New to this site, not new to the symptoms....still undiagnosed.

Forgot to say that I am living in Europe, recently moved here.

If you had your gall bladder out and are having cramping, pain, and diarrhea following eating or even in the middle of the meal, has your cdoctor considered you might be suffering from bile salt diarrhea? This is somewhat common in patients following gall bladder removal. Here is a link to read about it: http://www.gihealth.com/html/education/bilesaltDiarrhea.html

I'm confused: do you still have your gall bladder, or have you had it taken out?

Some doctors will lie to you and tell you that once you get your gall bladder out, you'll be right as rain again and then they turn around and tell you that you have IBS when you don't recover. Um, no, it's not IBS; it's the fact that you're missing a major organ of the digestive tract. Why wouldn't you have problems afterwards? Can you take out a lung and expect to run a marathon on the other lung alone? Why think you can take out a gall bladder and still digest your food perfectly? Being able to live without an organ doesn't mean that it served no function or that you can even be normal without it. Problems after gall bladder removal are called Post-Cholecystectomy Syndrome.

Mind you, it is quite possible that the problems you had before and after your gall bladder removal were not related to it at all; it is possible that they misdiagnosed you with gall bladder disease when none existed and that's why you have not gotten any better. Or it could just be that yes, it was your gall bladder to begin with and now it's your lack of a gall bladder that is the problem. Given how hard it was for me to get a postitive diagnosis with my bad gall bladder, when it clearly was the root of my problem all along, does make me think it highly unlikely that they gave you the wrong dianosis; but that doesn't mean it was the sole source of your problems either.

I got some better after I had my gall bladder out. Namely the pain/attacks stopped. But I was still having bile diarrhea. Most bile diarrhea is bright yellow and burns like acid, but I have read that bile can also be green--which would explain your coloration. My G.I. put me on Welchol and boom, the diarrhea stopped. Like Questran, it is a cholesterol medicine that absorbs bile. But I have heard many people complain of gas cramps while on Questran and my mother-in-law and I have neither one had that problem on Welchol, so I always recommend it first.

Yes, you can have pain after having your gall bladder removed. A lady I worked with got what we jokingly called "phantom gall bladder" problems once or twice a year. She would hurt in her upper right quadrant, just as she did when she had a gall bladder, and she felt sick, had diarrhea, the whole nine yards. There are some people on here who also continue to have pain after their gall bladder removals, and in that same area. It is possible, if you had stones, to still have a stone lodged in your bile duct. It is also possible that they damaged your bile duct when they removed the gall bladder and that can be the source of your pain. And it is also possible, especially if the pain is elsewhere besides the upper right quadrant, that you have pain because you have irritated your intestines with excess bile; if you had excess before and excess now, that's why there has been no change in your condition, despite the surgery. That is (part of) what happened to me last summer. I had gone off my Welchol for a while because of a change in diet which made it unnecessary and then I had a round of antibiotics and then I got into some sugar alcohol which I seem to be very allergic to and between all three, I think, I developed daily diarrhea and a lot of pain. After two months I finally got it cleared up with extra doses of my Welchol, the calcium supplements (which are supposed to be good for soothing intestinal irritation), and some yogurt.

I know you mentioned that calcium supplements made you worse. How is yogurt on your guts? Good bacteria and calcium from it is a double good helping. Calcium can also help absorb bile, but if you have a lot of it, you may need the Welchol too. Go back to the doctor and make them test your stool for excess bile. That will tell them right there if that's your problem. Bile is an acid; how can having too much of it NOT irritate your intestines? It's like having acid reflux and heartburn of the colon.

Of course all of this is contingent upon bile being your problem. It usually is a problem after having your gall bladder removed, but it may not be the main source of your problem, since your gall bladder may not have been the original problem all along. But it may have very well been; not everyone gets normal after having it out. In fact, I don't think I know of anyone who IS normal afterwards. My mother is lucky in that she doesn't have bowel problems, but she does have really bad acid reflux and my G.I.'s nurse said that in some people the bile can go up and cause heartburn and reflux problems; in other people it goes down and causes diarrhea.

If I were you, I wouldn't be too afraid of the native doctors, provided you can find one that speaks good English. The best place to start is to ask people you know for references. You can even ask a friend to go with you to help smooth over any translation problems and to make you feel more comfortable. I felt like my doctors in Ireland were superior to the ones I had in the U.S., even though I still didn't get a diagnosis. They took a lot more time with me, were much more thorough and seemed genuinely concerned. It also cost me just 25 IEP to see one, and that INCLUDED the blood work!!! Try seeing an American doctor for $25, much less getting blood work to boot. And I didn't go through the NHS; I just walked up the block to a clinic with a bunch of doctors in together and I saw the first one available. I didn't wait more than 20 minutes either. And then I bet I spent 30 minutes or more with each of them.

There is a growing trend of people in America to go overseas for medical procedures or diagnoses, especially dental work. A lady I worked with was friends with a couple, and I think the man was a Czech citizen, and they would go over there every winter (they were retired) and they had all of their dental work done while they were over there because it was SO much cheaper and every bit as good. I think he also had a knee surgery done over there for the same reason. Much is made of the American health system, but I think a lot of it is hype or, at least, unfairly knocks the health systems of other countries. The newest report out shows that white American men are unhealthier than white men in England of the same socio-economic background, despite the fact that America is spending something like 4 times as much on healthcare than England. So obviously throwing money at healthcare isn't the answer to having good health. Or it may be, as someone in a news article (about the fact that America has a higher infant mortality rate than most every country in Europe) remarked, America is THE place to come when you have some unknown ailment or hard-to-treat or rare disease, but we are WAY behind on just plain old, run-of-the-mill daily health care. So, who knows, you may do better by going to a non-American doctor. Most Europeans live longer than us anyways, so they must be doing something right.

I think most people who have chronic gas pains take the Gas-X before they eat, since they're positive that they'll get gas anyways. I don't know that taking it when you don't have gas hurts you any, so long as you're not taking more than is recommended.

Your pain may or may not be gas. I do know, though, that when my gall bladder was acting up, I did have a lot of trapped gas pains in addition to my gall bladder pains. For some reason I couldn't pass gas. Burping, farting, it all stopped and everything stayed trapped inside. Since I've had it out, I am some better, but I don't fart as much as I did when I was a kid. Could be a diet change, could be related to the old GB

If you're having bile poops, then your pain may be caused by that. The bile can irritate your intestinal lining and give you pain that way. It could also trigger your intestines to spasm and that's causing pain. I'd start with the Welchol and then if you don't get any pain relief from it, ask for an antispasmodic as well. I had a lot of painful diarrhea last summer that the calcium and Welchol together seemed to take care of. As the diarrhea diminished, so too did the pain, so it's possible that if you can stop the excess bile, you'll stop hurting.

A lot of us use heating pads and/or hot, soaking baths to relieve abdominal pain. I think Europeans are still pretty fond of hot water bottles. Get you one of those at the chemist's and put your electric kettle on (I know THAT'S a required item in European kitchens, lol) and then fill your bottle with hot water. I took my hot water bottle with me to Ireland and that's how I used it. When I had my horribly severe attack, I filled it up with boiling hot water and just laid in on top of my clothes and sheets until it got so hot I couldn't stand it, then I moved it over a little. I suggest a slightly more tolerable temperature in yours.

IHOP and Golden Corral. Blech! Definitely two bad places to eat. Long before I developed gall bladder problems, Waffle House food, regardless of what it was, make me sick to my stomach. I shudder to think about what all nasty, greasy junk was in what I was eating. I certainly didn't go there of my own accord. After I got sick the second time I ate there, I refused to eat there anymore; if I was with my parents or friends and they wanted to eat there, I'd sit with them, but I refused to order anything. Like I said, that was BEFORE I developed any gut problems at all. Some restaurants just have food that's too nasty to digest, regardless. I have never been impressed with the quality of food in those "steak house" buffet places like Golden Corral and Ryan's. Cheap restaurants like that, Shoney's, etc., etc., aren't the first bit better for you than any fast food place. All of their food is full of unpronounceable ingredients, pre-frozen, and then just heated up when you order it. They don't cook any more food in a Shoney's than they do at McDonald's. Chick-Fil-A is the only decent fast food place that I know of; they at least deep fry in non-hydrogenated peanut oil which is one of those good fats (they also have an excellent chicken noodle soup); food from them has never bothered me, even fried.

Bile breaks down fat. Eating fat triggers the production of bile. Eat less fat, produce less bile. If you aren't already on a low-fat diet, by all means, try it out and see if that helps relieve your symptoms a bit until you can get some medicine. I went off my Welchol for almost a year while on (and even after coming off of) a low fat diet. Unfortunately I went to the other extreme while on my diet and had severe constipation. I don't think I could achieve a balance without the medicine, but at this point you'd probably welcome a little constipation; I did too at first.

You need to be really careful about what you eat, and not just in terms of fat. I think some fats are worse than others on your guts. Partially-hydrogenated oils of any kind--really, really bad. Cheese, olive oil, salmon, not so bad. I've been doing some studying on French diet versus American (Italian is supposed to be good too), and it's really amazing how much fake crap we put in our foods and how much of it we eat. I think all that junk may be a factor in some people's IBS. Our guts weren't designed to process benazthone-hoperperkseoijriejriowejhroie or Red #40.

Do you know there's a law in France that says bread for sale can only be made from water, salt, yeast and flour? You can't buy bread like that here! All of it has sugar because Americans somehow can't brown bread without sugar, even though the French manage it, and all of our wheat has to be enriched and our yeast autolysed (whatever that means). And that's in bakery bread; bread off the shelf is worse. When I went to toss out some fresh bread that had molded after a week, I noticed I still had a half-eaten loaf of low-calorie, high-fiber bread in the pantry. I realized it had been in there two months or so, yet when I pulled it out, it wasn't molded!!! It was so fake that mold wouldn't even grow on it! How shameful!

You're lucky in that you're in a country that has a good reputation for serving good food. Make sure you do everything in your power to avoid American foods while there. Eat what the natives eat and try to lighten up on the cheese and any cream sauces. The trick to eating low-fat isn't buying low-fat products (which are full of sugar, starch and even more unpronounceable chemical combinations): it's having just a little taste of good fats and no bad fats (like the partially-hydrogenated stuff in fast food and American pastries). If you are invited to dinner, ask them if they can serve something light since you have a delicate digestion and can't handle a lot of cream and cheese. In a restaurant, order things that don't have a heavy sauce. Most soups that get served for appetizers are light and brothy. Salads don't bother me any--although never eat pre-cut lettuce from a salad bar or from a bag-o-salad (not that they have either over there) as it is washed in chemicals to keep if from browning and this gives normal people diarrhea a lot of times. Only eat pork and red meats very occasionally, and avoid fatty meats like duck and mutton and organ meats, like liver. Eat a lot of flavored vegetables and some white meat chicken and fish and shellfish. Bread has never been a bother either; spread good butter or olive oil on it very thinly, just for a little taste. I have heard that good Italian olive oil and good, fresh butter is so rich that Europeans only ever use a tiny amount anyways. And, of course, you're living in pasta country. Eat it with tomato-based or broth-based sauces for low fat. You shouldn't be hurt by any yogurt, either, although go light on it because it's doubtful they make it over there with anything other than full fat. But, having eaten full fat yogurt myself, I can tell you a little goes a LONG ways. It's so rich, you can make a breakfast off just a couple of tablespoons. But, whatever you do, eat small portions and eat them slowly. This goes a long way towards keeping your guts happy and from feeling overwhelmed. If you have to, take some of your meal home to eat on when you get hungry later. It's better, when you have aggrevated guts, to take your regular three-squares and divide them all in half and eat less more frequently. I say take a regular meal and divide it in half because if you just make some food here and there, you'll end up eating more rather than the same amount.

Caffeine was my biggest trigger before and after my gall bladder removal. If you habitually drink cokes or coffee, try eliminating them. They both can cause additional problems through acidity and carbonation, so even non-caffeinated versions should be avoided. Also avoid alcohol; it seems to be bad for just about anyone with a messed up gut (regardless of why it's messed up). They'll probably look at you pretty strange for not wanting wine with your meal, but stick to your guns and just drink water. If they like to sit around and have coffee, then bring your own tea bag; the caffeine in the vast marjortiy of teas is so low as to not be a bother (at least not to me, and I'm pretty sensitive). I like green tea with a bit of sugar served at room temperature or iced and I also like English Breakfast tea with some cream and a bit of sugar; it's very good with chocolates. Ceylon tea needs almost no sugar and is also good after a meal.

Oh, and I'm not fiber expert (never has helped me any), but there are supposed to be some brands that mix up clear and don't get thick. Maybe some of the fiber drinkers will be around to recommed something else, or you can make a separate post asking which fiber supplements you can try.

Sounds like you have an excellent diet and are pretty much doing all you can to help yourself. You're probably just going to be like me and require a little medicine to get balanced.

You can always beg off the wine and coffee with "I've given it up for ______". When it's not Lent, Friday or Sunday, then you can always insert "penance" or "spiritual reasons". I'm quite sure in Italy that will be understood. At first I felt like giving up caffeine was like a punishment, but I eventually got over it. I treat myself to a Stewart's black cherry cola 4-pack once a week (no caffeine) and that satisfies my want for something other than water. And now that I have gotten used to them, caffeinated drinks--ones that I used to really, really like--taste horrible. I can't really describe the taste of caffeine, but it definitely has one. When you're on regular colas and you switch to the same brand minus the caffeine they taste so much different (usually for the worse).

You know what American item I liked most while I was in Ireland? Charmin toliet paper. LOL. And not just because I had diarrhea a lot. I found the packaging humerous, especially that it had HRM's official seal or sanction or license--whatever it's called. I liked to think that the Queen of England also used Charmin (not that the seal meant that, but maybe she does anyways), LOL. And I don't know if they're in Italy the way they are in the British Isles, but American candy bars over there, like Snickers (I think they were labeled "Snickies" or something like that) were far superior to the same one over here; much higher-grade chocolate. Still, I preferred the imported Swiss and German ones instead. Milka bar was my favorite.

Here's a little tidbit for you that I read last week on MSN: fast food companies put more fat into American food than they put into that same food in other countries. McDonald's and KFC both did this. They said that they based their recipes on local tastes. Imagine how much less bad fat Americans would consume if all the fast food restaurants used their European recipes over here and just got us used to less fat. And boy, it doesn't take long to get used to eating good stuff; I'm already turning my nose up at things just a few weeks ago I would have eaten with delight. When you come back, I hope you don't get food shock! I certainly experienced reverse culture shock when I came back from Ireland, but not over food.