Gallstones

[TotalBeginner]

I've just got back from A & E after servere epigastric pain. Blood tests, ECG and BP are all fine, so the doctor is going to arrange for me to have an ultrasound to see if I have gallstones.

Flying is obviously out of the question at the moment, but if it turns out that I have gallstones, will I be able to fly again? (Currently hold a class II medical) I'm really worried that I've just kissed goodbye to my PPL :(

[Loose rivets]

I have written quite a bit about gallstones in the past. Firstly, no problems on the medical.

I had the bag removed, along with a single stone the size of a small chicken egg, through a hole that left almost no scar. I was walking about in the foyer of the hospital 36 hours after I walked in.

I allowed mine to get very bad before it was correctly diagnosed. It's hard to describe the pain, but it was totally disabling. Using a weeks worth of Pethidine sp? in one night didn't touch it.

So, while you're waiting, take extreme care with your diet and read up on how to relieve the pressure should you be unlucky enough to have another attack.

[TotalBeginner]

So, while you're waiting, take extreme care with your diet and read up on how to relieve the pressure should you be unlucky enough to have another attack.

That's my biggest fear. I really don't want to go through another one of those. The pain was like nothing on earth :yuk:

[RobertS975]

If you do indeed have gallstones, then you will have your gallbladder removed surgically (cholecystectomy). After a recovery period of a few weeks, you should be good to go. The gallbladder operation is most commonly done nowadays with laparoscopy (keyhole surgery) and the post-op discomfort and recovery time is minimal.

[TotalBeginner]

I've heard that having your gallbladder removed can cause complications. Apparently when the gallbladder is removed, bile drips continuously into the small bowel which can cause loose stools, diarrhea and increase your chances of bowel cancer. Is this true?

[Loose rivets]

Some people say that they can no longer pig-out on fatty meats, but for the most part they are okay. I have felt not the slightest change, but would have wanted four weeks before flying again.

I did in fact have four small holes, one under the belly-button for the extraction, one somewhere else for the camera, one for more tools of the trade and one for a drain tube. The single worst experience was the removal of that tube, it felt like a long piece of spikey ice being halled out. No real pain, just strange.

[TotalBeginner]

Can anyone advise me on what I need to do next? Should I write to the CAA?

[RobertS975]

I've heard that having your gallbladder removed can cause complications. Apparently when the gallbladder is removed, bile drips continuously into the small bowel which can cause loose stools, diarrhea and increase your chances of bowel cancer. Is this true?

Loose stools is sometimes a by-product of a cholecystectomy, but it is one with an easy solution. There are products on the market (by prescription in the US, not sure about Europe) that are bile-binding resins. They stop the diarrhea overnight. One such product is Questran (cholestyramine) which is a powder that comes in small dose packets. Another is Colestid tablets. These products were originally developed to lower cholesterol, but they are not particularly good for that purpose.

Anyway, if someone has symptoms from gallstones, there really are no good alternatives to surgical removal.

[airbus2boeing]

I did the keyhole surgery last year and the only problem I have is I go to the bathroom immediately after breakfast. But there's a way to flush the stones (do some research on line), I'm not quite sure how, but I think you have to drink mxture of olive oil, apple juice and something else.

[Capt Chambo]

Here is my experience for what it's worth.
I was diagnosed as having gall stones, in my case they were the small stones that can pass down the tube from your gall bladder into your gut. I can confirm that the pain is excruciating and in my case always lasted 4 hours. I went to see the company doctor, who liased with the CAA and I was shorthaul I was cleared to continue to operate.
I had the gall bladder removed by key hole surgery as an out patient in the UK. I walked/hobbled out of the hospital some 6-8 hours after surgery. The most painful post op. experience was a severe ache in my right shoulder. Apparently this is a by product of having your chest/stomach cavity expanded by gas so that the surgeon can get at the relevant bits, this aggravetes a nerve that travels through your stomach/chest area and through your shoulder. (I am sure a Doctor will explan this better!).
I was fine within a few days for anything light, but would not recommend trying fly.
Nearly ten years on I am fine, I experience no dietary, or bowel function problems. My scars have all healed nicely except for the one in my navel which has a fair bit of scar tissue on it but this was probably my fault through moving too much and not allowing the wound to heal quickly.
I was advised that there is no way too remove the stones by ultra-sound as this refers to kidney stones. In fact breaking up the gall stones would only make the problem worse, providing more nucleii for more gall stones to form on. I was also told tht the gall bladder is largely a redundant item only really necessary to help with the digestion with a very fatty diet.
The one piece of advice that my company Docter did warn me about was that about ten years ago when I had mine done, the key hole surgery procedure was in it's infancy, and apparently "some" surgeons "may" be inclined to continue with key hole surgery, even if there are complications and they should be opting for more major open surgery. His advice was to check the reputation of the surgeon in question, which it turned out was good. As I say ten years down the track they are now a more common operation and you should be fine.
One final point, you may be one of the few people who has an inverted/prolapsed gall bladder. You should try to make sure they check this, because I believe if you are in this small minority then key hole surgery is not an option for you.

[BelfastChild]

There is a slightly increased risk of bowel cancer following cholecystectomy but it is fairly small from what I recollect. I believe it is in the order of a 1% increase, most likely affecting the caecum/ascending colon. I vaguely remember reading this in the Oxford Textbook of Surgery (a long time ago I might add) - I don't have it anymore but if anyone does they might be able to check.......

[TotalBeginner]

So what now? Do I write to the CAA immediately, or wait until I've had an ultrasound?

Has anyone had treatment for this on the NHS? Is it likely to be a long drawn-out wait? Somone has told me that I could be waiting months just to get an ultrasound and that the waiting-list for a laparoscopic cholecystectomy is huge :( :( :(

[RobertS975]

There is a slightly increased risk of bowel cancer following cholecystectomy but it is fairly small from what I recollect. I believe it is in the order of a 1% increase, most likely affecting the caecum/ascending colon. I vaguely remember reading this in the Oxford Textbook of Surgery (a long time ago I might add) - I don't have it anymore but if anyone does they might be able to check.......

I am a board certified GI specialist... I have not heard that before. One needs to be careful how one looks at data... those having gallbaldder surgery may have more attention paid to them medically afterwards, and thus they may have more of this and more of that found, but only because they are getting a closer inspection than the population that isn't seeing doctors.

[BelfastChild]

RobertS975 - I agree with what you say. I'll track down a copy of Oxford Textbook of Surgery and find out exactly what it says and see if I get get the source article it is quoting. I think the theory was that the increased bile acids in the bowel were responsible, but they only affect the ascending colon because they are broken down before they make it around to the left. The again it could all be sh1te as you say.......

Just did a medline search. Here are a few articles.

T Shao, Y Yang. Cholecystectomy and the Risk of Colorectal Cancer
The American Journal of Gastroenterology 100 (8), 1813–1820. 2005


E S Schernhammer et al. Cholecystectomy and the risk for developing colorectal cancer and distal colorectal adenomas. Br J Cancer 2003 Jan 13;88(1):79-83.

Goldbohm RA et al. Cholecystectomy and colorectal cancer: evidence from a cohort study on diet and cancer. Int J Cancer. 1993 Mar 12;53(5):735-9.


Ekbom A et al. Cholecystectomy and colorectal cancer. Gastroenterology. 1993 Jul;105(1):142-7.


Giovannucci E et al. A meta-analysis of cholecystectomy and risk of colorectal cancer.
Gastroenterology. 1993 Jul;105(1):130-41.


Moorehead RJ et al. Cholecystectomy and the development of colorectal neoplasia: a prospective study. Ann R Coll Surg Engl. 1989 Jan;71(1):37-9.

[perthboy]

I too have had the gallstones and Keyhole surgury. I had it done about a year ago now. I do not miss the excruciating pain cause by the passage of the stones. I have all my stones in a container they are about the size colour and texture of COCO Pops/ Rice Bubbles.

They only side affects I have are the going to the toilet to do loose stools about 2 hours after I eat. Not pleasant at all.

Cheers perthboy.

[RobertS975]

The loose stools are easily remedied by taking one of the bile binding agents that are available... cholestyramine etc.

[TotalBeginner]

Well still no letter from the hospital about a scan and I'm so fed up! There was a woman on the news last week complaining that she had to wait 18 months to have her gallbladder removed. I'm going to be so miserable if I have to wait that long before I can fly again, I'll be like a starved dog! :{ :{

[TotalBeginner]

Well, I've had my Ultrasound and he found 1 large stone, nearly filling the gallbladder. I'm going back to see my GP next week so I guess he'll come up with a plan of action.

[Loose rivets]

If they let you keep the stone, cut it in half...mine was better than a geode.

[wopen]

Are there any herbal / natural treatment methods anyone knows here for gallstones (http://www.liverpain.org/gallstones.php)?

[piggybank]

In Indonesia we have an over the counter herbal medicine names after its main content, Keji Beling. I bet Europe has something similar because one of the other ingredients is one of the milkweeds.

It mainly used for kidney stones but also advertises for gall stones.

As to effectiveness, it is a popular product and cheap. about US$4 for 15 days medication.

My wife has kidney stones and after a botched lithotripsy in Singapore (big name hospital) refuses to undergo the process again, so she has taken Keji Beling since January.

Size of stones in one kidney was 18mm and the other 12 mm.

Three ultrasound checks have been done so far. The results are that in one month there was considerable relief after a lot of pain. The 18 mm stone is now 12 mm, the smaller stone of 12 mm has now become 8 mm. She will have an ultrasound again in a month so we will know how the treatment is going.

She is taking medicine for depression and paranoia and there seems to be no interaction between the medications.