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I'm seeing a surgeon in 3 days regarding the removal of my Gallbladder. I currently have upper right quadrant abdominal pain, extending to the back, for 3 weeks and all tests are indicating it's the gallbladder. (There are no stones). Pain is generally brought on with eating or drinking and then relieved with Ibuprofin.

I've had my J-Pouch for 35 years and it's aging like the rest of my pelvic floor after 2 children. I have my strategies and medication go-to's for management but, I'm increasingly concerned at the effect the loss of my gallbladder will have on my continence and daily management. What issues have people experienced when unable to digest fats etc?

I'm not concerned at the actual surgery, it's that I need to know what to expect post-surgery, what diet complications I'll need to adjust to both short term and long term (after surgery)?

Is there anything else I should be considering to prepare my questions for discussing this issue with my surgeon?

Finally, has anyone experience non-stone related pain and issues which has responded to non-surgical management. I know diet adjustments will help but is there an alternative treatment, such as specific anti-inflammatories or medications targeting gallbladder flare-ups?

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I just had emergency gallbladder removal surgery three days ago and the only dietary advice I was given upon discharge was to avoid foods that are high in fat until I'm feeling better. I was told that otherwise I might have diarrhea, which made me laugh for obvious reasons. They said every patient's different and you'll learn by trial and error if there are foods you should now avoid.

Something I was unprepared for was how difficult it was to have bowel movements for the first 1.5 to 2 days. It's getting easier now but is still unpleasant. Part of this is that I was on intravenous antibiotics, followed by oral antibiotics. Those meds completely eliminate gas for me, and without gas it's hard to empty my pouch. Part of it's the abdominal pain every time I tried to push. The pain's particularly bad in the area where they cut through old scar tissue.

I am in a similar boat. I have had large gallstones for a few years now, but I have had 10+ surgeries and a pouch redo 5 years ago. My GI Dr Shen stated a lot of my aches were most likely adhesion related and to not rush to get the gallbladder out as it can cause more GI issues. But recently the stones have gotten larger and I am getting wall thickening of the gallbladder which means inflammation. My bile ducts are getting mildly dilated as well. My new GI at CLEVELAND CLINIC stated today that it may be time to have it removed before it becomes an emergency type surgery. So my plan is to have it out by the end of the year. I asked her about PSC with the bile ducts becoming dilated but she does not feel I have that at this time. My fear is not the surgery itself but afterwards with diet and more toilet issues. I already have minor leakage and I am afraid it will get worse after its out. But my thinking now is that the gallbladder is completely full of stones and its not really functioning at this point anyways so when its out my function shouldn't change much....hope I am right about that.

and diet change will be hard for me, I eat everything and not very healthy choices

I'm a month post-surgery now and have fortunately (knock wood) had no lingering pouch issues relating to the emergency gallbladder removal. The first 7 to 10 days weren't always great, mostly due to pouch-emptying difficulties, but once the abdominal pain was better and the antibiotics completely wore off things returned to normal. 

Diet-wise, not much has changed. I ate gingerly the first few days but allowed my intake to normalize pretty quickly. This will be a very individual phenomenon, but my absorption was poor to begin with so I worked under the assumption it couldn't get much worse!

@Pals posted:

Does having a J pouch make Gallbladder surgery more difficult?  Meaning them hitting our pouch with an instrument.

This is another "your mileage may vary" thing, but I'll tell you what my surgeon shared. First, he said he's done the procedure on several j-pouch patients. He could not tell me ahead of time whether it would be open surgery. His preference is to try it laparoscopically (for faster recovery time) and if the scar tissue is too much of a problem he'll switch to open. He wasn't concerned about the actual pouch sustaining an injury.

The first question I asked when I woke up was "Was it open?" The nurse said no, he'd managed to do it laparoscopically. But it took longer than usual and was billed at a higher level of complexity because "there was a lot to blast through." That was in reference to the scar that goes down the middle of my stomach, not the ileostomy scar (which was untouched).

That gallbladder scar that goes through the colectomy scar was more painful and took longer to heal than the ones in other locations and still looks kind of strange.

Last edited by bowelsofhell
@Scott F posted:

@bowelsofhell The “scar tissue” that took the surgeon time to “blast through” was internal scar tissue (adhesions), not the midline scar. A scalpel goes through scarred skin about as easily as pristine skin, but they have to take time with each adhesion once the laparoscope is making its way to the target.

Correct. Sorry if that wasn't clear, I figured it was obvious the internal scar tissue was the problem.

I had my gall bladder (large stones) out last summer.  I have had ZERO changes to the functionality of my pouch (which-because of a previous fistula surgery/damaged rectum I essentially had functional incontinence, altho with the various things I have/do to manage that, I am functionally pretty continent most of the time/live a full life).  All that to say, I have not changed my diet at all since the gall bladder surgery and have noticed no ill effects on my already precarious continence, so I think that should be reassuring!

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