system, the patient can eat without restrictions (which does not negate the need for a proper healthy diet), do not limit oneself in physical activity, and do not take special medications.

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Our department performs the whole range of diagnostic procedures and operations for the treatment of cholelithiasis, as well as other diseases of the liver and pancreas. Contact us, we will help you!
Liver and pancreas surgery

Early or late removal of the gallbladder laparoscopically after a sudden attack of gallstone pancreatitis

Review question

The question of how long should elapse after a sudden attack of acute pancreatitis against the background of cholelithiasis before removal of the gallbladder is the subject of much debate.

We decided to answer this question by conducting a thorough search of the medical literature with studies comparing when laparoscopic cholecystectomy was performed. We only included randomized controlled trials (studies that can help us avoid wrong conclusions if they are designed and conducted properly). We searched the literature for research data up to January 2013. The two authors independently assessed which studies should be included and extracted data to minimize bias.Laparoscopic cholecystectomy was considered “early” if it was performed within three days of the sudden onset of symptoms. Laparoscopic cholecystectomy was considered “late” if it was performed three days after the onset of symptoms. For severe acute pancreatitis, laparoscopic cholecystectomy was considered “early” if it was performed immediately after a patient with sudden onset of pancreatitis was admitted to the hospital. If the laparoscopic cholecystectomy was performed on the next admission to the hospital, it was considered “late”.

Relevance

The pancreas is an abdominal organ that secretes digestive juices to help digest food. It also contains insulin-secreting cells that maintain blood sugar levels. Acute pancreatitis is a sudden inflammation in the pancreas that can affect nearby organs or affect other systems in the body, including the circulatory system. Depending on the presence of organ failure (eg, kidney, lung, or circulatory system) and local complications such as fluid accumulation around the pancreas, pancreatitis can be classified as severe acute pancreatitis and mild acute pancreatitis.Patients with severe pancreatitis have organ failure or local complications, or both. In patients with mild pancreatitis, these symptoms are not observed. The two main causes of acute pancreatitis, reported in over 80% of cases, are gallstones and alcohol. Removal of the gallbladder (cholecystectomy) is the final method of treatment, it is carried out to prevent further attacks of acute gallstone pancreatitis and only if the patient is not contraindicated for surgery.Laparoscopic removal (minimal access surgery) of the gallbladder is currently the preferred cholecystectomy method, with more than 99% of patients recovering completely from the procedure without any serious health consequences.

Characteristics of research

We identified one trial comparing early versus late laparoscopic cholecystectomy in patients with mild acute pancreatitis. Of the 50 participants in this trial, 25 had an early laparoscopic cholecystectomy, while the remaining 25 had a late one.All 50 participants were alive at the end of the trial. There were no significant differences between the two groups in terms of complications in study participants. Health-related quality of life was not reported in this trial. There was no transformation to open cholecystectomy in either group. The total hospital stay for early laparoscopic cholecystectomy was approximately two days shorter than for the late laparoscopic cholecystectomy group. The trial did not report the length of the temporary disability period and the cost.We did not consider trials comparing early versus late laparoscopic cholecystectomy in patients with severe acute pancreatitis.

Highlights

Based on observational results from one trial, there appears to be no evidence of an increased risk of complications after early laparoscopic cholecystectomy. Early laparoscopic cholecystectomy can shorten the total hospital stay in people with mild acute pancreatitis.For mild acute pancreatitis, if the appropriate equipment and specialists with the right skills are available, early laparoscopic cholecystectomy is preferable to late. There is currently no evidence to support or refute the effectiveness of early laparoscopic cholecystectomy in severe acute pancreatitis. Further well-designed randomized controlled trials in people with severe and mild acute pancreatitis are needed.

Quality of evidence

One trial reviewed is at high risk of bias, meaning there is a potential for fallibility in its conclusions as a consequence of the way the study was designed and conducted.

GKB # 31 – Pills or surgery?

The operative method of dealing with gallstones has long been recognized as the most effective and safe. However, for many, it still raises doubts.

What excites our readers the most?

The answer is Doctor of Medical Sciences, Head of the Department of Hospital Surgery of the Russian State Medical University, Surgeon of the City Clinical Hospital No. 31 of Moscow, Professor Sergey Georgievich Shapovalyants .

1) Why remove the gallbladder if only one small stone has formed in it?

– Small stones in this case do not mean a small problem.Quite the opposite, they are the ones that often cause serious complications.

If large formations lead to bedsores and breaks of the gallbladder, then small stones are insidious in their own way. They can easily move around and enter the bile ducts.

Wandering along them, the stones reach the duodenum. There, sooner or later, they get stuck, blocking the outflow of bile. Because of this, obstructive jaundice occurs.

Moreover, an attack of acute pancreatitis may develop unexpectedly.In this case, an ambulance is needed.

Therefore, small stones should not be ignored. Even if at least one is found, you need to act. To date, the only treatment for gallstone disease is surgery – removal of the gallbladder.

2) There is a method of dissolving stones with medication. Why not try it before you go to the surgeon?

– Indeed, there are such drugs. But the difficulty is that they rarely completely dissolve stones.Typically, medications only reduce them slightly. The stone doesn’t go anywhere, it just gets smaller. Good or bad is a big question. As we said above, small stones cause no less problems than large ones.

Moreover, drugs are effective only against cholesterol stones. If they contain a lot of calcium, conservative methods are useless.

One more point. The size of stones should not exceed 2 cm. It makes no sense to dissolve larger formations.This will take too long. After all, the stone, on average, decreases by no more than 1 mm per month.

It is not worth spending months or even years on this procedure. After all, no one can give a 100% guarantee of a successful result. And the risk of triggering a problem is quite high.

The drugs should be used with extreme caution in people with other diseases of the gastrointestinal tract. It is impossible to dissolve stones in case of stagnation of bile, acute inflammatory diseases of the gallbladder and bile ducts, liver diseases, stomach and duodenal ulcers, intestinal problems.

In addition, this seemingly harmless method of dealing with gallstones has its own side effects. The most common is stool disorder. And if we consider that conservative treatment is designed for a long period, then it is unlikely that it will be possible to “endure” unpleasant reactions.

The situation is not easy. On the one hand, the method of medicinal dissolution of stones is quite safe – no anesthesia, incisions, or postoperative rehabilitation are needed. On the other hand, it has many limitations and is not very effective.

3) How effective is the method of crushing gallstones, because they crush kidney stones?

– The analogy between kidney stones and gallbladder stones is often drawn. But these are completely different diseases, each of which manifests itself and is treated in its own way. It is incorrect to bring them to the same denominator.

At one time, the method of crushing gallstones using extracorporeal lithotripsy was widely used. During the session, multiple shock waves were sent to the stone outside.As a result, it was crushed into fragments, which then independently exited through the bile ducts and intestines.

In reality, not everything went so smoothly. Large fragments could not pass through the duct, so they remained in the gallbladder. Most of the small ones left “their place of residence.” But some of them got stuck in the bile ducts, clogged them and disrupted the process of bile formation. Therefore, after such a procedure, sometimes it was necessary to urgently perform an operation.

There is one more important nuance.Usually gallstones are even, smooth, adapted to the shape of the gallbladder. Outside the attack, as a rule, they are not felt in any way. But after crushing, fragments are formed, which can cause colic and other painful sensations.

Due to the impressive number of undesirable consequences, this method is practically not used today. And in some foreign clinics, it is generally prohibited.

4) Is it possible to remove only stones and leave the gallbladder?

– It is possible, but this method is today recognized as ineffective.It is believed that some people, especially young people, should not have their gallbladder removed. After all, it performs important functions in the body.

Proponents of this approach perform an operation during which a small incision is made in the gallbladder. Through it, gallstones are taken out. Then the bladder is sutured, and after two or three days the satisfied patient returns home. Without stones, and with preserved gallbladder.

But not everything is so simple. Approximately 2-3 months after such an operation, the disease begins to bother again.The percentage of her return of the disease at different intervals reaches almost 100%. The fact is that one of the prerequisites for the formation of stones in the gallbladder is its poor contractility. Bile stagnates in it, from which stones are then formed.

Another reason is the individual characteristics of the bile itself. With any diet, even the lightest, it concentrates and precipitates. In this case, removing stones alone simply does not make sense. The problem can be finally solved only by completely removing the gallbladder.

5) What is the advantage of laparoscopic stone removal?

– For a long time, gallstones were removed by the usual abdominal method. But today many large hospitals and clinics are switching to a simpler and safer technique – laparoscopy.

The entire operation is performed through three or four punctures in the abdominal wall. A miniature optical system is introduced through them. With its help, the abdominal cavity is examined, and then the gallbladder is removed with special instruments.

As a rule, this is where all the patient’s troubles end. After a short period of adaptation, he will be able to forget about gallstone disease forever.

Moreover, the absence of the gallbladder will be almost imperceptible. Indeed, in fact, his “biological loss” occurred much earlier – even at the stage of formation of stones. Even then, the gallbladder stopped working normally, and other organs took over its “responsibilities”.

6) Quite often, after removal of the gallbladder, a person feels even worse than before the operation.Maybe she’s not needed at all?

– There is such a thing as postcholecystectomy syndrome. This is a deterioration in well-being after removal of the gallbladder. Most often this happens if the operation is performed at an advanced stage of the disease, when neighboring organs are involved in the process.

In this situation, only one thing can be said – do not take matters to the extreme. Do the surgery as planned, not when the thunder breaks out. Then problems can be easily avoided.

There is another reason – insufficient preliminary examination.Today, removal of the gallbladder is considered technically simple for doctors and easily tolerated manipulation for patients. Therefore, the range of preliminary tests is often limited to one ultrasound of the abdominal cavity. And this is extremely small.

To get a complete picture and find out the true cause of poor health, it is necessary to thoroughly examine not only the gallbladder, but also all the organs located nearby. It is necessary to carefully assess the condition of the bile ducts, pancreas, duodenum, right kidney, stomach.

Not all medical institutions are equipped with the necessary equipment for this. Therefore, it is better to go to large clinics and centers.

Endoscopic ultrasonography of the bile ducts is now successfully used in cases of suspected stones. It is performed using a miniature ultrasound probe or endoscope, at the end of which an ultrasound probe is located. If there are stones in the bile ducts, you must first remove them, and only then take up the gallbladder.

Computed tomography will help to examine the liver and pancreas. A biochemical blood test will tell you many necessary details. Of course, not everyone needs this research. But if there are at least some doubts, they cannot be ignored.

It is a thorough examination before surgery that allows you to choose the right tactics of treatment, preparation and recovery period. After all, the purpose of surgical manipulations is not just to remove the problem, but to do it in the most comfortable way for the patient.

Ursodez instructions for use: indications, contraindications, side effects – description of Ursodez caps. 250 mg: 40, 50, 60, 90, 100 or 120 pcs. (33304)

The drug is taken orally. Capsules are taken without chewing and with a small amount of liquid.

Children and adults weighing less than 47 kg are recommended to use preparations of ursodeoxycholic acid in the form of a suspension.

Dissolution of cholesterol gallstones

The recommended (approximate) dose is 10 mg ursodeoxycholic acid per 1 kg of body weight per day, which corresponds to:

do not chew the capsules) with a small amount of liquid.

Duration of treatment – 6-12 months. For the prevention of recurrent cholelithiasis, it is recommended to take the drug for several months after the stones dissolve.

Treatment of biliary reflux gastritis

1 capsule (250 mg) of the drug Ursodez ^® daily in the evening before bedtime. The capsules should be taken without chewing and with a little water.

The course of treatment – from 10-14 days to 6 months, if necessary – up to 2 years.

Treatment of primary biliary cirrhosis

The daily dose depends on body weight and ranges from 3 to 7 capsules (approximately 14 ± 2 mg ursodeoxycholic acid per 1 kg of body weight).

In the first 3 months of treatment, taking the drug should be divided into several doses throughout the day. After improving the functional parameters of the liver, the daily dose can be taken 1 time in the evening.

The following regimen is recommended:

Ut

9000 Day

3

63

Capsules should be taken regularly O.

The use of the drug Ursodez ^® for the treatment of primary biliary cirrhosis can be continued indefinitely.

In patients with primary biliary cirrhosis, in rare cases, clinical symptoms may worsen at the beginning of treatment, for example, itching may become more frequent. In this case, treatment should be continued, taking 1 capsule daily, then the dose should be gradually increased, increasing the daily dose by 1 capsule weekly until the recommended dosage regimen is reached again.

Symptomatic treatment of chronic hepatitis of various origins

Daily dose of 10-15 mg / kg in 2-3 doses. The duration of treatment is 6-12 months or more.

Primary sclerosing cholangitis

Daily dose 12-15 mg / kg; if necessary, the dose can be increased to 20-30 mg / kg in 2-3 doses. The duration of therapy is from 6 months to several years.

Cystic fibrosis (cystic fibrosis)

Daily dose of 20 mg / kg / day in 2-3 doses, with a further increase to 30 mg / kg / day if necessary.

4036-90 49

Non-alcoholic steatohepatitis

Average daily dose 10-15 mg / kg in 2-3 divided doses.