Frequently Asked Questions
1. When I have pain in my abdomen it goes all the way up to my right shoulder, is it something else or is it related to gallstones?
If the pain travels from the abdomen to your right shoulder and does not occur independently, then yes it is related with the pain of gallstones. It happens because the nerve that supplies the gallbladder known as right phrenic nerve is coming from the same roots which are also giving a nerve to your right shoulder called the supraclavicular nerve, i.e. both the nerves share the same root value.
2. When should I go to the doctor?
As soon as you develop a symptom, you should go to your local GP. If the pain occurs continuously over time and does not stop and if it is associated with nausea and vomiting then you should consult a doctor rather than taking over the counter pain medications. Your doctor will help in diagnosing the cause of your symptoms.
3. Are gallstones a life threatening disease?
No, gallstones are not life threatening if they remain asymptomatic. But if they produce any symptoms which are either not taken seriously and are left untreated or are treated very late, then eventually the complications that arise as a result of symptomatic gallstones are indeed life threatening. Complications of gallstones are manageable and if the treatment is started as soon as they are diagnosed then there is no possible danger to your life. Treatment for most of the complications requires hospitalization.
4. Can gallstones be prevented?
A person can decrease their chances of developing gallstones but preventing them altogether from occurring is difficult. Predisposing high risk factors such as age, gender or family history cannot be removed or changed. But other factors such as maintaining a healthy weight, eating foods which are high in fibre and low in fats, leading an active lifestyle with regular exercise can reduce the risk of developing gallstones. Also rapid weight loss should be avoided because it can lead to gallstones.
5. How long is the ERCP procedure and how should I prepare for it?
ERCP can take anywhere from half an hour to 2 hours depending upon individual circumstances. You will be asked to fast prior to the procedure for at least 8-12 hours so that your stomach remains empty for the procedure. You will be kept in the recovery room till the sedation wears off; however driving is prohibited for 12-24 hours after the procedure, so plan for your ride back home beforehand. You can start eating and drinking within 2 hours of having your procedure.
6. What are the chances of developing complications after having an ERCP?
Only 6- 10% of the patients develop complications which requires hospitalization. But if you develop any of the following symptoms after your ERCP, then you should go to your doctor immediately:
7. How successful are the non-surgical treatments of gallstones and can they permanently remove gallstones?
Although there are non-surgical methods widely available, but unfortunately they are not very successful in removing gallstones. Oral medications for dissolving gallstones can take up to 2 years to work and there is a high chance of developing gallstones again because the predisposing factors are still present. Lithotripsy though very successfully applied in kidney stones, is of no use for gallstones, because it can break only small, hard stones and if the broken pieces are large they will not be able to pass through the narrow cystic duct thus obstructing it further. Even if the pieces are small, a functional i.e. a contracting gallbladder is required to propel the pieces down otherwise they will stay in the gallbladder. Because of these reasons surgery is the best method for treating gallstones.
8. There are two kinds of surgery can I decide myself which one to go for?
Unfortunately, it can only be decided by your attending surgeon which one to undertake. The surgeon will decide keeping your individual circumstances and needs in mind.
9. I have diabetes and hypertension, is it safe for me to undergo an operation and when should I discontinue my medication before the surgery?
Firstly, you have to inform your surgeon that you are diabetic and hypertensive. Yes, if your sugar and blood pressure are under control then it is perfectly safe for you to undergo surgery. You have to bear in mind that you cannot discontinue your medication under any circumstances and medicines have to be taken regularly. If you are on oral hypoglycemics, then your surgeon will stop them before your surgery and you will be put on insulin instead, just for a short period of time and after your surgery you will go back again to your oral medication. You should continue taking your diabetes medication regularly; otherwise it will take long for your surgical wounds to heal. If you are taking anti-hypertensive medications as well, then you have to continue taking them regularly including on the day of your surgery.
10. What happens after the gallbladder is removed, will my body function normally after it is taken out?
Your body will not be affected with the removal of gallbladder. The function of the gallbladder is to store, release and concentrate the bile which is produced by the liver. Once your gall bladder is removed, the liver will continuously pour bile directly into the small intestine i.e. the duodenum through the ducts as they are left intact (only the gallbladder is removed). The only difference is that the bile will not be concentrated but nevertheless it will do its job, i.e. dissolve and absorb fats.
11. How long do I have to stay in the hospital after the surgery and how soon can I go back to my routine life?
Your length of stay in the hospital depends on which procedure you underwent. If you had lap choly, then you will be discharged on the next day. You have to rest for a few days to recover and then you can join your work one week after the surgery. If you underwent open cholecystectomy, then you will be discharged from the hospital after 5-7 days. You will be advised to rest for at least a month before you resume working.
12. I have developed diarrhoea after the surgery is it serious and do I need to change my diet after the surgery?
It is not clearly known why some people develop diarrhoea while others do not. Studies suggest that since the bile is poured continuously in the small intestine and has a laxative kind of effect which might cause bloating and diarrhoea. It should resolve in a couple of days, if not then your doctor may prescribe antidiarrheal medicines, but it is not a serious condition. You can resume your normal diet after the surgery as there is no need to change it. Few doctors do suggest that you should take smaller, frequent meals, decrease intake of oily foods and increase in high fibre diet, however you should consult your doctor before changing your diet.
If the pain travels from the abdomen to your right shoulder and does not occur independently, then yes it is related with the pain of gallstones. It happens because the nerve that supplies the gallbladder known as right phrenic nerve is coming from the same roots which are also giving a nerve to your right shoulder called the supraclavicular nerve, i.e. both the nerves share the same root value.
2. When should I go to the doctor?
As soon as you develop a symptom, you should go to your local GP. If the pain occurs continuously over time and does not stop and if it is associated with nausea and vomiting then you should consult a doctor rather than taking over the counter pain medications. Your doctor will help in diagnosing the cause of your symptoms.
3. Are gallstones a life threatening disease?
No, gallstones are not life threatening if they remain asymptomatic. But if they produce any symptoms which are either not taken seriously and are left untreated or are treated very late, then eventually the complications that arise as a result of symptomatic gallstones are indeed life threatening. Complications of gallstones are manageable and if the treatment is started as soon as they are diagnosed then there is no possible danger to your life. Treatment for most of the complications requires hospitalization.
4. Can gallstones be prevented?
A person can decrease their chances of developing gallstones but preventing them altogether from occurring is difficult. Predisposing high risk factors such as age, gender or family history cannot be removed or changed. But other factors such as maintaining a healthy weight, eating foods which are high in fibre and low in fats, leading an active lifestyle with regular exercise can reduce the risk of developing gallstones. Also rapid weight loss should be avoided because it can lead to gallstones.
5. How long is the ERCP procedure and how should I prepare for it?
ERCP can take anywhere from half an hour to 2 hours depending upon individual circumstances. You will be asked to fast prior to the procedure for at least 8-12 hours so that your stomach remains empty for the procedure. You will be kept in the recovery room till the sedation wears off; however driving is prohibited for 12-24 hours after the procedure, so plan for your ride back home beforehand. You can start eating and drinking within 2 hours of having your procedure.
6. What are the chances of developing complications after having an ERCP?
Only 6- 10% of the patients develop complications which requires hospitalization. But if you develop any of the following symptoms after your ERCP, then you should go to your doctor immediately:
- Difficulty in swallowing
- Throat, chest or abdominal pain that worsens
- Vomiting
- Bloody or dark stool
- Fever
7. How successful are the non-surgical treatments of gallstones and can they permanently remove gallstones?
Although there are non-surgical methods widely available, but unfortunately they are not very successful in removing gallstones. Oral medications for dissolving gallstones can take up to 2 years to work and there is a high chance of developing gallstones again because the predisposing factors are still present. Lithotripsy though very successfully applied in kidney stones, is of no use for gallstones, because it can break only small, hard stones and if the broken pieces are large they will not be able to pass through the narrow cystic duct thus obstructing it further. Even if the pieces are small, a functional i.e. a contracting gallbladder is required to propel the pieces down otherwise they will stay in the gallbladder. Because of these reasons surgery is the best method for treating gallstones.
8. There are two kinds of surgery can I decide myself which one to go for?
Unfortunately, it can only be decided by your attending surgeon which one to undertake. The surgeon will decide keeping your individual circumstances and needs in mind.
9. I have diabetes and hypertension, is it safe for me to undergo an operation and when should I discontinue my medication before the surgery?
Firstly, you have to inform your surgeon that you are diabetic and hypertensive. Yes, if your sugar and blood pressure are under control then it is perfectly safe for you to undergo surgery. You have to bear in mind that you cannot discontinue your medication under any circumstances and medicines have to be taken regularly. If you are on oral hypoglycemics, then your surgeon will stop them before your surgery and you will be put on insulin instead, just for a short period of time and after your surgery you will go back again to your oral medication. You should continue taking your diabetes medication regularly; otherwise it will take long for your surgical wounds to heal. If you are taking anti-hypertensive medications as well, then you have to continue taking them regularly including on the day of your surgery.
10. What happens after the gallbladder is removed, will my body function normally after it is taken out?
Your body will not be affected with the removal of gallbladder. The function of the gallbladder is to store, release and concentrate the bile which is produced by the liver. Once your gall bladder is removed, the liver will continuously pour bile directly into the small intestine i.e. the duodenum through the ducts as they are left intact (only the gallbladder is removed). The only difference is that the bile will not be concentrated but nevertheless it will do its job, i.e. dissolve and absorb fats.
11. How long do I have to stay in the hospital after the surgery and how soon can I go back to my routine life?
Your length of stay in the hospital depends on which procedure you underwent. If you had lap choly, then you will be discharged on the next day. You have to rest for a few days to recover and then you can join your work one week after the surgery. If you underwent open cholecystectomy, then you will be discharged from the hospital after 5-7 days. You will be advised to rest for at least a month before you resume working.
12. I have developed diarrhoea after the surgery is it serious and do I need to change my diet after the surgery?
It is not clearly known why some people develop diarrhoea while others do not. Studies suggest that since the bile is poured continuously in the small intestine and has a laxative kind of effect which might cause bloating and diarrhoea. It should resolve in a couple of days, if not then your doctor may prescribe antidiarrheal medicines, but it is not a serious condition. You can resume your normal diet after the surgery as there is no need to change it. Few doctors do suggest that you should take smaller, frequent meals, decrease intake of oily foods and increase in high fibre diet, however you should consult your doctor before changing your diet.