Gall Bladder Stone Treatment in Chandigarh Mohali

facts-about-gall-bladder-surgery

Gall bladder diseases are very common these days. These diseases range from innocuous gall stones to cancer of the gall bladder which has a very dismal prognosis. As a GASTROINTESTINAL SURGEON with HEPATOBILIARY experience we daily see cases from one extreme to another. The majority are simple gall stones and are managed at the periphery, however, what we receive are ones that are either left to be referred to as higher-level or are complicated ones. Many a times we also deal with cases that are operated elsewhere and become complicated and are then referred to us.

So today in this blog I would like to discuss gall bladder diseases with a special focus on stone diseases. The most commonly asked questions in the patient’s mind are

How are stones formed?

Bile is juice produced by the liver and stored in the gall bladder and released when food reaches the small intestine. It is composed of bile salts, and pigments, and they are kept in solution form by mixing with cholesterol. So any change that disturbs this proportion of each component required to keep these in solution form can result in the formation of stones. For example diet rich in fats can result in high cholesterol components and can result in stone formation.

How can we prevent formation of gall stones?

Gall stones are usually formed by a mismatch in the concentration of cholesterol and bile salts in bile. So a balanced diet that is low in fats can help in decreasing the chances of gall stone formation.

What are risks associated with gall stones?

Gall stones can cause pain by themselves. They can result in jaundice if a stone slips into bile duct. It can cause pancreatitis which can be mild or life-threatening. The gall bladder neck can be blocked by stone resulting in huge distension of the gall bladder thus causing pain and can result in pus formation in the gall bladder. Large stones in gall bladder are risk factors for cancer of gall bladder.

If they are not causing any trouble, should I undergo surgery?

These are called asymptomatic stones. Asymptomatic stones usually do not require surgery unless
a. Patient is having low immunity
b. The patient is living in a place where medical facilities are meager.
c. Patient is undergoing surgery of abdomen for some other reason
Relative indications are
i. Multiple small stones
ii. Diabetic patient
iii. Large stone

Can we just remove stones and leave gall bladder behind?

We have to remove the gall bladder as its functionally abnormal and stones would reform. Moreover cut on gall bladder heal very poorly.

Will removal of the gall bladder affect my digestion?

There is no effect on digestion if the gall bladder is removed. Body adapts to removal of gall bladder very well and digestion is not affected at all.

What are dietary restrictions after gall bladder surgery?

There is no dietary restriction and the patient can have a normal diet as before. Digestive system adapts well to removal of gall bladder and there is no effect on the digestion of food.

Is it major surgery?

Gall bladder removal surgery is performed by laparoscopy. It is successful in more than 99% of cases. Occasionally it is done by open surgery if anatomy is difficult or there is a risk of injury to important structures. But as the experience of the surgeon increases chances of conversion to open procedure decrease.

Is it very painful?

Laparoscopy surgery is done through small cuts made on your tummy ranging from 0.5-1 cm. these are small cuts and pain is minimum.

Should we undergo open or laparoscopic surgery?

That is to be decided by the surgeon operating upon you. As mentioned above large majority of procedures can be done by laparoscopy and needs open surgery only if surgery is difficult or in the presence of gall bladder cancer.

How long does it take to remove gall bladder?

Surgery is never about time. It is better to finish the procedure safely than quickly. It may take from 10 mintues to an hour depending upon anatomy.

What are the risks of surgery?

Apart from anaesthesia risk that depends upon general condition of patient gall bladder surgery carries minimum risk. Still there is a small but real risk of bleeding, injury to bile duct or injury to bowel.

How long does it take to recover and get back to normal life?

Gall bladder surgery is usually done as daycare surgery and the patient is send home same evening of surgery. The patient is up about a Few hours after surgery and starts his normal routine within a few days of surgery.

How does the experience of the surgeon matter in gall bladder surgery?

The experienced surgeon has fewer conversion rate and the chances of complication are less. Surgeon experienced in hepatobiliary or gastrointestinal surgery can handle the majority of complications on table and can provide better outcome in difficult cases.

Why some people are unsatisfied after gall bladder surgery?

Gallstones can cause abdominal pain, bloating, or discomfort after food intake and the complications listed above. Symptoms such as indigestion, heartburn, constipation and increased frequency of stools are very common in the general population and are not related to gallstones. Mostly when the patients / treating doctors try to correlate these symptoms with gallstones it leads to unhappiness as these symptoms may not get relieved by the removal of the gall bladder. So proper patient selection and counseling can help avoid the unsatisfied patient.

Myths and Facts About Constipation

Constipation is a common problem affecting people of all age groups. It has many definitions according to people understanding and myths. It is correlated with many symptoms and afflictions. Many problems are attributed to constipation and many homemade remedies are used to get over these problems. Basically we lack understanding of process of passing motion and thus have many wrong notions and myths about passing motion.

“There is no standard when it comes to passing motion. Everyone’s system is different, so if you’re concerned about how many times a day you should pass motion, it really depends on your body. Some people pass motion three to four times per day, others pass it once a week – and they’re fine, not sick. Everything from motion’s consistency (soft or hard) and fecal size, to how long it takes the body to pass feces( stools) is based on the individual. At what time one should pass motion is different for different individual and depends upon his food consumption previous day. What’s important is to your track any changes in bowel habits.”

When is time to consult your healthcare provider is when you notice the following changes in bowel habits:

  1. Uncomfortable bloating
  2. Pain while passing stools
  3. Extremely hard stools, difficult to push out, or thin stools
  4. Uncontrolled passage of stools, accidents in pants or bed
  5. Feeling the colon never completely empties
  6. Pooping, or lack thereof, disrupts day-to-day work and functionality

Passing Gas

It’d be hard to talk about passing of motion without mentioning passage of gas, or as some people call it, farting. Like passing stools, gas is related to bacteria in our digestive system, as well as the foods we eat.
“Gas is a by-product of bacteria in our large intestine digesting leftovers of the foods we ate. Bacteria produce hydrogen, nitrogen, oxygen, carbon dioxide and methane. Yes, it’s the methane that explodes, if you fart near a flame. There is no healthy or unhealthy amount of gas. How much gas you pass and the odor largely depends upon what you have eaten.

Foods that Make You pass stools easily

It’s no surprise that what we eat determines how we pass motion, more or less. Eating foods high in fiber is well known for helping ease time spent on the toilet and producing voluminous, bulky stools, sometimes gas, too.

“Fiber, both soluble and insoluble, holds moisture, keeping stools soft and bulky, which allows the colon to gently squeeze your stools through, as opposed to squeezing and straining to pass small hard bowel movements, possibly with cramping and discomfort.

In addition to what you eat, how much you drink can also play a role.“Staying well-hydrated is important. You know you are well-hydrated if you’re urinating every three to five hours, and the urine is barely yellow. Generally, stools stays softer then, too.

You can try these natural laxatives to ease passage of stools for occasional use:

  1. Apple juice
  2. Coconut milk/juice
  3. Aloe vera juice
  4. Coffee
  5. Tea
  6. Fiber supplements

When is constipation a problem ?

  1. A sudden and recent change in the routine of passing stools
  2. Change in color of stool – black color
  3. Change in consistency and shape of feces
  4. Blood in stool
  5. Loss of weight and appetite along with any of the above symptoms

Don’t be scared or shy in discussing these problems with your physicians as they may indicate development of tumor. These symptoms are more important in patients with family history of cancer. They should not cause worry as they are signs for early check up to catch disease at early stage.