Once an individual has their gallbladder removed, they may have the assumption that they can no longer get gallstones. While getting gallstones after a cholecystectomy (removal of the gallbladder) is rare, it can occur and will require medical treatment. To understand how gallstones can return after gallbladder surgery, it is essential to understand the function of the gallbladder and how gallstones are formed.
Located just under the liver, the gallbladder is connected by the common bile duct to the liver. The liver produces bile, goes into the gallbladder and is then stored in the gallbladder. When we consume food, the gallbladder contracts and releases the bile through the common bile duct which finally travels into the small intestine. Bile is a fluid-like substance that helps our body digest the fats in the foods we consume.
Cholesterol in the bile forms deposits that resemble stones that can range in size from a tiny grain of sand to even golf ball size. These deposits are known as gallstones. While almost everyone has gallstones, only a portion of the population will develop complications from having these deposits. These complications occur when the gallstones block or become lodged in the duct, blocking the flow of bile.
Symptoms can range from minor to severe pain in the upper abdomen, upper back pain, nausea, and/or vomiting. Many times individuals may believe they are experiencing major indigestion and do not seek medical attention until the pain becomes unbearable. If the symptoms become reoccurring and begin to cause severe pain, a patient will usually undergo a cholecystectomy or gallbladder removal. While there are several procedures that can be done to find the formation of stones, I had a simple ultrasound that clearly showed the gallstones including the size.
After surgery, the bile will flow from the liver, through the common bile duct and into the small intestine. Because bile has to be produced for our bodies to work properly, stones can again become a problem. Although these stones will not be found in the gallbladder since the gallbladder has been removed, they can form in the bile ducts. This condition known as choledocholithiasis can cause the stones to travel and cause blockage of the pancreatic duct if left untreated.
ERCP (endoscopic retrograde cholangiopancreatography) is used to locate the stones in the bile ducts and can safely be removed. During this procedure, an endoscope is inserted down the throat and into the stomach until it reaches the small intestine. A light and camera at the end of the endoscope guides the surgeon and a dye is released into the bile duct so that the area becomes more visible. A small basket located on the endoscope will trap the stones and they are safely removed.
Since having a cholecystectomy, I have personally not had any side effects or any long-term problems. However, my doctor did educate me after my surgery about what causes the stones, the risk factors I have and how maintaining a proper diet was essential to prevent any further complications. Avoiding high-fat foods and keeping track of your cholesterol levels is important to preventing deposits formed by bile.
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Approximately five thousand cases of gallbladder cancer are diagnosed each year in the United States. Most of these cases are found incidentally while a person is being examined for potential gallstones. Gallbladder cancer has a very poor prognosis, typically because the symptoms tend to be very vague and nonspecific. In addition the gallbladder is anatomically difficult to access surgically, making surgical interventions problematic. These factors often delay the diagnosis of gallbladder cancer until it is relatively advanced and make treatments more difficult.
Risk Factors
The risk of gallbladder cancer increases with age. Women are two to six times more likely to get gallbladder cancer than men. Gallbladder cancer is found more commonly in caucasians than in the black population.
Approximately 70 to 90% of people who come down with gallbladder cancer will also have a gallstone present. This makes the presence of gallstones one of the most important risk factors for the development of gall bladder cancer. It should be noted however that a vast majority of people with gallstones will never get gallbladder cancer. In fact, the rate of gallbladder cancer in patients with gallstones is only approximately 1 to 3%. The exact relationship between gallstones and gallbladder cancer is uncertain.
Another risk factor for gallbladder cancer is an uncommon condition associated with chronic gallstones known as porcelain gallbladder. Porcelain gallbladder is a condition where the interior wall of the gallbladder becomes calcified and smoothed, looking much like a porcelain surface. This condition is almost exclusively found in people with gallstones. The incidence of gallbladder cancer in patients with a porcelain gallbladder is quite high. Various studies have estimated the incidence to be anywhere from 15 to 50%.
The presence of small polyps within the gallbladder can be a risk factor for gallbladder cancer. These polyps are small outgrowths within the mucosal wall of the gallbladder, and are typically found incidentally when a patient is being evaluated for a different gallbladder issue. Gallbladder polyps can be benign or malignant, and the exact association between them and gallbladder cancer is not well established.
There are two infections which have been associated with increased risk of gallbladder cancer. The first of these is a Salmonella infection. Several studies have shown an increased risk of gallbladder cancer in people with chronic Salmonella infections of the gallbladder. The exact mechanism by which a chronic Salmonella infection can cause the gallbladder cancer is not well understood.
The other infection which has shown an association with gallbladder cancer is Helicobater pylori. H pylori is the same bacteria which is commonly associated with peptic ulcer disease. Once again, the exact association between this infection and gallbladder cancer is not well understood.
Signs and Symptoms
Gallbladder cancer can typically progress for many years without any symptoms. The first symptoms to appear are often nonspecific and can easily be confused with many other conditions. Patients will often complain of pain, lack of appetite, vomiting, and nausea. The symptoms are similar to what is seen with gallstones. As gallbladder cancer advances to later stages, a person will often become chronically tired and lose a significant amount of weight.
Many patients with gall bladder cancer will also become jaundiced. This means that there skin and eyes will become notably yellow.
Methods of Diagnosis
As with many cancers, the sooner gallbladder cancer is detected, the better the outcome can be. Because of the nonspecific nature of most of the symptoms, gallbladder cancer is typically detected by imaging the gallbladder directly.
The most commonly used imaging technique for any condition related to the gallbladder is an ultrasound. These tests are inexpensive, easy to perform, and not uncomfortable for a patient. Unfortunately there are limitations to the effectiveness of an ultrasound. These tests are highly dependent on the skill of the operator, and have a high rate of missing a diagnosis.
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The gallbladder is a three- to four-inch long, pear-shaped organ situated beneath the liver. It stores bile, a digestive fluid produced by the liver, until needed by the digestive system.
Before Having the Gallbladder Removed, Read This
According to the National Institutes of Health, pain from gallstones results in 800,000 hospitalizations and at least 500,000 operations every year. It’s important to acknowledge that the gallbladder performs important roles in digestion. And by removing the gallbladder, digestive health is compromised for the rest of a person’s life, which, in turn, compromises other areas of health as well.
The gallbladder is required in order for the body to efficiently digest dietary fats, including essential fatty acids and vitamin A. Generally, doctors fail to inform patients after a gallbladder removal that they need to take supplements of bile salts every time they eat healthy fats, or else their bodies will not be able to absorb important fats, such as omega-3 fatty acids and other healthy oils. These patients then suffer from EFA deficiency, with symptoms of impaired nervous system function, irritability, learning problems, heart disease, unstable blood sugar levels and many more problems. The gallbladder enables the body to absorb vitamin A, which is needed for vision. Removing the gallbladder may contribute to blindness. Before having a gallbladder removed, a person would be wise to see a naturopathic doctor for other options. There are serious effects of removing this vital organ, and there are probably other options to avoid to doing so.
Bile
Bile is made up of bile salts, electrolytes, bilirubin, cholesterol and other fats. Bile makes the cholesterol, fats and vitamins in fatty foods more soluble for better absorption by the body. Bile salts stimulate the large intestine to secrete water and salts, which help move the intestinal contents out of the body. Bilirubin, a waste product consisting of worn-out red blood cells is excreted in bile, as are the breakdown products of drugs and waste products of the liver. The gallbladder stores bile, and sends up to 90 percent of the water in the bile back into the bloodstream. What remains in the gallbladder is a concentrated solution of bile salts, biliary lipids and sodium.
Gallstones Gallstones are collections of crystals that form in the gallbladder or in the bile ducts. They are more common in women than men. Risk factors include old age, obesity, Western diet and genetic predisposition. An estimated 20 million Americans have gallstones, and one in ten people have gallstones without knowing it, according to Dr. James Balch, author of “Prescription For Nutritional Healing.” In the United States, 20 percent of the people over age 65 have gallstones, but most never experience problems as a result. More than a half million people have their gallbladder removed every year due to gallstones.
Gallstones range from the size of a grain of sand to larger than a pea-sized mass. Seventy-five percent are cholesterol stones and 25 percent are pigment stones (made up of calcium salts.) Bile normally contains large amounts of cholesterol that remains liquid. When bile becomes over-saturated with cholesterol, the cholesterol may become insoluble and precipitate out of the bile, resulting in gallstones. Gallstones in the bile ducts can lead to severe, even life-threatening, infections of the bile ducts, the pancreas or the liver.
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To maintain a healthy body vitamin B12 is essential. Vitamin B12 is also known as Cobalamin. Vitamin B12 is needed for the process of converting carbohydrates, fats and protiens from food into energy.
Vitamin B12 also more importantly helps keep the red blood cells healthy and in so doing helps prevent heart disease. It also keeps the immune system healthy and functioning at it’s maximum level. In addition B12 is used to create a protective covering of all nerve cells in the body.
The most important function of vitamin B12 is to form healthy red blood cells.However, all cells need vitamin B12 to keep them healthy. The white blood cells among others need vitamin B12 to ensure the immune system functions properly. All the nerve cells in the body need vitamin B12 also to form there protective fatty layer.
The fatty layer is essential for all the nerves, but exspecially so for those in the brain. If there is not sufficient B12 in the body to create this protective layer then the brain will not function properly. Suprisingly the amount of vitamin B12 the body needs is relatively small,but needed on a regular basis.
However, B12 on it’s own is not enough because the body cannot absorb it easily. To help the body absorb B12 the stomach produces intrinsic factor, which enables more B12 to be absorbed.B12 is only found in animal food such as liver,fish,eggs and meat, but most people consume more than the recommended daily amount of B12.
Too much B12 is not a problemas the body can only absorb half of the B12 that is consumed. It is worth noting the body can recycle B12 which helps prevent B12 deficiency. However, strict vegetarians or vegans are likely to require a B12 supplement if they do not eat animal products. If the body dont get enoughB12 anaemia is the most common symptom.
That is because there is not enough B12 to make healthy red blood cells. Anaemia can also be caused by the stomach not creating enough intrinsic factor to help absorb B12. The body tends to make les intrinsic factor around the age of 50 and supplemental B12 may be required. Kids are at risk of anaemia if they do not eat enough food that contain B12. Pregnant women need more B12 for the baby to grow an develop properly because it is absorbing B12 during the pregnancy.
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The gallbladder is a small, pear shaped organ, situated just underneath and behind the liver. It aids in food digestion and stores bile. The liver makes bile, which, when secreted from the gallbladder helps break down fat from foods you eat. The most common cause of gallbladder problems is gallstones.
The Role of Bile
Bile is important because it breaks down fat so that your body can use it. Without bile, your body would not be able to absorb necessary nutrients like fat-soluble vitamins, such as vitamins A, D, E, and K. Additionally, essential fatty acids would pass right through your digestive tract, without being absorbed. This causes dry skin, calcium deficiency, and scalp problems.
Bile is also an antioxidant. It helps remove pollutants from your liver. The liver acts as a huge filter in your body. It removes foreign substances that are harmful, such as drugs, alcohol, prescription medication, bacteria, and viruses. The liver sends these foreign substances along their way via bile, into the gallbladder, and eventually out of your body through the large intestine in the form of feces.
Symptoms of Gallstones
Gallstones form when bile does not empty from the gallbladder. This stagnate bile then becomes thick and sludge like, eventually forming into small crystals or stones. These stones then block the bile duct, which causes more bile build up within the gallbladder and ultimately more gallstones.
Common signs and symptoms of gallstones include the following:
* Chronic heartburn
* Constipation
* Pain in the right abdomen
* Pain under the right shoulder
* Clay colored stools
* Nausea and/or vomiting
* Jaundice (yellowing) of the skin or eyes
Although there are many causes of gallstones, including heredity, gender, and family history, certain lifestyle factors and pre-existing conditions may put you at an increased risk for gallbladder problems.
Risk factors include the following:
* Daily diet: regularly eating a diet high in fat and cholesterol and low in dietary fiber increases your risk for gallstones
Age: people over 60 typically secrete more bile than younger folks
* Diabetes: people with diabetes usually have high triglycerides, which increases the risk of gallstones
* Gender: women are twice as likely as men to develop gallstones due to estrogen production
Treatment for gallstones includes the removal of the gallbladder and/or prescription medication. Your gallbladder is not necessary for you to live; therefore, doctors may remove it with no adverse side effects. Prescription medication may help dissolve gallstones; however, since they generally recur after being dissolved, total gallbladder removal is usually the best treatment.
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To my surprise after becoming raw vegan I came across a question an interested friend that threw me for a loop. The question raised was about B12 deficiency. Astonished to be asked the question, I was dumbfounded and couldn’t come up with one good answer.
Like a good health freak that I am, I took to the internet and library to seek answers. Even though I took numerous animal science classes it had never been brought up that humans could have a deficiency with B12 just by not eating meat. For those of you whom are not familiar with Vitamin B12, it is basically what gives the body energy and keeps the brain and nervous system working correctly.
Without the proper B12 supplement levels, a person will feel lethargic, depressed, loss of feeling in fingers, loss of feeling in spine, poor sense of balance, and decreased reflexes. B12 is available through bacterial production only; this is the point my friend brought up since I wasn’t eating meat.
My research found that many people have the wrong opinion about how and where B12 is created and entered into the body. Apparently the human body creates Vitamin B12 by itself. In fact, every human body contains B12 producing bacteria throughout the body. This is good bacteria, so for bacterophobic people do not worry it is safe.
One interesting fact that I found in most of my research materials was where the body creates B12. Apparently microorganisms between the teeth and gums, around the tonsils and around the nasopharyngeal passage actually produce .5 micrograms of B12 per day. Then absorption begins in the stomach and diffused throughout the body.
So, with this in mind along with my raw vegan diet; I should not be worried. Since our bodies naturally produce .5 micrograms per day our bacteria produces enough to supply a daily amount. In fact, a B12 producing bacterium was found to be produced in larger amounts than in meat-eaters. This is mainly because a lot of B12 bacteria are found in water and on the outside of uncooked vegetables.
It is important to mention that raw vegans have higher B12 than vegetarians. A large part of the deficiency is due to vegetarians cooking the essential nutrients out of the vegetables. In fact scientists suggest for meat-eaters and vegetarians to get their B12 levels tested every few years to assure enough B12 is in the body. Raw vegans are usually at no harm of low levels.
Although there are natural supplements that can be purchased from the health food store, there are foods that help out too. Some of these foods are mung beans, bean sprouts, lettuce, peanuts, peas, dulse, kelp, whole wheat and fermented soybeans. Each harvest contains various amounts of B12 however these foods will always contains some amount.
My research lead me to why people have deficiencies. There were many reasons however the most popular causes were: an increase of consuming fat or protein, cooking foods instead of eating raw, drug intake (includes antibiotics, birth control pills, colchicine and illegal drugs), too much Vitamin C intake, low iron, consumption of raw soy products and et cetera.
The answer to my friends question was simply – nope, I have no issues with B12 deficiency however does she since she’s a meat-eater?
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In most cases, gallstones don’t cause symptoms for long periods, if ever. This is especially true if they remain in the gallbladder. It is when they obstruct the ducts that a person experiences pain, which tends to come and go. The pain may be sharp and intermittent, lasting up to several hours. Usually, the pain is in the right upper part of the abdomen, which may be tender. The pain may extend to the right shoulder blade. Nausea and vomiting are common. If infection develops with duct obstruction, fever, chills and jaundice may also occur. A persistent obstruction of the cystic duct causes the gallbladder to become inflamed, while gallstones that obstruct the pancreatic duct cause inflammation of the pancreas. Other symptoms associated with gallbladder disease include constant pain below the breastbone that shoots into the right or left shoulder area and radiates into the back, lasting from 30 minutes to several hours. Dark urine (coffee- or tea-colored), shaking, chills and jaundice are common. Gallbladder attacks are more common in the evening, and sometimes mimic a heart attack.
Often times, people mistake indigestion symptoms as being caused by gallstones. However, symptoms of belching, bloating, feeling of fullness in the abdomen and nausea are just as likely to be caused by peptic ulcer or indigestion as from gallstones. Pain in the upper right abdomen that occurs after eating fatty foods may be gallstones. Abdominal pain, jaundice, chills and fever often indicate gallstones in the bile duct.
Herbal Remedies for the Gallbladder Several herbs are beneficial for gallbladder health. Alfalfa cleanses the liver and supplies vitamins and minerals. The recommended amount is 1,000 mg. twice a day for two days, with a glass of warm water. Turmeric may reduce the risk of problems in people prone to develop gallstones. Dandelion, horsetail, ginger root and catnip may also be beneficial.
Natural Remedies for the Gallbladder *When an attack occurs, drink one tablespoon of apple cider in a glass of apple juice. If pain does not subside quickly, go to the emergency room to rule out heart or gastrointestinal disorders. Apple juice helps soften gallstones.
*For inflammation of the gallbladder, consume only distilled or spring water and eat no solid food for a few days. Then drink fresh pear, beet and apple juice for three days. Then add solid foods: shredded raw beets with two tablespoons extra-virgin olive oil, fresh lemon juice and freshly made applesauce.
*For gallstones, take three tablespoons of olive oil with juice of one lemon before bed and upon arising. Stones are often passed and eliminated in stool with this technique. Grapefruit juice can also be used.
*For acute gallstone pain, try using hot castor oil packs. Heat (but don’t boil) castor oil in a pan. Dip a piece of cheesecloth into oil until saturated. Apply cloth to gallbladder area and cover with a piece of plastic larger than the cloth. Place heating pad over plastic to keep pack warm. Keep in place for one-half to two hours, as needed.
*Eat a diet consisting of 75 percent raw foods that includes applesauce, eggs, yogurt, cottage cheese, broiled fish, fresh apples and beets.
Gallbladder Health Tips
*Avoid sugar, animal fat and meat, saturated fats, dairy products, fried foods, spicy foods, margarine, soft drinks, chocolate and refined carbohydrates.
*Do not overeat. Obesity and gallbladder problems are related.
*Rapid weight changes and yo-yo diets increase the risk of gallstones and need for surgery up to 70 percent.
*Physical activity can reduce gallstone risk by 20 to 40 percent.
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Loss of hearing is a significant concern among the elderly population. As the number of individuals within the elderly population is expected to grow significantly in the next decade, the issues involving hearing loss are becoming a public health concern.
For some elderly adults, the loss of hearing may be associated from many years of lifestyle abuse upon the ears, or may be attributed to disease. For some, however, the loss of hearing may simply be attributed to a vitamin deficiency that has occurred over many years. For elderly adults, the deficiency of vitamin B12 is quite common and may be the underlying factor that results in age-related hearing loss.
As a side effect of vitamin B12 deficiency, many older adults report the initial symptoms of hearing loss to be complications of tinnitus, or ringing in the ears, followed by auditory hallucination development. If you, or someone you love, is experiencing these symptoms, it may be prudent to seek the medical attention of your family practitioner. With proper diagnostic studies, the serum vitamin B12 levels can be tested to determine if a deficiency is the underlying cause for these complications.
Fasting before a vitamin B12 serum test is important as a diet that is high or low in protein may lead to false-positive or false-negative blood tests. Additionally, because most age-related hearing losses are associated with the cochlea complication, damage to myelin may also distort any auditory tests that are done.
Without proper testing and intervention, by supplementing with vitamin B12, many older adults experience a decline in hearing. Because the supplementation of B12 will not restore hearing, the focus upon treatment should be one that involves prevention and early diagnosis. Therefore, as the aging process continues, it is important to maintain healthy levels of vitamin B12 throughout the course of your life.
In addition to healthy vitamin B12 levels, you will also want to mange the health of your ears by keeping them clean, avoiding excessive water exposure and managing any risks for infection. Because inflammation and can damage nerve cells in the ears, infections that lead to inflammation must be well managed.
As with any complication that involves your senses, it is important to seek medical attention early when the complications begin. While tinnitus and auditory hallucinations are common with many ear diseases, your physician may be quick to dismiss the complication as an infection or other age-related ear complication. Insist on testing for serum vitamin B12 levels as this test result may provide the clues into the progressive deterioration in hearing. With proper vitamin B12 supplementation, you can prevent further deterioration in age-related hearing loss.
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Getting a flat stomach can be very challenging for many people, and often there is the urge to give up. A major factor that contributes to people giving up is that they just aren’t eating right or doing the right exercises. So what diet and exercise techniques can really help you get a flat stomach?
Surprisingly, the path to a flat stomach does not lie in crunches or sit-ups. Cardio exercise is actually the best way to achieve a flat stomach. Leg lifts and stomach crunches aren’t going to help you out, but cardio exercises – because they burn so many more calories – definitely will. Cardio exercises actually burn fat from your entire body, instead of just one targeted area. Once you start burning away all the fat on your stomach, your stomach muscles will begin to show.
This is the key to getting a taut, flat stomach! If you can’t start exercising right now, you should at least make some changes to your diet. Then once you’ve gotten your diet down pat, and a cardio routine in place, you can start adding in crunches to further strengthen your core and flatten your stomach.
But which crunch exercises are really going to work? The basic crunch will help tone your upper abs. You perform a basic crunch by lying flat on your back, preferably on an exercise mat. Place your hands to the side of your head and bend your knees at a 90 degree angle. Lift your shoulders from the ground like you’re trying to bring your knees and chest together. Remember not to move your legs at all! This exercise should engage only your stomach muscles. Do this in 3-4 sets of 15-30 reps. And remember to rest a few minutes between each set.
The reverse crunch is the best exercise you can do for your lower abs To execute the reverse crunch correctly you will need to lie on your back on the floor with your hands directly behind your head, with your knees bent and your feet elevated around 5 inches above the ground. You need to slowly bring your knees toward your chest and pick your butt slightly off the ground. Concentrate hard on your stomach muscles as you do this. Again preform this exercise in 3 to 4 sets. As before you should repeat the move 15 to 30 times per set and rest for about 2 or 3 minutes in between.
There are other various exercises out there that can help you get a flat stomach, but these 2 are definitely the best. The main problem people face when trying to get a flat stomach is in proper dieting and executing the exercises for their abs incorrectly. I highly suggest taking these tips in this article serious, and performing these exercises exactly how they are outlined. Do not cheat yourself at the opportunity to get a flat stomach. If the workout calls for 3 to 4 sets don’t only do 1 and then try to make up for it the next day with 5. Consistency and routine is the key to success and achieving a flatter stomach. Good luck and get exercising!
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The challenge of achieving a flat stomach causes many to give up. Most people that try to get a flat stomach fail due to improper dieting and wrong exercise techniques. So what diet and exercise techniques can really help you get a flat stomach?
Crunches and sit ups sure aren’t the answer to getting a flat stomach. Cardio exercise is actually the best way to achieve a flat stomach. This is because cardio exercise burns far more calories than exercises such as crunches and leg lifts which focus primarily on the stomach. When performing cardio exercises, you will burn fat all over your entire body. The fat will burn off your stomach allowing for your stomach muscles to show through.
You can only succeed by taking the first step! If you’re not ready to begin a new workout routine you can begin by changing your eating habits and lose some fat this way. Once you have done cardio for a while, you need to do crunch exercises in order to get a flat stomach.
But which crunch exercises are really going to work? For your upper abs, your best bet is the basic crunch. To perform this exercise you are going to lie on your back on an exercise mat. Place your hands to the side of your head and bend your knees at a 90 degree angle. You will leave your shoulders off the ground as if you were attempting to touch your knees with your chest. Remember not to move your legs at. All! The point here is to lift you using your stomach muscles. Do This for 3 or 4 sets, 15 to 30 Times A set. Also remember to take a few minutes rest between each set.
The reverse crunch is the best exercise you can do for your lower abs the reverse crunch requires you to lie on your back with your hands directly behind your head, knees bent, and feet roughly 5 inches from the ground. Slowly bring your knees to your chest, lifting your behind off the ground a bit. Concentrate hard on tightening your stomach muscles. Perform do this exercise in sets of 3-4. As before you should repeat the move 15 to 30 times per set and rest for about 2 or 3 minutes in between.
These are the two best exercises that can help you define and flatten your stomach, in spite of the hype the multitude of other exercises might get. The main problem people face when trying to get a flat stomach is in proper dieting and executing the exercises for their abs incorrectly. Seriously consider the pointers in this article and perform these workouts exactly as described. This is your chance to get a flat stomach you don’t want to cheat yourself. If the exercise calls for sets of 3-4, that doesn’t mean you should just do 1 and than maybe 5 the next day to make up for it. You need to consistently perform the exercises outlined in this article for you to be truly successful in getting a flatter stomach. With a little hard work and luck, you’ll be on your way to a flat stomach today!
This article has been written by the author, Eric James. Should you require any moreStomachplease visit his Flat Stomach resources!
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