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GERD after gallbladder surgery?
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moscow2005 posted:
I recently (6 months ago) had my gallbladder removed and about 3 months ago started having really intense reflux. My GI doc says that he has seen a lot of cases in which people start having this complaint after having their GB removed. I was wondering if anyone else has experienced this?

Prior to my GB surgery, I had no issues with reflux whatsoever. My endoscopy was clean too. Right now, I'm having pretty much 24/7 reflux with really bad globus sensation. I've been started on prevacid 30mg once a day, which seems to be helping hit-or-miss style. I have intermittent nausea too, but my main worry is that I'm doing damage to my esophagus.... At this point, I'm just worried that I will have to deal with this problem the rest of my life! Any suggestions would be welcome.
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CalGal37 responded:
Moscow, your doc is right. But to my way of thinking there are far too many cases of the 'GERD following GB removal' for my taste. What some people find is that it may not be GERD at all, but continuing problems with their now non-existent GB. You're not going to process fats the way you did when you had your GB, so if you're not following a low fat diet you may want to consider it. It seems that a number of people end up with diarrhea due to bile dumping, and bile reflux that has all the symptomology that would accompany GERD. So when the issue is brought to the attention of the doc, they routinely say 'it's GERD.' But no actual testing is done - they're diagnosed based on symptoms.

Talk to your doc about that possibility. From what I've seen bile is a more likely culprit than acid.
 
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LAK0427 responded:
I'm having similar problems! I had my gallbladder removed on 10/28/08 along with ERCP to remove stone in common duct, and have been suffering with what they call GERD ever since. Never had it before, though about a week before the surgery I started having a low level warm sensation in abdomen. Dr put me on pepcid, which they kept me on after surgery. It stopped working, so they put me on Prilosec which did nothing, now I'm on Prevacid which worked a bit, though not lately! I have a dr appt on Jan 30th and was told to stay on Prev and take one chewable Pepcid at night. I was also given sucralfate right after the surgery which is to bind bile, but it did nothing. So is this acid or bile? Did you have endoscopy before gallbladder surgery or after? Did you have stones? I'm at the point where I just wish medication would actually work - I don't even care if I have to be on something the rest of my life. The pain is getting worse.
 
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moscow2005 responded:
LAK0427, it sounds like we are having the same type of thing. From all the research I have done, and the non (or small) response to PPIs, antacids, etc, I am inclined to believe that it is bile or a combo of bile and acid. I had an endoscopy about a month before my GB surgery, and it was totally clean. No H. pylori, no esophagitis, no ulcers, etc. During the surgery, it was found that my GB was necrotic and infected (gross...) and that I had three 2cm stones. I have been doing some searches on bile reflux and it seems like the only "cure" is medication and/or surgery. Lifestyle and diet changes seem to have minimal effects. I am a vegetarian, so I think my diet is pretty low fat already (in response to the other post), but I am going to try to reduce the fat even more. So far, it's been about 1 week on Prevacid, and it's gotten a little better, but still not 100% gone. I agree that I just want something to get rid of the horrible symptoms. The feeling of something stuck in my throat is really distracting and sometimes really painful. At this point, if surgery is an option, I'm willing to do it because I really feel like I will never be "normal" again without doing something!
 
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CalGal37 responded:
Moscow, you may want to rethink the 'diet and lifestyle doing litte.' Most people really DON'T change their diet all that much although perhaps more do make some lifestyle changes. I really hate to say it, but people won't change their food unless they are SO miserable they're forced to. Most will pick out a couple of things they know cause problems and stay away from those - sometimes - but face it, no one want's to follow a strict diet.

Even those with gluten issues - which is a substance that actually poisons the body and can end up resulting is SEVERE symptoms that can be neurological (or other), even those people don't believe it until severe symptoms literally hit them over the head.

Food is too much of a comfort to many and they refuse to change. They want a quick fix instead. And if you think the Nissen or other surgery for GERD is easy, think again. I don't know how old you are, but think long and hard before you go that route. And there's nothing to guantee that the 'wrap' will cure the problem.

Take a look at a couple of the posts at the top of the board. You'll be reading of two individuals who did change their diet and found out it worked. But they're in the minority - they took a large step in dietary change.
 
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moscow2005 responded:
CalGal37, thanks for the advice. I am actually a medical professional, so I'm at least aware of the implications of different types of surgeries. I am only 33, and very healthy otherwise, so that doesn't worry me (Since I am so young, my big issue is the continued damage to my esophagus for the next 30 years if I can't get this under control now...). Which is not to say that I'm eager to undergo another surgery. The GB sx kicked my butt. The problem, really, is that I am most likely dealing with bile reflux, rather than with true acid inspired GERD. I'm unsure as to whether "traditional" GERD treatments will work. They haven't so far.... I am willing to exhaust all non-surgical alternatives before going the sx route (including homeopathy, etc), but if unsuccessful, I don't really see much choice by to try sx. And, as I said, being a vegetarian, I think I already practice a pretty strict diet, so I'm not sure how much I could change it! I've been wanting to go raw for a while, so I might try, although they say that cruciferous veggies can cause issues too... (And given the fact that I had absolutely no GERD issues before the GB surgery, leads me to believe that my diet was never the issue...)
 
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CalGal37 responded:
Okay, then with your background and what you're saying, I'm going to go out on a limb and suggest something VERY non-traditional...........find someone who is highly trained in visceral manipulation.........and while you're sitting there thinking I'm nuts after reading a bit about it, consider all of the connections and interconnections of the connective tissues/ligaments and how function(s) can be skewed by 'mal-positioning.' It's possible it can help, but you won't know until some one with highly trained hands figures out where your restrictions are and exactly what's going on. I just wrote a reply to someone on the IBS board on this subject. You may want to check that out, too.
 
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LAK0427 responded:
What is visceral manipulation? Mr dr thinks I may have missed gallstones and recommends another ERCP. I have such burning in stomach/chest/abdomen that nothing seems to affect (Prevacid may have helped a bit, but stopped) - I am on Aciphex as of this morning - it's doing nothing and according to what I've read it's supposed to work in an hour!
 
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durandiana responded:


It should be mandatory for Dr's to tell you about this issue BEFORE you have your gallbladder removed. I had heartburn symptoms long before I got my gallbladder out in 06, but man... did I EVER suffer with it after the surgery! I tried every single OTC medicine, then went through all the presciption strength medicines too until I got Nexium. That was the best medication for me, and I took it twice a day up until a few months ago, when my husband got a different job and this health plan won't cover the majority of the costs, and we can't afford to pay $100 a month for this med, so I"m back to suffering with it, even while taking Prilosec. Nexium was what worked for me, I wish I could take it again.
 
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CalGal37 responded:
Aciphex can take up to 14 days or so to actually fully kick in, so you're going to have to stick with it and wait to see what happens. Not a nice thought I know, but all the PPIs work in that fashion.

Check out visceral manipulation at the Barral Institute website. It gives a great overview of what it is and how it works. If you have questions after looking at the site, let me know.
 
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MsNeiheisel responded:
Sucralfate and Nexium have helped me sooooooooooooo much. The Sucralfate I take 1/2 hour before I eat. It coats your stomach and then when the food enters it coats it too. So when GERD acts up, the food is already coated and doesn't hurt your esophagus. It has made a world of difference for me. Plus, since you have to take the sucralfate 1/2 before you eat, you plan your meals better too.
 
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JoycePaula responded:
Hi - I'm brand new to this forum and am SO glad to have found it.

I had my gall bladder removed 20 years ago, and for years had no digestive problems at all, although I have always been careful to stick to a low-fat diet.

About two years ago, I started feeling weird throat sensations - as if my throat were closing up, along with a feeling of fullness in my ears. No pain. No changes in any other system. I went through a battery of tests for ulcers, GERD, etc., and everything was negative. I had a repeat endoscopy about 9 months ago, and everything was still fine. So I carried on, just hoping it would go away. Increased my exercise, decreased my stress.

About two months ago, the symptoms got worse - now I'm at the point where although I wake up feeling absolutely fine every morning, but as the day wears on, my throat starts burning and my ears feel full and sometimes burn, and this lasts more or less all day. It comes and goes, but more often comes and stays.

I started a very strict diet plan yesterday, given to me by a naturopath - cooked, bland foods only, spaced three hours apart. I have done this kind of purifying diet before, and know it works, and my symptoms clear up. But it is very restrictive, and I can only stay on it for a couple of days. Then I slowly add in other foods - and eventually, at least in the past, the symptoms creep up on me.

I have an appointment with my doctor for two days from now, and think that as opposed as I am to medication, I should start taking something, because as one of you above mentioned, I, too, am worried about the long-term effects on my esophagus. (Not to mention the fact that the burning puts me in a rotten mood...)

I wish my surgeon 20 years ago - the top laparoscopic surgeon in Israel - had told me what might be in store. He probably didn't even know, which is very bad.

Thanks for "listening"!

--Joyce
 
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CHOOKIE1 responded:
I too had my gall bladder out 4 months ago, however i have been diagnosed in july 08 with acid reflux. My endoscopy and other tests showed nothing and even my gall bladder test came back ok. i met with a surgeon who thought it might still be my gall bladder causing the acid symptoms and pains in my stomach, so i had it removed. The pain in my stomach went away and the surgery did show that my gall bladder was diseased after all. For two months after my surgery I still had the same acid reflux symptoms and then felt good for 2 months. Now it seems for the last week I am suffering terrible from acid reflux. The surgeon advised me that it could take up to 14 months to discard the bile from your gall bladder and the feeling is the same as acid reflux. I'm not sure if I have acid reflux or leftover gall bladder problems. My chest is tight feeling, the burning sensation radiates to my back, but nothing helps. I have been on medicines since july 08. i currently take 40mg of prilosec and 300 mg of zantac and today still needed to add in some mylanta to try to help it. My heartburn doesnt occur after eating or at night as the usual symptoms state. I wake up with it and go to bed with it. It lasts all day and once it starts it goes on for weeks. Does anyone else feel this way?. I don't think removing your gall bladder gives you acid reflux , I think you are just getting rid of the bile and I wish there was a real cure for all of it.
 
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CalGal37 responded:
Chookie, there is no such thing as 'getting rid of the bile.' Your body puts out bile each and every day and will do so for the rest of your life. Bile is necessary for the digestion of fats that you eat. I believe you may have misunderstood what your doc was saying. There can be changes in the way bile is released after surgery and that may be causing some of the problems you're currently seeing.

Many people have problems after GB surgery and some find that they need to modify their diet into a low fat one following GB surgery.

If the release of bile is the problem, or if you're currently refluxing bile, taking PPIs will do vry little to help. You may want to discuss using something like carafate or another substance that will coat your stomach and help protect against damage from either bile or acid.
 
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tdoland responded:
about 3 mos after my gb was taken out i had the same problems my dr gave me nexium and it went away


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