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jkingdon
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Quote jkingdon Replybullet Topic: Barrett's, Hiatus Hernia and Gallbladder
    Posted: 12 Apr 2014 at 2:12pm
Hi, I am new to Barrett's Wessex and to this Forum but I have a question. I have gallstones and will probably have to have my gallbladder removed. Does anyone know whether this could make my Barrett's worse due to the possibility of more bile reflux following removal of my gallbladder? Any thoughts gratefully received. John
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teacher man
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Quote teacher man Replybullet Posted: 12 Apr 2014 at 3:17pm
Hi john, welcome. What are your symptoms.?
I have read some people do a flush and prevent their gallbladders from being removed. Could be hog wash though.
I did find this helpful and read some people helped their gallbladder with carrot juice.
Try this if you want. Go to a place where they juice. Ask them to make you a carrot juice. Then take that carrot juice base and put it in to a smoothie machine and have them add carrots. It's the carrot fiber that will flush your system. I didn't have mine super fiberous but it was smoothie like. Try this for a few days. Also, eat lots of carrots. But carrot smoothies all the way. With a try.
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Pyrrhonist
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Quote Pyrrhonist Replybullet Posted: 12 Apr 2014 at 5:08pm
> I am new to Barrett's Wessex and to this Forum but I have a question.
> I have gallstones and will probably have to have my gallbladder
> removed. Does anyone know whether this could make my Barrett's worse
> due to the possibility of more bile reflux following removal of my
> gallbladder? Any thoughts gratefully received.

Did you have gall stones before you started taking PPIs?
http://www.springerlink.com/content/2238h2k756607401/
http://www.springerlink.com/content/p4qt7lx3j53g2813/
These papers seem to indicate that PPIs very commonly interfere with proper gall bladder operation. I have heard of four people who all believed that their gall bladder problems were due to long term PPI use.

I know noything about gall stones, except that they are said to be mainly cholesterol crystals. Cholesterol is excreted by the liver as a standard function of digestion.

Chemically - crystals will form if the concentration is too high. The gall bladder does concentrate bile but should release it in the normal course of digestion. If the gall bladder is prevented from operating normally, bile concentration can only increase.

It's a theory to discuss with your doctors and may give you some thought for further research. Google scholar is a search engine for technical papers and can be very useful - though a lot of the medical papers are far too technical for all of us who have no medical training. But there are some authors who do their best to avoid techical jargon.
Richard Torrens. - See my www site for my own experiences with Barrett's and reflux etc.
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Sandra W
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Quote Sandra W Replybullet Posted: 13 Apr 2014 at 12:23pm
Hi all,
 
Please don't mess about if you have gall bladder problems, especially stones.  If you have symptoms, you need to take this seriously and make sure you get a referral to get this sorted as soon as possible.
 
My mother suffered years of chronic sickness and agonising abdominal, chest and shoulder pain.  Although her GP knew she had gallstones, he did not refer her to a specialist but just kept telling her not to worry.  Finally, in early 1997, she saw another doctor and got sent to see a surgeon.  He arranged tests and a follow-up appointment to attend the clinic on 14 August 1997 to get the results.
 
Unfortunately, he never got the chance to try and sort this out.  Mum was taken very ill and subsequently died 24 hours later on 7 August, exactly a week before her clinic appointment.  The post mortem report states the cause of death as septicaemia caused by empyema (pus in body cavity) of gall bladder, which had developed from complications of inflammation and infection arising from the untreated stones.
 
If you have a gall bladder problem, just make sure you get help, fight your corner and DON'T let them fob you off!!!
 
All the best,
 
Sandra.
 
All the best,


Edited by Sandra W - 13 Apr 2014 at 12:25pm
E-mail: swilliams888@hotmail.co.uk
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jkingdon
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Quote jkingdon Replybullet Posted: 26 Apr 2014 at 4:42pm
Thanks for the replies. Specifically, I was seeking views as to whether by removing the gallbladder there might be more bile refluxed into the stomach resulting in damage to the oesophagus in a person who also had a hiatus hernia. The doctor that I have consulted was not sure. Any further views would be much appreciated. Thanks.
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Pyrrhonist
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Quote Pyrrhonist Replybullet Posted: 27 Apr 2014 at 1:10pm
link - it is very tenuous and not at all common.

But I think if you already have a tendency to form large stones, PPIs cannot help.

> Specifically, I was seeking views as to whether by removing the
> gallbladder there might be more bile refluxed into the stomach
> resulting in damage to the oesophagus in a person who also had a
> hiatus hernia.

Nobody here will be sure either. However the gallbladder's function is to hold and concentrate bile. Concentrating bile is how stones form. Probably most people only small crystals form which are easily removed with normal gall-bladder function.

With no gall bladder, any bile produced has to be passed very quickly into the duodenum. Whether this makes bile reflux more or less likely I cannot guess. My own experience is that, as PPI dose wears off, he gall bladder expresses bile erratically - even spasmodically. Expressing bile at the wrong time can lead to bile reflux. It seems possible that a more even flow (because of cholesysectomy) could cause less reflux.

To learn more about the liver etc, see
http://www.vivo.colostate.edu/hbooks/pathphys/digestion/liver/index.html
or search for the Sphincter of Oddi.

Good luck.
Richard Torrens. - See my www site for my own experiences with Barrett's and reflux etc.
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bouncethruit
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Quote bouncethruit Replybullet Posted: 02 May 2014 at 4:03pm
Hi jkingdon

I sincerely hope you are not suffering with your gallstone issue anymore and that it has been effectively resolved.

In answer to your query and speaking from my own experience (NB: Always please bare in mind that everyone is different) I had my gallbladder removed together with the offending large black gallstones the insides of which were composed of grey crystallised bile salts, (I still have them and keep them in my jewellery drawer just to hiss at now and again!)

My gallstones were absolutely intolerable and it had become impossible for me to lead a normal life, I had no choice but to have the wretched things removed. However, prior to this I stupidly attempted to "flush" them out(lol), believe me, you have to drink a heck of a lot of apple juice or white cider vinegar to break those things up and anyway, they have rugged sharp exteriors. I think I did accidentally pass one (before I ever knew I had gallstones) a number of years before and it felt like a rat was trying to gnaw its way out of my stomach, painful is not the word.

I didn't have a diagnosis of Barrett's at endoscopy prior to removal of gallbladder. After removal of gallbladder, I started suffering itchy/burning sensation inside oesophagus and one year later, when I was again scoped, I was diagnosed with 1cm Barrett's which unfortunately appears to be increasing.

Between a rock and a hard place on this one.

Cheers.
Gilly

Edited by bouncethruit - 02 May 2014 at 4:11pm
GfromWalesUK
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bobgil
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Quote bobgil Replybullet Posted: 20 May 2014 at 9:31pm
As some people will know, I had a private halo for removal of non-dysplasic barrett's. However, it was also found that my gallbladder simply didn't work, probably due to long term use of PPI's. I can control it with a strict, non-fat diet and only rarely get any pain. When I spoke to my consultant, (whom I trust), he was undecided over the benefits of taking it out, because it may make trhe reflux problem worse. At present,I dont suffer any reflux and was barrett's free, at the last scope. So in my case, is it better to not have the gallbladder removed.
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jkingdon
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Quote jkingdon Replybullet Posted: 20 May 2014 at 11:41pm
Hello bobgil,

Thanks for you message. I have a similar dilemma in that I have gallstones which occasionally cause me a problem but I am uncertain whether to have my gallbladder removed due to the possibility of bile reflux being made worse. It is interesting to note that your consultant was undecided about whether your reflux would be made worse by gallbladder removal. Like you I control my gallbladder by a very strict low fat diet. I have done some research on the pros and cons for people with Barrett's and Hiatus Hernia having their gallbladder removed. There are many papers that say bile reflux is made worse and a few that say it makes no difference. On the other hand holding onto a gallbladder with gallstones also comes with risks. I think this is a particular concern for those of us with Barratt's and I am finding it very difficult to find definitive advice. I am seeing my Gastroenterologist shortly to put the issue to him and thereafter may seek a second opinion. I would be most grateful to know the name of your consultant should in my case a second opinion be necessary - perhaps using a private reply if you feel that is appropriate. As always, any other comments from Forum Members also gratefully received. Thanks.
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Pyrrhonist
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Quote Pyrrhonist Replybullet Posted: 21 May 2014 at 9:29am
I only have experience of bile reflux - caused by PPIs. The gall bladder's function is to store bile, concentrate it, and release it into the duodenum as food leaves the stomach. The release is via the Sphincter of Oddi - a Google will reveal lots of informative diagrams:
https://gi.jhsps.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_ID=BB532D8A-43CB-416C-9FD2-A07AC6426961&GDL_Disease_ID=7AB086B0-AB01-446E-B011-2E67CAFEF96D
seems good.

Logically, if the gall bladder is not working as it should, it should be encouraged to work properly by eating foods and herbs that promote bile release.

Preventing bile release will concentrate the bile even more and the gall-bladder will then either release it spasmodically - or form gall stones.

I found that, as the PPI dose wore off, bile would be released but not times to coincide with food exiting the stomach. That caused bile to back-flow into my stomach, hence bile reflux. My consultants were unwilling (of unable) to discuss this!

But timing is the problem. Timing is controlled by a complex mix of hormones such as gastrin and cholesystokinin. PPIs certainly interfere with these hormones.



http://www.pfaf.org/user/Search_Use.aspx?glossary=Cholagogue
gives you a list of herbs and plants which are said to be Cholagogue - i.e. they promote bile flow. The list includes many edibles - e.g. Leek, garlic, olive oil, marjoram, cardoon. And many more which even I would not dare experiment with unless guided by a competent and qualified medical herbalist. Some doctors are so qualified,

It may give you more understanding and more information to discuss with your doctors!

Best of luck with your problems - keep us informed!
Richard Torrens. - See my www site for my own experiences with Barrett's and reflux etc.
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