
Me and my 'useless' gall bladder - dnetesn
http://www.bbc.com/news/magazine-29594479
======
derekp7
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.

~~~
freshyill
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.

------
CapitalistCartr
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.

~~~
chdir
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://www.cancer.org/cancer/gallbladdercancer/detailedguide/gallbladder-
risk-factors)

[http://umm.edu/health/medical/reports/articles/gallstones-
an...](http://umm.edu/health/medical/reports/articles/gallstones-and-
gallbladder-disease)

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

~~~
thirsteh
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.

~~~
SiVal
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.

~~~
chdir
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.

~~~
SiVal
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.

~~~
thirsteh
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_.

~~~
SiVal
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.

------
SoftwareMaven
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.

~~~
abecedarius
More than anecdotal:
[http://www.ncbi.nlm.nih.gov/pubmed/24321208](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.

------
Leon
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.

------
Morgawr
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.

------
tahn
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.

~~~
Jtsummers
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.

------
bitwize
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.

~~~
vanderZwan
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.

~~~
csdrane
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](https://news.ycombinator.com/item?id=8454918)

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

------
jmiwhite
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.

------
VLM
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.

------
flyrain
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.

------
duckingtest
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.

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

