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Me and my 'useless' gall bladder (bbc.com)
56 points by dnetesn on Oct 14, 2014 | hide | past | favorite | 40 comments



I had to have mine removed last year. Prior to that, I had about 2 years of periodic extreme stomach pain, which felt kind of like the pain you would have after drinking too much strong whiskey. The first time that it got really bad I went to an acute care center, they said it was either ulcer or gastritis. Eventually, after about the 4th trip to the doctor I ended up on the ER due to the extreme pain. They did an ultrasound test, and found gall stones logged in the duct leading to the stomach. Meanwhile I was put on a zero fat diet until the surgery (since fat activates the gall bladder and pushes on the stones in the duct).

Now this is something that gets me upset. Before the surgery, I had to go in for another test, where they observe the gall bladder by injecting iodine. Then after 2 hours the radiologist said there is a second part of the test which activates the gall bladder, so they could observe that. I then asked him what the effects of that would be, since the stones are logged in the duct, and I was on a no-fat diet due to it. So he calls the surgeon, then comes back and says "We are skipping that second test -- if we went through with it, you would have been in so much pain that we would have to hospitalize you". Again, this is an example of needing to know enough about your own condition, and not leave all the details in the hands of the professionals.


I had mine removed two years ago and my experience was similar. The first time it happened, it felt like just an odd kind of hunger—it seemed like my stomach was just telling me to feed it. Then I was fine for about four or five years before it would come back periodically over two years or so, getting worse each time.

The second time I went to the doctor about it, they did some bloodwork and found that I had an elevated white blood cell count. It was two days after the appointment and they called me up (I was still home sick) and told me to get to the ER immediately.

They considered operating that night, but said I'd have a better chance of getting a laparoscopic surgery if I waited for the infection to subside. They injected me with some really good painkillers and eventually sent me on my way.

I was on antibiotics for a few weeks before surgery. As it turned out, the stones were still too big, and the whole thing was still a mess, so my surgeon just had to just cut me open. He later told me it was one of the worst gallbladders he'd ever seen. Instead of one night in the hospital, it was five days, and then another few weeks of recovery at home.

Overall it was pretty rough but I haven't found that it has affected my ability to digest fat much, if at all.


I had gallstones a few years ago. They are intensely painful. At first I chalked it up to bad food. The second time, I thought I must have an ulcer. The third time I realized it was my gallbladder. I went to an excellent specialist who confirmed to me what it was.

The internist tells me he'll simply remove it. "You don't need your gallbladder anyway." I beg to differ. He wants to provide a sure result, first time, every time. I have a different goal: I want to do the least harm, least intrusion possible. I was perfectly fine with suffering a bit longer to achieve my goal. I postponed my appointment to proceed with the surgery and started by trying a "gallbladder cleansing." This is far from 100% reliable, but for me it worked.

If it hadn't, I would have proceeded to the next mildest approach. Surgery is my last resort. For my doctor, it was his first. I'm in this for the long haul; it's my body and I have a responsibility to learn and understand it, to take proper care of it.


I am not against your "least intrusion" concept. BUT, in this case, please follow your Doctor's advice & research rather than simply trusting your instinct. There's some correlation between gall bladder stones & cancer. It's safer to have it removed.

http://www.cancer.org/cancer/gallbladdercancer/detailedguide...

http://umm.edu/health/medical/reports/articles/gallstones-an...


Yeah, cutting out parts of your body is always the best first course of action.


Sure, the gluten-free, organic approach is to drink a lot of lemon juice and keep your gall bladder. But medical science has established that it is an almost completely useless organ, and that it may harm you in some cases. So aside from the risks inherent for any kind of surgery, it is a perfectly reasonable course of action once that organ starts causing problems.


I think the article and all the comments about how "medical science has proven that the gall bladder is nearly useless" are dangerous nonsense. I'm not claiming you should not remove a gallbladder when necessary, just that it is not useless.

I also had my gallbladder out, which left me unable to eat a meal without suffering extreme diarrhea about 20 minutes later. I found a good gastroenterologist and described my symptoms, and he recognized them immediately. Surprisingly common, he said. He said that the gallbladder served as a reservoir of bile acids produced by the liver, holding them in reserve until needed to help digest fats. A "bladder" for "gall". Unfortunately, bile acids can be irritating to the intestines, so if the gall bladder isn't available to catch it, it will drip into the intestines when there is no fat for it to work on, causing a chronic bowel irritation in many people that can result in diarrhea.

After many gallbladder surgeries, the tubes carrying the bile from the liver to the GI tract will stretch a bit and recreate a bit of the reservoir function of the "nearly useless" gallbladder, but this doesn't happen in everyone. I was not so lucky.

Without hesitation, he prescribed Cholestyramine powder (I get a generic version), which is a "bile acid sequestrant", which is a resin that encapsulates bile in the intestines. It changed my life in one dose. Problem instantly vanished. I was once again able to both leave the house AND eat on the same day. Just one problem: it was not a cure. It just sequestered some of the bile acid that my missing gallbladder used to sequester. If I missed even a single day, the diarrhea would return with a vengeance the following day unless I fasted all day.

Like many other people, I'm lucky to have this $150/month medicine, which gave me my life back, but I'll have to take it every day for the rest of my life, never missing a day, because I need it to compensate for the lost gallbladder--you know, the one that medical science has proven to be nearly useless.


I'm sorry to hear about the outcome. Did your Doctor mention what percentage of people share the same problem as you? If the percentage is small, isn't that the case with most medical procedures & medicines i.e. risk of side effects ? My understanding is that gall bladder removal has been perfected over a long time span and it's considered safe far a very high percentage of patients.


The surgeon made a comment about roughly 3% of people having side effects, but I'll have to say that I'm skeptical. The way he said it made me think he was just repeating a line he'd heard years ago and never questioned. Certainly, he never knew how I ended up and made no effort to find out. His interest was in the surgery itself, not the eventual consequences of the lack of a gall bladder.

The gastroenterologist, on the other hand, seemed to imply that problems were a lot more common than 3%, but I was too busy telling him about my problems to even ask about statistics.

And then, after surgery, far more than 3% of others I've spoken to have had various problems, BUT it's still clearly a minority.

So, in all of these three "data sources" of mine, I'm guessing about tone of voice, getting an impression, and so on--not very reliable statistically, I'm afraid, but I'm trying to be both honest and somewhat detailed here in case it proves useful to someone.

I think your understanding is correct that 1) the removal (meaning process of extraction) has been essentially perfected, and 2) that it is considered safe for a (very?) high percentage of patients. It also seems to me that if you are going through the agony of gallstones, you'd do better to live without a gallbladder than to live with gallstones.

What I object to is the BBC putting an article out there that basically claims that science has proven that the gallbladder has no useful function and that the only risk in removing it is the risk of the actual cutting itself. Nonsense. Just being a "bladder for gall" was making it possible for me to work outside the home, go on business trips, vacations, etc.--a very useful function whose loss I have to compensate for with daily medication.


I appreciate you telling your story, and apologize for insinuating that it was a useless organ rather than an organ that you can live fine without in most cases.


Yeah, that statement I agree with. And no apology necessary (but +1 to you for it anyway), because it wasn't an issue of etiquette but of factual correctness. And not just "someone is wrong on the Internet." This one matters, because if someone with a somewhat gravelly gall bladder but no history of gallstones (picked up by ultrasound while looking at something else) decides to go ahead and have it removed based on the assumption that it literally does nothing except put you at risk of gallstones and can be removed with no risk other than the very minor cutting, he might end up like me, and I'm hoping to prevent a few cases of that. I'm also hoping to put something out there for people who end up like me to find via Google, so they can try Cholestyramine. Apparently it doesn't help some people, but it was miraculous for me.


I've had nothing but problems digesting food reliably since my gallbladder was removed. I have to eat lots of ginger and turmeric if I want to eat anything with fat in it.

Seems mine served the purpose of storing bile and regulating bile flow. I miss it. Perhaps yours is useless, and I'm an edge case.


"useless organ" - yet revolution did not remove it. Did modern science finally decide whether caffeine or fat are ultimately good/bad? Because they seem to be changing their opinion every year.


Usually the best course of action is what your medical professional recommends. If it is a major decision, such as a risky and major surgery, they will often advise that you seek a second opinion.

That said, gall bladder removal is considered routine these days. The organ is unnecessary (much like the appendix) and in the event of trouble it's far safer to remove it than try to keep it and risk more serious complications down the line.


I had a similar experience recently.

I recently had an ingrown toenail. The last time I had one (in high school) I let it get so bad that after gym class my white sock would be entirely red with blood. I had to go to a pediatrist who ended up using some kind of special scissors to cut a large chunk of my toenail off to fix it and wrapped it up for a while.

Presuming I would have to go through this again, and would need a referral, I went to my local physician. Not surprisingly, said it was indeed an ingrown toenail. But, surprisingly, her first suggestion was to prescribe me some antibiotics!

That was the first time in my life I had wondered about the suggested treatment, and I actually asked her "how would that help?" And I can't remember her answer, but it seemed really dumb, so I just said "no thanks" and asked what the alternatives were, and she said "to just let it grow out" after which I would be all fine.

Now, recalling this story, I remember someone telling me about "BRAIN" or something like it, an acronym that includes "risk" and "alternatives" and "intrusive" and something else.


I had the opposite experience. I went with an ingrown toenail to a urgent care, and was prescribed antibiotics that did nothing.

I finally went to a pediatrist who explained that people have ingrown toenails often, but it's typically not an issue. The only time you notice you have an ingrown toenail is when it becomes infected. He said that sometimes the antibiotics cure the infection, but it leaves the ingrown toenail intact to become infected again at a later date. He also said that it's hard to predict what type of bacteria will infect the toenail so it's hard to treat it properly and the antibiotic is a shot in the dark.

What he did was cut the ingrown toenail out with his special scissors and told me that if that toenail became ingrown again he'd do something called a "partial nail matrixectomy" My toenail became ingrown again about a year later and he did the matrixectomy. What happens is the toenail grows from a "matrix" at the bed of the nail, and they burn a tiny section of it with an acid and it scars. This prevents a few millimeters of the nail from growing, preventing it from ever becoming ingrown again. The toenail functions perfectly normally and looks normal after about a year.


I recently had mine taken out. I had a hard look at the nonsurgical alternatives, and what studies I found convinced me that they are essentially quackery. Given that one of the largest causes of emergency room visits (and emergency surgeries) are related to gall stones, and the given the possible cancer and infection risks, I couldn't come up with a rational reason to not have the surgery.

Very glad I did, incidentally. It was an easy laparoscopic procedure, and it's had nothing but a positive effect on my life.


Problem, in the case of the gall bladder, is that some organs basically don't heal. I put up up with the pain (an agonizing few hours, but afterwards felt just fine), which after repeated instances eventually led to an infection and the observation that even if that were resolved the damage had been done with no reversal expected. While I was quite attached to may gall bladder, surgery happened and I've not missed it.

Sometimes doctors do something precisely because they know the "milder approaches", know they don't really work, and want to get to a reliable & acceptable solution before other damage occurs requiring more severe treatment.

The "cleansing" approach, which (without further description from you) I presume amounts to "consume lots of fats and lie down until your body pushes the stone out" may work, and may also result in severe damage requiring more urgent & worse treatment than simple removal of an organ that's nice to have but far from necessary for survival. Remember, some organs don't really heal, and some treatments have pretty severe risks.

(BTW: I say all that having been in the 2% of GB removals that don't go well. On blood thinners, the incisions didn't close properly inside for some time. They didn't let me eat for two weeks.)

Surgery may be the last resort, but sometimes you should accept the expert view that other methods will, most likely, get you to that point - and with more damage to contend with. Remember: Steve Jobs famously followed your "surgery is my last resort" notion - with bad results.


> and started by trying a "gallbladder cleansing."

Can you elaborate on what this is?


Sure sounds like steve jobs. Look what happened to him.


My sister had acute pancreatitis that her doctor said was caused by her gallstones. She'd been ignoring them for several years and had gotten used to the pain. When she started to get feverish, though, she went to the hospital. The doctor told her that she was at reasonable risk for sepsis if she'd let it go too far.


This happens all the time with spine/back and discs. I was told I had to absolutely have surgery.

I didn't; I'm doing 95% better. I'm happy I didn't get a microdiscectomy


What did you do instead?


Not the one you asked, I did PT for my lower back and neck injuries. Along with losing weight and following the doctor's orders (don't lift heavy stuff for a while, improve posture, etc.) I've recovered (mostly) from both injuries. Still some things I can't do or that I have to be more careful about than if I hadn't been injured, but nothing severely limiting (mostly it's just good practices anyways: be careful how much I lift, be careful how I move when lifting, watch my weight, exercise to strengthen supporting muscles and improve range of motion).


In a nutshell?

- Injections - Prednisone Course - STRICT Paleo (low inflammation diet) - Supplementation: Cissus, Vitamin C, Tumeric, Ginger - Lost 20lbs (muscle, I was not overweight) - FOUNDATION TRAINING - Google It - Movement & Mobility Physical Therapy (not traditional PT) - Posture correction - Standing Desk - Upright posture sitting in car - Minimized sitting - Strength program (Crossfit)

6mm L5-S1 sequestered herniation and L4-L5 bulge. Strong sciatica pain, calf and glute atrophy.

Total time: 1 year.


People blame gall stones on a fatty diet, but I think that is mistaken causality. It is certainly true that gall stone attacks often accompany fatty foods, but that's to be expected: the gall bladder's purpose is to pump out bile to help digest fatty acids.

My anecdotal surveys of people with gall problems has led me to believe it is often a low fat diet that causes the stones, perhaps because the gall bladder is not being used enough to fully "clean" itself out between meals. This may be made worse by a lack of vitamin K2 causing poor calcium handling within the body (which, itself, is a fat soluble vitamin). These conditions cause impurities to build into gall stones and, when a fatty meal is eaten, the gall bladder tries to secrete bile and pushes the stone(s) into a biliary duct.

Many people have been told they cannot eat fatty foods after their gall bladder is removed. For most, this isn't true, but it does take effort to rebuild one's ability to eat fat (you need to slowly work up to it), and some people are required to supplement with bear bile. Given a reduction in fat almost necessarily implies an increase in carbohydrates, and an increase in carbohydrate is strong associated with increased insulin resistance and the negative health outcomes associated with that, it's a worthwhile effort.

I have misgivings about any supposedly "useless" organs. We know a lot about how the body works, but we certainly don't know everything. That a person can live without an organ does not mean they are living an optimal life without it.


More than anecdotal: http://www.ncbi.nlm.nih.gov/pubmed/24321208

Another anecdote: of the people close to me, one has had gallstones and gallbladder removal; they are also the one who'd done the most low-fat dieting over the years.


As someone who had their gallbladder out with complications afterwards, I feel like this article isn't realistic to the after effects. It's great the author did not have any, but before they recommend people go have it removed they should know that someone might be tied down to taking medicine daily for the rest of their life in the not-so-rare situation that their body disagrees with not having a gallbladder.


When I was 17, 8 years ago, I was diagnosed with gall stones. Before that, I remember eating something before going to sleep, it was around 2AM (bad eating habits, I know) and as soon as I finished my sandwich an acute pain hit my chest. I was 100% sure I was having some kind of heart attack and I rushed into my parents' room asking for help. I had to lay down on my bed with my mom panicking while my father called an ambulance, by the time they arrived the pain had completely stopped. I was given a quick check but nothing serious so they just went away. Then the following night it happened again (curse you, bad eating habits) and I got rushed into ER. They found a lot of gall stones and one of them was blocking some ducts, I think with pancreas but I don't remember. Due to an atrociously slow and bureaucratic process, I had to stay in the hospital for a whole month before surgery, because my delicate situation wouldn't let me eat even the lightest of foods, not even soup.

Eventually I got surgery and said bye to my gall bladder. It's certainly an experience I wouldn't recommend to anyone. It's fairly low risk and very common, however the pain and feeling of something holding your chest was atrocious.


In recent weeks I've been laid out a few times with gastrointestinal pain for 8+ hours after eating, and fat is maybe a correlation (pizza, chorizo in a meal, potatoes with butter). Then again, donuts seemingly haven't bothered me and I also got sick after a roast beef sandwich. Unfortunately I live in the middle of nowhere and my GP's only idea after everything he knew to try was negative has been to refer me to a gastroenterologist in a major city, with even the "emergency" appointment weeks away. After reading the story and comments, think I'll double down on avoiding fat and see if my GP can do anything about checking my gallbladder.


My diagnosis was either ulcers or gallstones. I didn't fit the typical age or gender for gallstones, but they checked anyways. The diagnosis was confirmed with an ultrasound. Even in the middle of nowhere there's likely a clinic that can examine your gallbladder via ultrasound if they have someone that knows what they're looking for, otherwise perhaps it could be sent off to a hospital or doctor in a nearby city without requiring you to travel.


Anecdote: two people close to me have undergone cholecystectomy, and both developed IBS-D shortly following the operation; cholestyramine (essentially a powdered resin that absorbs bile in the the GI tract) proved to be a safe treatment.

It seems that removing the gallbladder didn't make things worse on the whole - the symptoms of biliary obstruction were far worse than diarrhea or the daily requirement to consume orange-flavored plastic dust - but it did reveal an underlying excess of bile production that would irritate whatever it could downstream. I would be interested to know what caused that in the first place, and if it could be treated non-surgically.


Apparently care varies greatly by country. In Wisconsin about three months ago my mother in law was jerked around for about two weeks in the hospital before they would take it out. Multiple MRIs and endless apparently pointless tests. In her opinion they were making too much money off her, to be interested in curing her permanently by just taking it out. She's fine now.


I have my gall bladder removed half year ago. Feel very good now. I am glad to see this post. I don't think "gallbladder cleansing" is a good idea. One of reason is that the gall bladder keeps making stone, and the little stone in the gall bladder might drop into the bile duct, which cause more serious problem.


My sister had hers out -- while 9 months pregnant no less. There are dietary changes that must be made, as it becomes more difficult to digest fatty foods. So while you can live without one, it is not a useless organ -- much like the appendix.


There was a recent hypothesis that the appendix was a kind of "storage" for beneficial gut bacteria, important in keeping the gut flora ecosystem going. Of course, the whole notion of gut flora as being important for digestion is relatively new, so that turns out to be its main function it's no wonder we used to think it was useless.

I wonder if that kind of misunderstanding applies to the gall bladder as well.


Agreed. I think blanket statements like "medical science has established that it is an almost completely useless organ [1]" need to caveat this with "medical science as it currently stands today".

[1] https://news.ycombinator.com/item?id=8454918


I think we can safely infer that we are not referring to medical science from the future.


I had mine removed about 4 years ago, haven't ever felt healthier than I do now.


Removing 'useless' organs like gall bladder, as a standard practice, would be catastrophic. Civilization is not a given, people can get stranded on uninhabited islands even today. Having these ancient adaptations in these situations can make the difference between life and death.




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