The Definitive Guide to Gall Bladder Disease

Eating bland should not cause a back-up of bile in the GB. It always releases some for digestion, but releases more with the more fat you eat. Whatever it releases, the liver puts it back in fairly quickly (as far as I understand it). So the gall bladder stays full most of the time anyways, ready to release when you eat.

I would be careful in using your term "sludge" as it is actually a medical term for when the bile (which is made out of bad cholesterol) partially soldifies. Gall stones happen when it fully solidifies. As far as I'm aware, no one yet knows why some people get a hardening of the bile. So, in other words, don't blame your eating habits for causing it; genetics--which you clearly inherited!--play a big part in it too. I got those genes myself. Also, my surgeon said people with a Native American heritage seem to have a higher likelihood of GB problems (again, genetics)--and I have a dose or two of that in my tree too. My mother said one rule of thumb said the 4F's for suspecting gall bladder problems--fair, female, fat and over forty. Apparently being fair-skinned (not just white, but a fair-skinned white person), a woman, overweight and middle-aged or better also increase your risk factors. Pregnancy also increases your risk.

You can't know if you have sludge or not right now. An ultrasound may find it, but sometimes the sludge isn't solid enough to show up, that particular machine isn't sensitive enough, the tech isn't trained enough, etc. You could just have a gall bladder like mine that misfires. Sometimes mine would work just fine. Then sometimes it would not release bile when it was needed, then it would just dump it all into my empty digestive tract. I think this is what caused my severe pain--it spasamed releasing all of that bile. Then, of course, all of that bile got to come out the other end! I think the nausea, fulness problems, trapped gas problems, arm aches, etc. were related to me eating but no bile (or not enough) coming out to digest my meal. When my GB wasn't working, I got it coming and going! I don't know if it would get inflamed and cause the misfiring, or if misfiring made it get inflamed because it was holding bile too long. I also wonder if my liver doens't try and produce too much bile (and thus overloaded it); I certainly seem to have a lot of it.

In any event, there's a lot of reasons why your GB might not work properly!

I don't know why artichoke would trigger the gall bladder, unless it was in dip or heavy oil; then it would be the cheese or oil doing it. Bread was always pretty safe for me. Non-fried rice as well. Baked meats (you may find that chicken and fish are easier on you than pork or especially red meat). Sometimes things aren't very logical; while I normally shun deep-fried foods, I can eat Cracker Barrel chicken and okra with impunity (ate a lot of it during my bad spells). I can also eat Chick-Fil-A, but I think that's because they fry in peanut oil; it's the vegetable oils, especially the partially-hydrogenated ones, that don't like me. I don't know what Cracker Barrel cooks in.

That you suddenly developed an allergy to shellfish makes me wonder even more about a gluten problem. That's the danged thing about allergies--I don't think I know anyone that's allergic to just one thing. If you're allergic to pollen, you are probably allergic to mold too. I'm allergic to pollen mild-to-moderately, and cats moderately. My mother is allergic to everthing but horses, dogs and food. And--this is weird--she didn't develop any of those allergies until she got pregnant with me. She used to have cats, but when she got pregnant, they had to go. Now she is pretty severely allergic to them. So allergies can pop up at really weird times and for no reason.

Since you very much suspect a fish allergy, you should probably get tested for both it and a lot of other things. If you have a fish allergy, you need to know it and you need to speak with an allergist about what to do about it. Itching isn't a very good sign; people who are bad enough to itch/get hives or rashes (as opposed to just stomach discomfort) might go on to further develop a deadly reaction. An allergist would better be able to tell you what the likelihood is of that happening and tell you what signs to look for to know if it's progressing into a bad shock. Shellfish is one of those foods (along with peanuts--ever think about that with your sandwich the other night???) that has a bad tendency to become a deadly allergy. I don't know if I've ever heard anyone dying from a gluten allergy, though. It tends to just mess up your guts bad.

Keriamon said...

I don't know why artichoke would trigger the gall bladder, unless it was in dip or heavy oil; then it would be the cheese or oil doing it.

I did some research and a few sites mention that artichoke stimulates bile, so there were some warnings about eating it if there are stones/symptoms it might aggravate it / make it worse.  Whether or not that was the case for me, I don't know but I hadn't eaten any artichoke in years and the day I did was the first of the really bad symptoms.  So, while it surely isn't the root cause it may have been a trigger.  [ One example google search link to gov document, html format: http://64.233.167.104/search?q=cache:ZjoLncjntxwJ:www.elib.gov.ph/edatabase/elibgetdb.php/http/healthlibrary.epnet.com/print.aspx%3Ftoken%3D2bca6a35-7ee0-4bae-9304-0e08a36fb860%26chunkiid%3D21516%26target%3D_blank+artichoke+stimulate+gallbladder&hl=en&ct=clnk&cd=2&gl=us ] another example @[ http://www.umm.edu/altmed/articles/gallbladder-disease-000066.htm ] 

As for allergies, I do plan to see a doc about the shellfish and if possible get tested, understand the risks, know what I need to do, etc. 

I'm going to try out gluten free.  Reading up on it, it's not much of a stretch from where I'm at now so may as well cut it out too.   http://allergies.about.com/od/foodallergies/a/glutenfreediet.htm   I can than introduce things back (to test for symptoms) if/when I start feeling better. 

12/5/07 update:

So I've been on gluten free for a few days and that and other things I'm feeling a lot better.  I have hardly had any nausea and rarely any significant pressure in my chest (but a few times I've had that gnawing/burning sensation, just milder than before).  I have had a few periods of the day (usually in am, up until mid-afternoon) where I'll have some 'something isn't right' feelings with my nervous system.  My heart rate will sometimes be a bit higher than normal, or maybe I'll just feel on-edge.   Still have to wait for the ENDO on the 12th, but, in the interim here are some suppliments and foods I've tried and my + or - rating on them for me:

Mastic Gum Pills ($12-18 for 22 day supply):  (+) These seem to help me.  If I take them before (or even after eating) I can feel my stomach tension easing.  They cause a little gas but it seems to help me feel better, rather than worse.  Whether or not they offer any cure for H.Plyori, I am in agreement they do settle my stomach.  They can be taken with my Antacids too, if/when needed.

Broccoli (Regular, not sprouts):  (+) for some reason I feel better after I eat it.  There is enough material out there that indicates this may not be good for ulcer conditions, so, YMMV.  The studies on effectiveness to H.Pylori are inconclusive to me, but, it's healthy and didn't make me feel any worse so I've been eating about a cup-full of it daily w/ other foods.

Olive Oil: (+) Taste isn't so great, but, I've been using it in small quanties, as a substitute for other options for fat and seems to be agreeing with me.   A little fat in the diet is good, so, I try and add some to my food or salad when I haven' thad anything else fatty that day.  This is also part of a gall bladder clense but I haven't been using for that purpose, or in any way close to the amounts they suggest--I might have a tablespoon or two throughout the day with various foods, but, not 'cup fulls'. 

Apples / Grapes: (+) Have been using for snacks or light meals; They are also part of 'gall bladder clense' suggestions, but, I didn't use for that purpose, only in small quantities and with other foods.  They seem to help with the digestion process for me.

Beets (Jarred, with no sugar added): (+) I nuke a few of 'em shortly and then eat them on the side with something else.  I've tried them a few times when my chest felt a bit of pressure and each time they seem to have helped.  Supposedly the help thin bile and move things through the liver/gall bladder. 

Ginger (Pills, haven't tried raw stuff): (?) To early to tell, but, first day I tried had no adverse affects and it's supposedly good for you, so, will continue to experiment here. 

Milk Thistle (Pills): (?) To early to tell, but first time didn't cause any adverse affects and supposedly helps the liver to heal and function, possibly thinning bile, etc.  So, will try a few more times and see.

Pepcid AC: (+) Works well for an OTC in relaxing the burning sensation I get less and less frequently now. 

Protonix: (?) I had some weird side effects while taking it and haven't ruled out it or food yet, but, have been better since switching to Pepcid AC and using the other items so unless I get worse again I'll hold off.

Eggs: (-) I'm 90% certain I had my most recent bad days after having eggs and/or food with mayonaise. I've been avoiding for over a week now and have had no more really bad spells.  I'm still avoiding a lot of other bad foods and been much better, so could be other things too. 

I'm basically eating healthy foods, mostly fruits, vegies, and chicken for protein.  Lots of water.  Cut out gluten, although in the last day I had a few things that had a little bit of bread as part of the contents.  So far so good.

I've had a little non-fat, no-sugar yogurt as well for the pro-biotics and other benefits.  I'm trying to get the right dietary balance without causing my symptoms to get worse.  All in all in I'm eating healthy and trying a few suppliments and my results are at least in a positive direction.

If it's my GB, it's likely I'm just delaying the inevitible, but, if I can feel better while doing that and determining what exactly is the problem, than I consider that a success.  YMMV, please research and discuss with your doctor as appropriate.  If any of the above is helpful for you, please reply back and let me or others know!

Post Edited (eihcet) : 12/5/2007 10:20:37 AM (GMT-7)

Keriamon: no I am not taking any meds except for Hyoscamine for spasms (as needed) and Klonopin (as needed)-------no PPIs or anything else.....

I am beginning to wonder if I injured my rhomboid muscles (next to your shoulder)---or my serratus anterior (wraps around to your front ribs under your armpit)---b/c that is where my pain has always been---just various degrees of pain----and I never get to rest my "right upper quadrant" b/c I am constantly using this side! ;)

I have NOT checked for torn rotator cuff or pinched nerves b/c my MD never went that route! (mad face)---he just automatically assumed it was my GI tract somewhere------even though I told him about my working out--the exercises I was doing, etc...........SIGH!

Does no one listen *in the med profession* ? OY!

thanks Keriamon---
Laurel

Keriamon:

did your arm ache all of the time---or just after you ate something that would trigger an attack? Mine aches all of the time from shoulder to elbow----on the bottom side, and tingles, and goes numb....my hand gets cold when I am driving, or using the mouse on the computer---or carrying bags, etc....

so, I am just wondering what your experience has been.......

thanks!
Laurel

Thanks so much Keriamon---

I have been going to a sports med MD---and I did go to a chiropractor-- I told them about the pain in my shoulder---but, the intensity wasn't this bad (at that time)---I am going to PT on Wednesday evening for an evaluation (per Sports Med MD referral)---so I guess I will see what they think----

I am able to rotate my arm in a full circle like you suggested above----but, it's just really weird----the pain is just incredible for some reason----and it stinks! Thanks so much Keriamon---I am kind of scared, so this makes me a little anxious....OK---- a lot anxious! :(

Laurel

Better it's your muscles or nerves messed up than the GB!

 

 

I sure hope so Keriamon.....I sure hope so-----

Glad you are feeling better. I hope it lasts!

You need to go to the doctor now, while you are hurting, and insist on a HIDA scan. I think the reason why my first two scans didn't show a bad gall bladder was because I had to have them done when I was home from college, and I just happened to not be having a problem at that time. So it's important that you go when you are having a lot of problems to give the test its best chance of finding something (conversely, if you get it done when you are in pain and sick, and yet nothing shows up, then you may very well have something else wrong with you).

I think I would have held out for an endocopy to prove an ulcer before taking medicine for it. And if anyone starts in on that again, insist that they do a scope and see if there is indeed an ulcer in there. People kept trying to treat me for acid reflux, even though I did have a scope done and it showed no sign of damage from acid reflux, which as often as I was sick, would have surely been there--if that had been the problem.

And yes, bad gall bladders run in families. My surgeon asked me about mine and I could name off a bunch of people in my family who either had theirs removed, or suspected it sometimes went on the fritz. In fact, digestive tract problems run in my mother's family; she's had her gall bladder out and has been diagnosed with a slow-emptying stomach, her sister and two uncles on their father's side have/had Crohn's, and a first cousin on their mother's side has had her stomach pretty much quit working all together and they are considering doing gastric bypass on her.

Well, the sympathetic doctor that I was talking about in the previous post, actually turned out to be a surgeon. I got his number from
someone who had their gallbladder out by him, and were very pleased, so I called them anyway. I explained that I had had tests ran two
years ago and that I wasn't feeling any better still, so they asked that I get the test results sent over to his office and I have an appointment
at 2pm on Friday. Here's to hoping for relief! I've had a few rough days since I last posted. I have had the runs pretty bad and my side and
back have been hurting off and on. It's usually worse at night after dinner. At least i'm looking for something now, rather than sitting in misery!

I never had a HIDA Scan, so there is no way to know if it was bad or not. I just had a CT Scan and ultrasound. They didn't see stones,
so they just assumed it wasn't that and started guessing at other causes. It was a terrible experience.

I'm not sure what to do.........
Been feeling sick constantly for 3 days, no appeteit, woke up in pain last 2 nights running and couldn't sleep. Sharp pain under right rib with every little movement, this pain then spread to my right shoulder, neck and upper arm and became unbearable. I decided to go see my GP who asked me q's poked me about and told me it was inflammed muscle under my ribcage. I told her I haven't been exercising or done anything unusual, oh well she said it's nothing just take pain killers. I told her I had tried but they didn't have any effect and she gave me some anti inflammatory pills and sent me on my way. I still have pains which have now also spread to my lower back and become very bad, still feel sick and not interested in eating. I keep getting this odd gurgling in my stomach and a strange sensation like something is bubbling out somewhere......hard to explain but it's very uncomfortable. I spoke to my Gran who has gallbladder problems and she told me she had same symptoms and was rushed in for a scan. I can't understand why I'm being fobbed off by my doctor. Does this sound like gallbladder problems? I get really embarrased about creating a fuss so I'm a tad reluctant to go back and harrass my GP.

Helen, I'd go back to the doctor and insist on a HIDA scan. Muscle pain should not make you feel sick to your stomach and put you off food. Pain under the right rib cage and up into the right arm is usually a pretty big symptom--not to mention nausea. The fact that it runs in your family is also telling; they seem to be genetic a lot times. It does involve getting an IV line and laying on your back for about an hour, but otherwise it's not an invasive test and doesn't take too long.

My mother said they taught her in nursing school of the 4 F's: fair, fat, female, 40+ (years old). Those are the most likely people to develop gall bladder problems. Also, pregnant women or women who have been pregnant have higher odds. And my surgeon said that people with Native American ancestry and a family history were also at quite high risk. I was female, fat, fair, although just 18 when mine went bad, with a family history and a bit of Native American ancestry. So I hit quite a few of the high-odds markers. If you are young, many doctors are dismissive that it might be your GB, but I'm proof that it does happen early. There are some others on here who also had problems with theirs in their late teens/early 20's.

I lived with mine for five years. You don't want to live with that for five years. Push, push, push. If your gran says that's your problem, I'd bet money she's right. Everyone in my family that had had a bad gall bladder had me diagnosed years before a doctor did. When you've had it, you KNOW it.

Some medical terms for the various types of Gallbladder issues (based on Keriamon's first post):

 

1. The first type, "the most common form of GB disease: the infamous gall stone." => Cholelithiasis (Gallstones); Choledocholithiasis (bile duct gallstones).  A stone / blockage can lead to Cholangitis (inflamation of the bile duct).
2. The second type, "—and probably the second most common form—is sludge." => Acute Cholecystitis (Acute cholecystitis is a sudden inflammation of the gallbladder that causes severe abdominal pain ); also see Chronic Acalculous Gallbladder Disease
3. The third type, "a malformed GB—sometimes referred to as a “strawberry GB” because of how it is shaped and colored." => Cholesterolosis of Gall Bladder / gallbladder mucosa
4. The forth type, "is the kind I (keriamon) had and it is a malfunctioning GB." => Chronic Cholecystitis (Dysfunctional Gallbladders)

Some very good medical info at the UMM website, start here and follow the links on the left for symptoms, diagnosis, etc: http://www.umm.edu/patiented/articles/what_gallstones_gallbladder_disease_000010_1.htm

Personally, my symptoms (no diagnosis yet) have been noted earlier but range from indigestion (dyspepsia), nausea (no vomiting-yet), gnawing/pressure in my mid-chest below rib cage (but very minimal pain and lately no pain), occasion bouts of dizzyness (rare), rapid heart beat, & low(ered) blood pressure.  While I'm feeling ill I therefore have loss of appetite and can only eat mild foods, and experience weight loss (~.5lb/day).  I've posted about some tests done so far, no signs of H.Pylori or ulcers.  I have a followup near the end of this month to learn more.

Mild exercise helps, eliminating fatty foods and refined sugars, apples/beets seem to help, lots of water, etc.   Eggs (especially in mayonaise and/or dressings) seem to cause me problems but I need to experiment more to confirm.

Hope this post helps others, I'll update the thread with my ongoing quest for diagnosis as I learn more.