Something About Postcholecystectomy Syndrome
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Many patients complain of persistent symptoms, even though they had their gallbladder taken out.
Postcholestectomy syndrome
- Dyspepsia, Flatulence, bloating, and diarrhea
- Nausea and vomiting.
- Persistent pain - Heartburn and acid reflux like pain in the upper right. Sometimes this can entire upper abdomen.
The liver produces bile and the gallbladder acts as reservoir. From the gallbladder, bile enters the intestine in individual portions. In the absence of gallbladder, bile enters the intestine constantly, but in small quantities, not in an insufficient amount for digestion of fatty foods. Approximately 50% of cases are due to the biliary tract causes, like biliary stone, biliary tract injury, dysmotility, and choledococyst. The remaining 50% are due to non-biliary functional gastrointestinal disorder, not related with the gallbladder.
Preventive measures
- Eat smaller and frequent meals that reduce pressure on the lower esophageal sphincter, helping to prevent reflux
- Stay upright after eating. After a meal, wait two to three hours before lying down. This allows time for your stomach to empty.
- Limit fatty foods because high-fat meals relax the lower esophageal sphincter and slows the rate at which the food leaves your stomach.
- Avoid smoking, it increases the production of stomach acid
- Avoid caffeinated and carbonated drinks, chocolate, citrus foods and juices, vinegar-based dressings, onions, tomato-based foods, spicy foods and mint.
- Limit alcohol use
- Raise your head end of the bed. Sleeping with your upper body raised 4 to 6 inches (10 to 15 centimeters) may help prevent reflux symptoms.
Medications to use are Pancreatin 8000 units twice daily with each meal. One month of Baclofen 10 mg q in the morning. Thirty tablets of omperazole 20 mg q bid po. One month of Reglan in small doses. It can decrease symptoms of nausea, vomiting, and stomach and abdominal pain.
