tag:blogger.com,1999:blog-30499448.post5694485095623087087..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: FlushSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger245125tag:blogger.com,1999:blog-30499448.post-38200458533300397842017-09-10T12:26:42.106-07:002017-09-10T12:26:42.106-07:00Ultrasound is, indeed, the best modality for findi...Ultrasound is, indeed, the best modality for finding stones. It doesn't really distinguish those "trying to pass" from others in the gallbladder. Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-3943494381381781552017-09-10T09:02:39.132-07:002017-09-10T09:02:39.132-07:00Thanks for the input.
Not alcohol or medicinal as...Thanks for the input.<br /><br />Not alcohol or medicinal as far as I know. Also not sure why it's intubated but that seems to be the doctor's preference. I do not think I have any medical factors that make that necessary. I guess I'll try to discuss that with him.<br /><br />One final question I think: My research seems to indicate gallstones are best detected with ultrasound. If there were any gallstones lurking in my gallbladder, would the ultrasound most likely detect them or is it mainly geared towards ones that are trying to pass?<br /><br />Thanks again.Bobnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-74850996920569678892017-09-10T07:31:51.946-07:002017-09-10T07:31:51.946-07:00Intuitively, the idea of "exercising" th...Intuitively, the idea of "exercising" the gallbladder makes a little sense: making sure it empties regularly would lower the likelihood of sludge formation. I don't know of studies that address it, however. There are recent studies, however, suggesting low-fat diets aren't as healthy as once thought. (Seems that dietary recommendations change with the weather, doesn't it?) Since I'm no expert in nutrition, I'll leave that decision to you and your docs. Low-fat diets are usually recommended, though, after pancreatitis. As you know, I assume, avoiding alcohol is important, too; and I assume your episode wasn't related to an alcohol binge, and that you're not taking medications associated with pancreatitis.<br /><br />As to the ERCP, I don't like to make specific recommendations or comments on therapies or interventions from so far away. I prefer to provide general information. I'd say though that unless there are specific medical or anatomic reasons, general anesthesia with intubation isn't common.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81338291065174745432017-09-10T07:15:23.628-07:002017-09-10T07:15:23.628-07:00Sid,
Found your page while looking up the efficac...Sid,<br /><br />Found your page while looking up the efficacy of the gallbladder purge. You seem to have confirmed what I suspected. Now let me get to my question(s). Hopefully these weren't all answered because I did scan for a while but didn't read everything.<br /><br />Background: I had a bout of pancreatitis that landed me in the ER. Lipase was up above 20k. The bout lasted a few/couple hours. By the time they had ruled out more serious issues, it had passed. I did have an ultrasound done right after the bout passed which showed no gallstones or other abnormalities. I also had a CT scan done now a couple weeks after the event which also showed no abnormalities. I would assume it was gallbladder related because I have dropped weight relatively fast over the summer (30 lbs at about 2lbs/wk but finished a month prior to the episode). I also generally eat a low fat diet. However, my doctors didn't see any liver enzyme elevation they would expect with gallstones. I've been on various bland/low fat diets since the event 2 weeks ago. I've felt mostly fine but my stomach is off digestively (milk is giving me severe gas).<br /><br />Now my first question is: Does one need to keep "exercising" the gallbladder to prevent gallstones? My diet typically is 30 grams fat or less I'd guess (since the bout it's been lower I'm sure because I haven't been eating normally). Should I be shooting for more fat, and does it matter what type? I guess I'm worried that if this was gallstones or sludge, that by sitting on this low fat/bland diet I'm going to cause another episode.<br /><br />Second: my doctor wants to do an ERCP test to further investigate. I'm a bit hesitant to be sedated unnecessarily (it would include intubation). Opinions on the necessity of this test?<br /><br />Thanks.Bobnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-47746803265237099782017-05-03T10:29:01.735-07:002017-05-03T10:29:01.735-07:00I don't know.I don't know.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81405143079043521812017-05-03T10:20:26.099-07:002017-05-03T10:20:26.099-07:00Thank you for your reply. The minimally invasive c...Thank you for your reply. The minimally invasive cholecystolithotomy procedure using a laproscope and cholecystoscope has become a routine gallbladder (GB) preserving procedure in China in recent years. An incision is made in the fundus of the gallbladder and a soft or rigid cholecystoscope introduced into the GB cavity and the gallstones removed using stone baskets and suction. The incision in the fundus is the sutured. The operating time is comparable to laproscopic cholecystectomy. Stone recurrence rate has been shown to be significantly decreased (4% over 6 years) with this procedure but is dependent on lifestyle and diet following tx. <br />Although I presently have an asymptomatic gallstone discovered during CT scan a year ago, I am concerned about cancer risk the longer I keep the stone and desire to retain my gallbladder as it does play an important function in regulating bile release etc.<br />My question is why to the best of my knowledge is the procedure only available in China (Yang Zhang et al)when outcomes have been demonstrated to be superior to removal of gallbladder in benign cases?<br />alfredonoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-14965951018171480002017-05-03T07:30:39.104-07:002017-05-03T07:30:39.104-07:00As you've no doubt learned, alfredo, a 2.5 cm ...As you've no doubt learned, alfredo, a 2.5 cm calcified stone won't dissolve medically. And, as I've written, people who form stones tend to keep forming them as long as they have a gallbladder, even if the original stones were made to go away. I'm not sure what you mean by "percutaneous laparoscopic-endoscopic cholecystolithotomy." I haven't heard that combination of terms, since they sort of preclude each other. <br /><br />To remove a one-inch stone would require either a sizeable hole in the gb, or the breaking up of the stone by lithotripsy. The latter leaves fragments inevitably which might or might not pass and might or might not cause complications if they do. Lithotripsy fell out of favor not long after it began, because of complications and low long-term success. <br /><br />The good news is that stone as large as yours is virtually impossible to pass out of the gb to cause serious complications such as cholangitis or pancreatitis. Assuming there aren't any smaller ones hiding in the shadows. So if you're set on retaining the gallbladder your future complications are likely to be limited to episodes of colic and the possibility of cholecystitis. And, as you may have learned, the long-term risk of gallbladder cancer which pretty much only occurs in people who've had gallstones for many years. While relatively rare, it's an aggressive one.<br /><br />The bottom line, as I told my patients, the main reason to remove the gallbladder is to relieve symptoms. Preventing future complications is an issue, but a crystal ball sort of thing. So if you're having symptoms and they're tolerable enough that you prefer to live with them and you're okay with possible future risks of unknown likelihood, it's not an unreasonable choice. But there really isn't any viable "between" option.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-56461936881187644082017-05-02T22:30:30.688-07:002017-05-02T22:30:30.688-07:00I learnt I have a calcified 2.5cm gallstone in the...I learnt I have a calcified 2.5cm gallstone in the gallbladder from a CT scan. Given the gallbladder does play an important role I too have searched for options to be able to remove the gallstone but retain my gallbladder. Why isn't the percutaneous endoscopic-laproscopic cholecystolithotomy procedure available as an option for those who wish to retain their gallbladder?<br />I would appreciate your advice.alfredonoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-85664274335463719562016-12-20T09:11:55.422-08:002016-12-20T09:11:55.422-08:00Thanks for taking the time to follow-up, Mark. Gla...Thanks for taking the time to follow-up, Mark. Glad (and unsurprised) it worked out well.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-50989923882046895542016-12-20T09:03:18.366-08:002016-12-20T09:03:18.366-08:00Hello again Dr. Schwab,
Mark R. here. Well, I ha...Hello again Dr. Schwab,<br /><br />Mark R. here. Well, I had my gall bladder surgery a little over one month ago. The surgery was done laparascopically, so I only have four little scars that have been healing up very well.<br /><br />I am feeling great and have not had any problems since having my gall bladder removed. In fact, I am greatly relieved to not have to deal with the little bugger anymore.<br /><br />I just wanted to come back here to thank you very much for your blog and responses to my questions. Thank you! You truly helped me to finally decide to do what I should have done over 20 years ago, get that darned thing out of me!<br /><br />Let me say to anyone else who is struggling with their decision about gall bladder surgery that I wish I had done it many years ago. I put myself through much needless suffering and wasted a lot of time, money, and energy pursuing alternative treatments (oil/lemon juice flushing-many times, acupuncture and herbs, controlling my diet, etc.) None of this worked at all! I had many terribly painful attacks over many years, but I was stubborn and wanted to believe I could find another path. I was very wrong in that belief.<br /><br />My surgery went very well. I experienced very little pain. In fact, I only took one dose of the painkiller prescribed. I even returned back to work six days after my surgery (desk job). And now knowing that I will never have to worry about this again is very, very satisfying. That's my testimony. Good luck with your decisions out there.<br /><br />Again, thank you very, very much Dr. Schwab! Enjoy your holidays and happy New Year! Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-52919017816013858102016-09-05T11:41:00.909-07:002016-09-05T11:41:00.909-07:00Dr. Schwab,
Yes, I'm going to have the gallbl...Dr. Schwab,<br /><br />Yes, I'm going to have the gallbladder removed on Nov 21st. I'll be glad to be done with it after all of these years.<br /><br />Thanks again for the valuable information you provide here, and thanks for your responses to my questions. You make a difficult decision easier to process.<br /><br />Sincerely,<br /><br />Mark R.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-17134720913208755652016-09-03T09:12:42.689-07:002016-09-03T09:12:42.689-07:00If I had symptomatic gallstones I'd have my ga...If I had symptomatic gallstones I'd have my gallbladder removed.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-90166605190311688972016-09-03T09:06:41.267-07:002016-09-03T09:06:41.267-07:00Hi Doctor Schwab, and thank your for your response...Hi Doctor Schwab, and thank your for your response.<br /><br />I do understand why you can't give specific advice here, and I really do appreciate how you try to give all of the facts and options that are available.<br /><br />As I said before, I have not had any symptoms from my GB in over two years, so I hate to have the surgery if I'm not really in need of it. However, I had many, many attacks over many years and my GB is still very full of stones, some of which are very large. And I suppose I will just keep making stones as time goes by, so there is probably a good chance of future attacks.<br /><br />I will still go ahead and have my GB removed as a preventative measure. I really don't want to ever have to go through that excruciating pain again. However, no one wants to undergo surgery, ever. Understanding that you can't give me specific advice, can you tell me if you would get the surgery if you were in my situation? Or am I trying to cheat here? :-)<br /><br />In any case, thank you for the wealth of information you have provided here.<br /><br />God bless,<br /><br />MarkAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-90882567041151746342016-08-31T17:48:07.303-07:002016-08-31T17:48:07.303-07:00I really can't (well, I could, but I choose no...I really can't (well, I could, but I choose not to) make specific recommendations to individuals in this venue. All I can say is that in my practice if people had stones and had had symptoms, I recommended surgery. I also said no one can predict what'd happen with or without it. And unless the person had complicating factors like diabetes or immune system disease, either of which could make a gallbladder infection more dangerous, I generally didn't try to talk them into it. The main reason is to relieve symptoms, and the secondary reason (how far down the list is a subjective thing) is to prevent future problems. <br /><br />So, as a general approach I'd say that a person who has stones and who's had symptoms is making an easily supportable decision to have surgery.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81361493233467676392016-08-31T16:17:30.192-07:002016-08-31T16:17:30.192-07:00Hello Doctor,
Mark R. here. I first commented he...Hello Doctor,<br /><br />Mark R. here. I first commented here in June 2015.<br /><br />Well, I decided to not do any more flushes and chose to go a different path. I've spent the past year getting acupuncture and taking Chinese herbal medicine. Those seemed to help my psoriasis condition somewhat but did not help my gallstones at all. I just had another ultrasound and my GB is still packed full. To be fair I must admit that I wasn't at all consistent in following the Chinese Doctor's dietary advice, so I don't want to judge the efficacy of his treatment on my experience alone.<br /><br />So, I decided to go for surgery. I'm scheduled for November 21st, 2016, unless a cancellation can get me in sooner.<br /><br />I haven't had any symptoms for almost two years. My GB looks ok with just a little bit of wall thickening. Prior to these past two years I had many attacks over a 20 year period. Several of those attacks drove me to the ER seeking relief from the pain. I know that no one can predict if I will ever have another attack or not. I just don't really recall a time where I would go so long without any discomfort or symptoms of my GB acting up.<br /><br />I think getting the surgery now is a good idea to avoid the possibility of needing the surgery in an emergency situation sometime down the road. I'm 54 now and in good health. I wouldn't want to go through this when I'm much older and perhaps less healthy. Do you feel I'm making the right choice now, or does the lack of symptoms for two years and the good condition of my GB in the ultrasound test suggest that I should not have surgery at this time. Perhaps, just wait and see if my GB acts up in the future?<br /><br />Thank you,<br /><br />Mark R.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-32674727799888774212016-04-09T16:55:02.080-07:002016-04-09T16:55:02.080-07:00I cannot thank you enough for your thoughtful resp...I cannot thank you enough for your thoughtful response. It is so appreciated as I try to navigate this new world of information. I have seen some horrifying things on SOD - and the fact that it's more likely to affect women - that still give me pause, but your words have been incredibly helpful and reassuring. So thank you so much for taking the time to respond, and thank you for all that you do here. Erinnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-26214309039863801032016-04-08T12:23:48.052-07:002016-04-08T12:23:48.052-07:00Well, Erin, I have to agree with your surgeon. Whe...Well, Erin, I have to agree with your surgeon. Whereas there are situations, as you've read here, where it's unclear if the gallbladder is the culprit, in your case you've described both biliary colic (pain episodes without evidence of inflammation) and cholecystitis, where the gallbladder is inflamed. The former, if that's all there was, is only a matter of choosing to live with episodes or not; the latter is potentially more serious. In your case, having stones, story, and evidence of inflammation, unless you have other medical issues that make surgery risky, I doubt you'd find any surgeon who'd suggest otherwise. (Disclaimer: I base my comment on what you've written, and without access to all the relevant info, of course.)<br /><br /><br />No one has a crystal ball; we base recommendations, to a large extent, on what's known about large groups of people. You're in a category where it's highly likely to be a recurring thing, and where more serious complications might occur. Maybe you've already had all the trouble you're gonna have; maybe next week something dangerous could happen. There's no way to tell, individually.<br /><br />I think "post-cholecystectomy syndrome" is a very capacious and mixed bag; ie, it includes people who didn't need the surgery because their symptoms were due to something else, and it includes a lot of vague issues that might or might not be due to the absense of the gallbladder. As I've written, the vast majority of people who have the surgery for the right reasons (which, based on your information, would appear to include you) are happy to be rid of the symptoms and note no adverse after-effects. I won't rewrite here my take on why that is, but you can find it in my several posts on the gallbladder.<br /><br />It's true that some people have diarrhea after the operation. The number, in my experience, is small. I've taken out a couple thousand gallbladders and have had only a couple of people with diarrhea that wasn't easily controlled. By far the most never had it at all; or if they did, it went away within a short time after surgery. As you probably surmise, people post their horror stories online. People who sailed through, ie nearly all of them, have no reason to.<br /><br />Good luck with your decision. If I had that crystal ball, I'd tell you exactly what you want to know. But I'm pretty sure I know anyway.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-79319454965524009922016-04-08T11:29:55.632-07:002016-04-08T11:29:55.632-07:00Not sure if you still check comments, but in the h...Not sure if you still check comments, but in the hopes that you do: Your blog has been extremely helpful as I try to make my surgery decision, so thank you so much for that.<br /><br />Question: Regarding Post Cholecystectomy Syndrome, what is your theory for its occurrence? Do you think the gallbladder was never the real issue, or do you think it was and these people are just unlucky enough to not live well without one?<br /><br />I'm a 43-year-old woman, and I've known I have gallstones for at least 15 years. I thought they never gave me trouble, but am now wondering if the occasional gnawing, clenching pain I felt in my upper abdomen, right in the center below where my ribs meet, was actually my gallbladder acting up when I was eating poorly. I assumed it was an ulcer or heartburn. At least one doctor told me years ago it was my gallbladder, but since I could eat a pretty high-fat diet with very little problems, and my pain was never directly on my right side, I ignored it. <br /><br />I had my first classic attack last Thanksgiving (before I ate), ending up in the ER thinking it was a heart attack. The pain was unbearable but only lasted between 30 and 40 minutes. But I was able to go home and eat Thanksgiving dinner with no problems. My second attack was about two weeks ago, on an empty stomach, and consisted of severe stabbing pains throughout my abdomen and back. The pain lasted four days - nothing I took relieved it - and became so bad on the fourth day I went to my doctor. She felt around my abdomen and I yelped when she pressed on my gallbladder, even though the pain seemed mostly on the left side (but certainly there was plenty on the right, and everywhere else). An ultrasound showed a gallbladder "virtually filled" with stones and walls thickened to 7 mm. Blood tests showed slightly elevated white blood cells and liver enzymes. I couldn't eat solid food for nearly a week because of the pain.<br /><br />The surgeon I was referred to said it was a no-brainer to take it out. But, like most other people here, Ive seen far too many negative experiences to take it as cavalierly as many doctors seem to. And I know of at least two people who have had it done and now have to cope with urgent and unexpected diarrhea after eating certain things. As of now the pain is mostly gone, but just enough little cramps and stabs (incredibly minor) remain for my gallbladder to let me know it's still not happy. <br /><br />I know there really aren't any studies on the ability of the gallbladder to heal or to reverse disease. But I'm still in agony over this decision. When I think of scheduling surgery, I break out into a cold sweat and think, but what if?? I already canceled surgery once, but I know I need to make a decision.Erinnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-73455386364503849212015-06-18T22:26:18.871-07:002015-06-18T22:26:18.871-07:00Good thoughts, Doctor. You have given me much to ...Good thoughts, Doctor. You have given me much to consider, and your comments have helped me to feel very reassured that having the operation would have a positive result.<br /><br />I'll think things over a bit and decide how to proceed. At least I am finally resolved to deal with these stones and to do so within the next few months.<br /><br />I'll let you know how things go.<br /><br />Thank you for caring enough to be here for us.<br /><br />Mark R.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-44445821670388455282015-06-18T07:55:12.532-07:002015-06-18T07:55:12.532-07:00I understand your frustrations, Mark. And, of cour...I understand your frustrations, Mark. And, of course, it's impossible to sort through internet information to cull out that which is meaningful and that which isn't. In my experience, those people who had the surgery when symptoms were clearly related to stones, and had documented stones, were uniformly happy with the outcome. Sadly, there are people in whom it's not as clear that the gb is the problem, who've had surgery anyway, with less than great results. And, yes, it's true that some people will have digestive changes after removal. Remember, though, that it's about the most commonly done operation, and the 99% who're satisfied have no reason to be posting complaints. I did well over a thousand cholecystectomies in my career, and can count on one hand those that had issues; and of those, the solutions were simple dietary adjustments.<br /><br />As to your idea of being an experiment of one, I'd love to see the results, although I'm absolutely certain, in terms of the stones, what the result will be. The main risk, as you said, is of having intervening complications from the stones. Who knows if it'd happen? As to risks of the flush itself, I suppose it depends on the exact recipe you follow and for how long. I'd guess if you do one that causes lots of diarrhea, for example, there could be problems from that. I suppose there could be risks from ingesting lots of oils, too, in terms of blood lipid levels and the leeching out of certain vitamins; but I have no direct knowledge nor experience on which to base it.<br /><br />Good luck.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-87070958562798206052015-06-18T00:38:59.107-07:002015-06-18T00:38:59.107-07:00Dr. Schwab,
Thanks for the response to my questio...Dr. Schwab,<br /><br />Thanks for the response to my question about how the bile acid medicine gets to the stones. I sign in as Anonymous because I don't have a Google account, but you can call me Mark R.<br /><br />I saw my GI doctor yesterday and, yes, he referred me to a surgeon. That will have to wait because my insurance is changing from Blue Cross to Kaiser starting July 1st, so I'll have to start over with a new primary care physician.<br /><br />Like I said in my last post, I just had an ultrasound of my abdomen on June 11, 2015. I've got a copy of the report and the images. You can see the stones in my GB. There appears to be several big ones that are about 10mm in size. Hard to imagine how those would be expected to pass through my 2.5mm common bile duct. That's a bit on the small side of average.<br /><br />I think you are right when you say that the stones can't be flushed out, but I find myself tempted to give the castor oil packs and olive oil/lemon juice flushes a thorough test just the same. I think it would be good to have someone (me?) who is willing to provide some "proof" for others to consider.<br /><br />I could do the flushes for a few months and then get another ultrasound through my new insurance provider. That would provide proof as to whether or not the flushes did me any good. Then I could share the results on your blog if you like. <br /><br />Do you see any risk if I do that? I mean other than the risk of delaying surgery. Could there be a risk of the flushes causing me a problem?<br /><br />I don't know if I'm actually willing to do this or not. As I recall, oil packs and oil/juice cocktails aren't a lot of fun. But I am thinking about it.<br /><br />Mark R.<br /><br />P.S. Reading your blog really did strongly sway me toward finally having the surgery. But then I had to go out on the Internet and read a bunch more from the advocates of gallbladder flushing and a bunch of the comments from folks who continue to suffer pains and bad digestion after having the surgery. And I found my self uncertain of my decision once again. That is what we gallbladder patients are faced with and it makes it very difficult to decide what to do.<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-83807736096450821172015-06-16T13:36:55.588-07:002015-06-16T13:36:55.588-07:00Well, you've made me flush with pride that my ...Well, you've made me flush with pride that my blog is helpful. I may not be right in all things, but the bogosity of flushes has been established beyond doubt. Which make it puzzling, at best, that so many still believe in it. Those bits of curdled oil are pretty convincing, I guess. <br /><br />As to how such meds as ursadiol work, this says it better than I could: <br /><br /><i>DRUG CLASS AND MECHANISM: Ursodiol is a naturally-occurring bile acid that is made by the liver in humans and is secreted in small quantities into bile. It is used to dissolve and prevent cholesterol gallstones and to treat primary biliary cirrhosis, a disease of the liver. Ursodiol blocks the enzyme in the liver that produces cholesterol and thereby decreases production of cholesterol by the liver and the amount of cholesterol in bile. It also reduces the absorption of cholesterol from the intestine. By decreasing the concentration of cholesterol in bile, ursodiol prevents the formation and promotes the dissolution of cholesterol-containing gallstones.(http://www.medicinenet.com/ursodiol/article.htm)</i><br /><br />Like most other meds, it gets absorbed from the gut into the bloodstream. From there, as with all thing absorbed from there, it goes to the liver.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-80878959528322237012015-06-16T11:56:20.080-07:002015-06-16T11:56:20.080-07:00Thank you, Doctor, for your blog. I just read thro...Thank you, Doctor, for your blog. I just read through all of the comments in this thread and I will be reading your complete info on gallstones next.<br /><br />I've had many very painful episodes with my gallstones over many years. I tried a few flushes when first diagnosed 20 years ago. I tried eating better but find I yo-yo back and forth from eating very well to very poor. Over the years I went to the ER several times due to the pain and was always advised to pursue gallbladder removal. But then I would go to the Internet and read all of the stuff that says I shouldn't do that and that I should do flushes instead. So, I've avoided surgery all of these years. I'm 52 now.<br /><br />I've had two attacks in the past year and a half, one was mild and the other was quite intense but not enough to get me to the ER. The last attack was months ago but I recently decided to see a doctor about by gallstones.<br /><br />I had an ultrasound last week that noted the many stones in my GB. I'll see a GI doctor tomorrow to discuss that result. I'm sure surgery will be recommended again.<br /><br />I was considering trying more flushes and was doing research about this idea when I found your blog, which has gone a long way on convincing me to finally get the darned surgery.<br /><br />I've been struggling with this decision, so I just wanted to thank you, very much, for taking the time to provide this information.<br /><br />I do have one question. If oil, apple juice, etc. can not get to the stones in the gallbladder due to the physiological structure, how do the bile acids medicine get there? Through digestion and bloodstream or ?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-31383914258368629742015-04-18T13:26:33.111-07:002015-04-18T13:26:33.111-07:00Oh, boy, Leo. Gallbladder polyps are yet another g...Oh, boy, Leo. Gallbladder polyps are yet another gray-zone issue in terms of gallbladder management. Do they cause symptoms? Maybe. Sometimes. Or not. Do they represent a risk for other issues, specifically cancer? Maybe. A very low risk most likely. <br /><br />At what point is it reasonable to have surgery for polyps? Some say if they're big enough, ie a centimeter or so, the risk of cancerous change increases. It's not really known for sure. If a person is having classic biliary colic and the only finding is polyps, can they be the cause? Maybe. Sometimes. <br /><br />Can small stones be mistaken for polyps? I've operated on people in the above circumstances an found that in fact there were stones. <br /><br />In your specific case, best to talk it over, I guess, with a surgeon. Meanwhile, here's a link: <br />http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359430/Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-22765578333917310522015-04-18T10:51:53.485-07:002015-04-18T10:51:53.485-07:00Hi Dr. Schwab. A follow-up to my recent post. I ju...Hi Dr. Schwab. A follow-up to my recent post. I just received GB ultrasound results; no stones but there are polyps? I would very much appreciate your experience with that, and opinion on necessity for GB removal. Can polyps cause a GB attack? Thank you so very much.Leohttps://www.blogger.com/profile/08815676457270560039noreply@blogger.com