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Medical Forum / General / General / June 2005Frequent biliary colic (severe pain without fever or vomit)
Hi all there, My sister (41) has been diagnosed with Cholelithiasis. It gives her severe pain for each "fatty" meal or even sugary drinks (for example, even drinking half a red Fanta bottle can give her colics (just severe pain, no fever, no vomit). Blood and urine tests result with no alterations, but ulstrasound scan shows she has "lots of small stones" (sand) of cholesterol. She refuses surgery (removal of colecystis): first of all because we have a relative who died of colon cancer (and constant leaking of gall in the intestin slightly increase colon cancer probability) at a relatively young age, then we heard not positive feedbacks from different women that underwent the same surgery: they have become unable to have a "heavy" meal because of severe head aches and unbearable gastic reflux. She is keen to take tables for dissolve stones. I red in emedicine.com the following: --- Dissolution agents are employed infrequently. The most widely used oral bile salt compound is ursodeoxycholate, which is effective only for small, pure-cholesterol stones located in a functioning gallbladder. Despite maintenance therapy, recurrence rates are high, averaging 50-60% in most published series. ---- This is exactly her case and she is willing to take the risk of the recurrence. 50% is always a good chance to get rid of the stones definitively. However, the doctor still discourages the drug: his opinion is that: "ursodeoxycholate gives metter results with big stones than with many small" (exactly the opposite of what the website states !!!). I wonder: * What are the side effect (if any) of taking "ursodeoxycholate"? The doctor was unable to inform her and I have not found anything online. * Are there specific exams that can show whether colecystis works properly or not (besides the presence of stones)? The main argomentation of the doctor is that it is useless to let the colecystis there because colecystis does not work (by the moment produces stones). On the contrary, in another website, I also red that the drug for stone dissolution is indicated if the colecystis works ok, otherwise better surgery. Can you please give us your own opinion? Many Thanks Fabian > Hi all there, > [quoted text clipped - 46 lines] > the drug for stone dissolution is indicated if the colecystis works ok, > otherwise better surgery. There is little doubt that removing the gallbladder is the way to go in your sister's case. It's a 20 minute operation and she would likely be able to go home the same day. The risk of complications and death is higher with her symptomatic gallstones than it is with the operation. Granted , I don't know how things are done where you live, but that would certainly be the norm around here. However, if she refuses the gallbladder operation, the next best thing is the use of dissolving agents, ursodeoxycholic acid or chenodeoxycolic acid. Note that she will likely continue to have the biliary colic, and she may have episodes of severe abdominal pain if the stones get small enough to pass through the duct system. Additionally, these drugs tend to cause nausea, so she may have that to contend with that in addition to the colic and occasional pain. And, the stones will return in 50-75% of cases. Even so, if that's the only alternative, that's what her doctor should do. HMc > There is little doubt that removing the gallbladder is the way to go in your > sister's case. It's a 20 minute operation and she would likely be able to go > home the same day. The risk of complications and death is higher with her > symptomatic gallstones than it is with the operation. Granted , I don't know > how things are done where you live, but that would certainly be the norm > around here. Thanks for your reply. Also here (UK) doctors suggest surgery. And I also understand your reasoning: it is better having all life long digestion problems and a very slightly increased risk of colon cancer (that is even not surely assessed) than risking of getting a acute pancreatites at a certain stage. It's statistics. However, I also fully understand my sister: before putting herself in the condition of having problems with food all her life long (problems doctors do not clearly inform patients about - at least in the cases of cholecystectomy of acquaintances I hinted before), she tries everythng possible to avoid this amputation. If you remove the gallbladder (that is a useful organ and makes its own job, despite the stones, apparently) nothing can bring it back. Even not in 5/10 years time when medicine might have found something better to dissolve stones, for example and my sister could cure a recurrent gallbladder stones episode in a better way. That's her hope. Thanks. Best regards, Fabian > Thanks for your reply. Also here (UK) doctors suggest surgery. > > And I also understand your reasoning: it is better having all life long > digestion problems and a very slightly increased risk of colon cancer > (that is even not surely assessed) than risking of getting a acute > pancreatites at a certain stage. It's statistics. I imagine if a surgeon is incompetent, (s)he could cause pancreatitis, but it's more likely that keeping a symptomatic gallstone situation would cause pancreatitis. That's what happened to one colleague of mine who went undiagnosed for quite a while. A friend delayed hers, until the symptoms were so severe, she was continually going to ER by ambulance, trying to speed up the surgery date, because of pain. She had leftover symptoms that were later diagnosed as GERD/reflux. She's since changed her lifestyle (exercise/weight loss/meal choices) and things are improving. Which will also minimize her risk of heart and most cancers. Some people die with gallstones and never have a problem. They seem to run in families. My father had gallstone surgery around age 47. I had gallstone surgery (much younger) 2 large stones. Yes, I may have slightly adjusted to eat less fatty foods, but why would a sane person want to eat high cholesterol fatty foods anyway? And yes, I can still eat some of that at celebration/hoiday times. It's only if I start eating fatty foods every day, that problems can occur. Some people are actually fortunate that they had theirs removed because at the time of surgery, it was discovered that they had gallbladder cancer, which is only curable if caught early. My sister in law had a bunch of small stones. She tried every dissolving method and suffered for years, until she finally got with it and had the gallbladder removed. She's been fine ever since. I've read about gallstones on this and other health newsgroups for years now and it is very rare for anyone to have had chronic problems afterwards. Tell your girlfriend to find a competent experienced surgeon and get on with it. (unless she likes suffering) > However, I also fully understand my sister: before putting herself in > the condition of having problems with food all her life long (problems [quoted text clipped - 7 lines] > better to dissolve stones, for example and my sister could cure a > recurrent gallbladder stones episode in a better way. Dream on. Surgery will always be the solution for symptomatic gallstones. PS Some of them were years ago and none have since developed colon cancer. They explain the various types of gallstones here <http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Gallstones?OpenDo cument> No, surgery is not *always* the solution for symptomatic gallstones; stopping the drug that was causing my GERD, helicobactor pylori ulcer, pancreatitis and gall bladder disease was the solution for me, and for hundreds of others with whom I have corresponded who had this reaction to Lipitor and others of the statins. If she isn't taking a statin it's irrelevant. If she is, it is indeed an avenue to pursue. Zee >>She refuses surgery (removal of colecystis): first of all because we have a relative who died of colon cancer (and constant leaking of gall in the intestin slightly increase colon cancer probability) at a relatively young age,<< COMMENT: I know of no evidence for that. Who says so? People who have gall bladders out have a slightly increased risk of colon cancer and other GI cancers diagnosed around the time they have it out, but that's no doubt either because either the cancer was found incidently at the time of surgery (less likely in these modern days of laparoscopic procedures, ironically), or else because the symptoms that caused the gall bladder to be removed were actually being caused by cancer, which is shortly diagnosed after it's discovered that the gall bladder isn't the problem. If you go out 2 years after cholecystectory, you find it doesn't contribute to colon cancer risk significantly after that. Which it would continue to do, if there was some big causal connection. SBH ========= Br J Cancer. 2005 Apr 11;92(7):1307-9. Cancer after cholecystectomy: record-linkage cohort study. Goldacre MJ, Abisgold JD, Seagroatt V, Yeates D. Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford Old Road Campus, Old Road, Oxford OX3 7LF, UK. michael.goldacre@dphpc.ox.ac.uk We investigated whether cholecystectomy is associated with subsequent cancer and, if so, whether the association is likely to be causal, by undertaking a retrospective cohort study using linked medical statistics, comprising a cholecystectomy group (n=39 254) and a reference cohort admitted for a range of other medical and surgical conditions (n=334 813). We found a short-term significant elevation of rates of cancers of the colon, pancreas, liver, and stomach after cholecystectomy, but no long-term elevation. Excluding colon cancers within 2 years of admission to hospital, the rate ratio for colon cancer after cholecystectomy, compared with the reference cohort, was 1.01 (95% confidence interval 0.90-1.12) and after 10 years or more follow-up it was 0.94 (0.79-1.10). It is highly improbable that the short-term associations between cholecystectomy and gastrointestinal cancers are causal, and we conclude that cholecystectomy does not cause cancer. PMID: 15770220 [PubMed - indexed for MEDLINE] > >>She refuses surgery (removal of colecystis): first of all because we > have a relative who died of colon cancer (and constant leaking of gall [quoted text clipped - 4 lines] > > I know of no evidence for that. Who says so? For example here: http://www.nature.com/bjc/journal/v88/n1/abs/6600661a.html http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 478598&dopt=Abstract As I previously said, her doctor was unable to tell her (too) many information, but he strangely confirmed that there is an association between Cholecystectomy and colon cancer, in his opinion. The doctor told her that gall is a "tough stuff" that is not meant to go down the intestin continuously. That's what she was told, at least. Fabian "As I previously said, Her doctor was unable to tell her (too) many Information, but he strangely confirmed That there's an association Between My Cat Chloe's Ecto And The Sign of Cancer, in his opinion." ~ Fabian "What ~ ? Chloe, your cat? What fur, she unzips?" ~ Arginine Are trolls lurking this newsgroup too? Ok, now I know. :-) Cheers, Fabian > "As I previously said, > Her doctor was unable to tell her (too) many [quoted text clipped - 7 lines] > Chloe, your cat? What fur, she unzips?" > ~ Arginine What, do you know? If so, tell me! >> >>She refuses surgery (removal of colecystis): first of all because we >> have a relative who died of colon cancer (and constant leaking of gall [quoted text clipped - 18 lines] > That's what she was told, at least. > Fabian The first article reports only a "modest increase" in colon cancer risk, the second one shows there is no relationship. The problem is irrelevant anyway, standard colon cancer screening recommendations (colonoscopy) completely neutralizes the risk of colon cancer in this setting. You sister, being so concerned about her health and all, is surely getting screening colonoscopies given her family history, right? Your sister is fooling herself. Her risk of dieing of abdominal sepsis or pancreatitis from her gallstones is far greater than her risk of dieing of colon cancer. I'll bet you a dollar that she ends up having her gallbladder removed, probably as an emergency, within the next 5 years. HMc > Your sister is fooling herself. Her risk of dieing of abdominal sepsis or > pancreatitis from her gallstones is far greater than her risk of dieing of > colon cancer. Did I say that she is going to keep her stones? Is the world just black and white? Luckily not. I know that if she had her gallbladder removed all the "stones" problems will be solved for ever, however she will have others and she is try to solve her current problems without getting the side effects and the irreveribility of a gallbladder-less. She is going to take tablets to dissolve them and if these should not work, she is going to let just the stones removed instead of the whole gallbladder (she phoned me yesterday: she managed to arrange this with her doctor/surgeon). Then, if/when the stones would be back again in the future, she will consider again what to do. > I'll bet you a dollar that she ends up having her gallbladder removed, > probably as an emergency, within the next 5 years. Come on, just 1 dollar...this is not a real bet/belief.... Bye 1-dollar-doctor, Fabian >> Your sister is fooling herself. Her risk of dieing of abdominal sepsis or >> pancreatitis from her gallstones is far greater than her risk of dieing [quoted text clipped - 22 lines] > Bye 1-dollar-doctor, > Fabian I can't imagine a competent surgeon who would agree to remove only the gallstones in an otherwise healthy person. That is bizarre in the 21st century. Sounds like you're fooling yourself as well. The bet stands. HMc > I can't imagine a competent surgeon who would agree to remove only the > gallstones in an otherwise healthy person. That is bizarre in the 21st > century. So, if you are so competent instead, can you tell us what's wrong in removing only the gallstones in an otherwise healthy person? > Sounds like you're fooling yourself as well. The bet stands. Such a low bet is not serious. I thought it was clear. Why do not offer more? Fabian >> I can't imagine a competent surgeon who would agree to remove only the >> gallstones in an otherwise healthy person. That is bizarre in the 21st [quoted text clipped - 9 lines] > > Fabian You don't even know if her gallbladder functions, do you? What were the results of the HIDA scan? That's a key component of gallstone dissolution therapy. Additionally, you report several small stones. Chances of leaving one or more of those little stones behind is great. Oral dissolving agents don't cure anything - more than 70% of patients whose gallstones are dissolved will have them recur within 2 years. The magnitude of the operation necessary to remove just the stones is not substantially greater than that of removing the gallbladder entirely. The recovery is the same for either operation.There is no downside to removing the gallbladder - the risks of leaving it in in the face of gallstones is greater than the risks of taking it out. The risk of colon cancer is not increased, especially in someone who undergoes routine colon cancer screening. Removing just the gallstones and/or dissolving them is reserved for special circumstances (which your sister doesn't meet, apparently), and that fact is recognized by virtually all of western medicine. Except for your sister's surgeon, apparently. As to the bet, winning it isn't worth more than a dollar to me. HMc > > So, if you are so competent instead, can you tell us what's wrong in > > removing only the gallstones in an otherwise healthy person? > You don't even know if her gallbladder functions, do you? What were the > results of the HIDA scan? That's a key component of gallstone dissolution > therapy. That's what I asked in my first post. That's important. What's the HIDA scan? She has not been asked to do it. > Additionally, you report several small stones. Chances of leaving one or > more of those little stones behind is great. During the operation? That's possible. Should 5 x 1mm stones give her ache? She has pain because she has many, the doctor that executed the ultrasound scan said she is "full" of little stones, of "sand" he called it: it's the quantity that causes ache. Oral dissolving agents don't > cure anything - more than 70% of patients whose gallstones are dissolved > will have them recur within 2 years. Besides the fact that I red other statistics and other recurrence times about this too (you can discuss this directly with your colleagues who say different stats), but even if it were the case? In two years time, she will reconsider it again, but she will still have a choice, in 2 years time. Not if she makes an irreversible operation *now* and suffers the side effects of *this* operation. See below for the downside. > The magnitude of the operation > necessary to remove just the stones is not substantially greater than that > of removing the gallbladder entirely. The recovery is the same for either > operation. Of course, it's the same. And so? > There is no downside to removing the gallbladder I do not agree at all. Besides the colon cancer risks (you can discuss it directly with your colleagues that do not agree with you: if medicine itself is not 100% sure, why should I believe you if you just belong to the "it's not correlated" party?); there is not the risk, but the certainty of having digestion problems all your life long. You cannot digest well fatty food any longer and it is also...expected: without the proper quantity of gall squeezed in the intestin by the gallbladder...so, even if you do not eat fatty meal every day (you should not, at least), you can forget about celebration meals...and the quality of your life is affected, yes. And normally doctors (all but you, so far) admit this downside. Even if some do not properly inform the patient before the operation (as it occured with my acquaintances). - the risks of > leaving it in in the face of gallstones is greater than the risks of taking > it out. Ok. Already said above. The risk of colon cancer is not increased, especially in someone who > undergoes routine colon cancer screening. Do you mean that with a screen, you can diagnose a colon cancer *before* it occurs so that you can *avoid* it?!? Or that you can cure it at an early stage....because the two things are very very different... Removing just the gallstones > and/or dissolving them is reserved for special circumstances (which your > sister doesn't meet, apparently), and that fact is recognized by virtually > all of western medicine. Except for your sister's surgeon, apparently. I know what literature on the subject says and my sister's surgeon knows it too. And so? You look like a computer software: "if...then...else", it's written in the bible, etc. If she does not want the gallbladder to be removed (and we all can understand why), shouldn't the doctors take it in consideration and choose alternatives, even if the doctor's bible gives different preferences? > As to the bet, winning it isn't worth more than a dollar to me. You know, I just wanted to know were you were heading to with this. I find all this bet thing really pathetic. But you can always think/believe that you said something "cool" or something perfectly normal (what's wrong with this, eh?)... Fabian > there is not the risk, but > the certainty of having digestion problems all your life long. You [quoted text clipped - 7 lines] > some do not properly inform the patient before the operation (as it > occured with my acquaintances). This is simply untrue. > Do you mean that with a screen, you can diagnose a colon cancer > *before* it occurs so that you can *avoid* it?!? > > Or that you can cure it at an early stage....because the two things are > very very different... Yes, colon cancer can be prevented by routine screening. If your sister has a family history, her risk of colon cancer may be increased (yours too) and her doctors should recommend screening beginning at at least age 50, perhaps earlier depending on the nature of the family history. HMc > > And normally doctors (all but you, so far) admit this downside. Even if > > some do not properly inform the patient before the operation (as it > > occured with my acquaintances). > > This is simply untrue. What is untrue? that my acquaintances were not properly informed by their doctors? Or that you do not admit the downside? If you admit the downside, well, you have pretended it not to exist for many posts. I wonder what's the use of it...just to have angry patients after their operation. > Yes, colon cancer can be prevented by routine screening. If your sister has > a family history, her risk of colon cancer may be increased (yours too) and > her doctors should recommend screening beginning at at least age 50, perhaps > earlier depending on the nature of the family history. Why do you assume that we do not do routine screening/do not know what it is? However, they have always told us that you do not prevent but can cure it at an early stage, and, you are telling me that you can detect it before it comes a cancer?!? And how is it called the before-cancer? Fabian >>>And normally doctors (all but you, so far) admit this downside. Even if >>>some do not properly inform the patient before the operation (as it [quoted text clipped - 4 lines] > What is untrue? that my acquaintances were not properly informed by > their doctors? Dr. McCollister is one of the relatively few doctors posting here and sharing his not inconsiderable knowledge. He gets no payment but the satisfaction that he may be helping someone. Why in the world would you be hostile to him for telling you how it is? Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > What is untrue? that my acquaintances were not properly informed by > > their doctors? [quoted text clipped - 3 lines] > satisfaction that he may be helping someone. > Why in the world would you be hostile to him for telling you how it is? This is not being hostile, this is asking a question. He has not been clear on what is untrue, IMHO. Curious that you have mistaken inquiry by hostility. Is it a way of changing the subject? I still expect his reply...what is untrue? The side effect, he not to admit, doctors being reticent? And by the moment you raised the word *hostile*, (you did!) I just doubt that he has not been *it* to me, my sister and all his colleagues doctors in this thread....I just doubt....but, anyhow, "scripta manent" (as latins said) and usenet lurkers can judge it very well by themselves from now on, till Google news will exist. Last but not least, the fact that he is posting for free does not give him any special right to be automatically replied in the way he likes or expects nor does grant him any extra special skills or competences. This is democracy. This is usenet. You just need to learn how to use it. If you like, please read a bit of netiquette: http://www.albion.com/netiquette/corerules.html. Cheers, Fabian >>>What is untrue? that my acquaintances were not properly informed by >>>their doctors? [quoted text clipped - 16 lines] > (as latins said) and usenet lurkers can judge it very well by > themselves from now on, till Google news will exist. I am a dentist, not a gastroenterologist. However, what Dr. McC has posted is so routine and mainstream, so representative of everything I've heard, that your questioning of his judgement leaves me perplexed. As for usenet ettiquette, I've been around long enough not to expect much in the way of courtesy. I do however know of a (relatively small) number of people out there that genuinely try to help, and Howard is one of them. The saying "no good deed goes unpunished" comes to mind. Steve > Last but not least, the fact that he is posting for free does not give > him any special right to be automatically replied in the way he likes [quoted text clipped - 7 lines] > Cheers, > Fabian SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > I am a dentist, not a gastroenterologist. However, what Dr. McC has > posted is so routine and mainstream, so representative of everything > I've heard, that your questioning of his judgement leaves me perplexed. I am also perplexed by his judgement, that's why I was questioning. He is a doctor, he could answer me issues that would takes months for me to find in Google or to be answered by my sister's doctor who he sees once a month. Or he can also not answer, his choice. Steve, I can be wrong, but your words look more like a situation as: "how do you dare? no one has ever done this to him..." :-) > As for usenet ettiquette, I've been around long enough not to expect > much in the way of courtesy. I do however know of a (relatively small) > number of people out there that genuinely try to help, and Howard is one > of them. Have I ever said the contrary? he is really and sincerely *try* to help my sister and me. However, he can convince you, but let me perplex because he is speaking differently by what I have heard so far by different sources. Wouldn't you be perplex if you were in my situation? In addition, his being so "hostile" and without any "courtesy" as you rightly have noted, does not help communication flow at all. > The saying "no good deed goes unpunished" comes to mind. What do you mean? That it's the doom of good men to be punished for their "good deeds". :-D So, tell me: what should I tell him? "Thanks doctor, finally you have opened my eyes: all my friends are liars, doctors I have been at are all incompetent and I will also cancel my internet subscription because they just tell a lot of bullshit there." Steve, have you ever tried to look for the same information we were discussing with Dr McCollister with Google? Please, do. Someone told me recently: usenet is like a pub: you enter you find whoever you find and when you have enough you can step out...that's how it work: there are not temples, no churches, no gurus, no untouchables here. Here, we are all just men/women in a pub. ;-) Have a nice day, dentist. :-) Fabian >> I am a dentist, not a gastroenterologist. However, what Dr. McC has >>posted is so routine and mainstream, so representative of everything >>I've heard, that your questioning of his judgement leaves me perplexed. > > I am also perplexed by his judgement, "also"? I'm not perplexed by his judgement--please don't put words in my mouth. that's why I was questioning. He > is a doctor, he could answer me issues that would takes months for me > to find in Google or to be answered by my sister's doctor who he sees > once a month. Or he can also not answer, his choice. > > Steve, I can be wrong, but your words look more like a situation as: > "how do you dare? no one has ever done this to him..." :-) Believe me, they've done it to him--and me, and every other doctor who spends any time around here. >> As for usenet ettiquette, I've been around long enough not to expect >>much in the way of courtesy. I do however know of a (relatively small) [quoted text clipped - 3 lines] > Have I ever said the contrary? he is really and sincerely *try* to help > my sister and me. Thanks for the clarification. > However, he can convince you, but let me perplex because he is speaking > differently by what I have heard so far by different sources. Wouldn't > you be perplex if you were in my situation? I'm not in your situation. I believe I wouldn't be perplexed if I were, but that's neither here nor there. > In addition, his being so "hostile" and without any "courtesy" as you > rightly have noted, does not help communication flow at all. Again, I see no hostility on his part, and didn't say so--I said YOU were hostile to his advice. That is of course your prerogative. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > >>I've heard, that your questioning of his judgement leaves me perplexed. > > I am also perplexed by his judgement, > "also"? I'm not perplexed by his judgement--please don't put words in > my mouth. I am not putting words in your mouth. I am also perplexed like you are perplexed. I am perpelexed by his judgement, you by something else. Sorry, if this has not been enough clear. > Again, I see no hostility on his part, and didn't say so--I said YOU > were hostile to his advice. That is of course your prerogative. Again, I never said you said he was hostile.I said you have noted hostility and lack of courtesy in the air, in usenet....it does not matter you were attributing hostility to me, it could have also been something else that made you say so... Bye bye, Fabian >> > And normally doctors (all but you, so far) admit this downside. Even if >> > some do not properly inform the patient before the operation (as it [quoted text clipped - 25 lines] > > And how is it called the before-cancer? Fabian, this post is quite indicative of the fact that, relative to both colon cancer screeing and gallbladder disease, your sister and you are either getting terrible advice from your doctors, or you're not paying attention to what they're saying. You're asking some very basic questions that indicate remarkable ignorance for someone whose posts here pretend to be authoratative. You and I are discussing things that I deal with every single day of my life. Your "arguments" come out of ignorance, and are based on "stories" told to you by a few friends. As to symptoms after gallbladder removal, if you have friends that had theirs out and are now miserable, then their doctors are incompetent. It simply does not happen except in rare circumstances. This fact is easily supported by a simple Google search. And, you should show your doctor how to do such a search too. HMc > As to symptoms after gallbladder removal, if you have friends that had > theirs out and are now miserable, then their doctors are incompetent. It > simply does not happen except in rare circumstances. This fact is easily > supported by a simple Google search. And, you should show your doctor how to > do such a search too. So your being untrue was related to the side effect I described. Nice that you have explained me in such a kind way, thank you! Your friend in the other post was just telling me that I was *hostilite*...uhm...very appropriate in this case, just the direction to be changed...I think one of your colleague shrink could call it "projection". Anyhow, let's come back to us: my "ignorance" comes from 1) Google search (that apparently you refuse to use), 2) at least 4 doctors and 3) 3 female acquaintances (I ensure you they are human being and not ectoplasm). They all confirm this side effect and doctors/Internet also confirm increase of colon cancer risks. Now, no offence, if you were me, would you believe to Google search results, real doctors and acquitances that directly live the problems or to the single doctor that says something completely different? And why? Why do not send me a link or something that shows me your thesis? BTW, you have not explained me the screening that can detect cancer before it is there. I am very curious (seriously). Cheers, Fabian >> As to symptoms after gallbladder removal, if you have friends that had >> theirs out and are now miserable, then their doctors are incompetent. It [quoted text clipped - 29 lines] > BTW, you have not explained me the screening that can detect cancer > before it is there. I am very curious (seriously). The information that I impart to you is routine, basic stuff that is absolutely common knowledge among physicians. You are in essence asking me to prove to you that the sky is blue. I see no need. You posted asking for opinions. You didn't like or agree with the opinions I gave you, so now you ask me to prove them to you. I have tried to give you information based on my opinions and observation which are in turn based on 25 years of experience as a surgeon, dealing routinely with the exact issues you raise. You now have a choice in whom to believe. I have nothing at stake here, and the outcome of your sister's medical condition, and whether or not you decide to believe my opinions is simply not important enough to me to jump through the kind of hoops you are demanding. As to colonoscopy, screening recommendations in this country are based on determining and eliminating pre-cancerous conditions. While finding a colon cancer at a early cureable stage is one component of that, the most important aspect is removing pre-cancerous polyps through the colonoscope BEFORE they become cancerous. If a colon cancer is discovered at colonoscopy, it means that the screeing process has failed, since the goal is to remove the polyp long before it ever has a chance to become a colon cancer. HMc > I have tried to give you information based on > my opinions and observation which are in turn based on 25 years of [quoted text clipped - 3 lines] > decide to believe my opinions is simply not important enough to me to jump > through the kind of hoops you are demanding. Ok, fair enough. On the contrary, I believe medicine is not something you are supposed to *believe* in. It is a science and, as every science, it can be easily observed by lab experiments and statistics. Whenever existing. Anyhow, thanks a lot for your time and contribution. Fabian Salut Fabian I refused gall bladder surgery in 1998. I still have the gall bladder. But I don't have any disease symptoms anymore. My gall bladder disease, severe acid reflux and pancreatitis was caused by Lipitor, the cholesterol lowering medication. I had never had such problems prior to Lipitor and I have not had them since stopping Lipitor. I am not saying your sister's problem is the same as my problem. But how the two physicians here can say your sister should have gall bladder surgery without examining her or knowing what other medications she is taking is beyond me. Hope it's beyond you too. Zee > > As to symptoms after gallbladder removal, if you have friends that had > > theirs out and are now miserable, then their doctors are incompetent. It [quoted text clipped - 31 lines] > Cheers, > Fabian > I am not saying your sister's problem is the same as my problem. But > how the two physicians here can say your sister should have gall > bladder surgery without examining her or knowing what other medications > she is taking is beyond me. > > Hope it's beyond you too. Thanks Zee for your witness. Unfortunately my sister has real gallstones. I dont know if she takes Lipitor or something. I dont think so, but doctors must know, yes. Did they find you gallstones too? Are they asyntomatic without Lipitor? The physician over here - just one - was speaking according to western medicine current rules. Unfortunately, they state that, for gallstones, the best solution is gallbladder removal. Full point. Other solutions are less effective and normally just followed if the first solution is advised against or if you oppose (as in your and my sister cases). Cheers, Fabian I am asymptomatic. Yes I had a diseased gall bladder. No I have not had symptoms since stopping Lipitor. I think you should find out if your sister is taking a statin. It is known that statins can cause gall bladder disease. In fact, some months ago Dr. McCollister concurred that statins can indeed do so. Zee http://groups-beta.google.com/group/sci.med/msg/b7ca7129250fe079?hl=en Dr. McCollister on gallstones and gall bladder disease... (--) Nothing has been shown that would indicate that any of the statins directly cause inflammation of the gallbladder. We DO know that they can promote gallstone formation. So, the current concept is that statins can cause gallbladder disease by causing gallstones and the gallstones in turn cause the symptoms. It's the gallstones that cause the gallbladder symptoms, not the Lipitor. Furthermore, once the Lipitor has caused the gallstones, the gallstones are there forever - they won't go away once the Lipitor has been stopped. Now, Dr. Rind's suggestion that Z's GI symptoms weren't due to gallstones, but were more likely due to side effects of the Lipitor is a good one. Given the fact that he hasn't had a repeat problem with them in 7 years, Lipitor-induced, non-gallbladder abdominal pain represents the most likely situation in his case. If one accepts this scenario, he most likely does have asymptomatic gallstones. (--) Zee >I am asymptomatic. Yes I had a diseased gall bladder. No I have not had > symptoms since stopping Lipitor. [quoted text clipped - 4 lines] > > Zee To clarify, statins can induce gallstone formation, which in turn can cause gallbladder disease. Once the stones are formed, they are there forever and remain capable of causing gallbladder disease long after the drug has been stopped. More than likely, your symptoms were due to GI side effects of the statin and unrelated to the gallstones. My suspicion is that you had and have asymptomatic cholelithiasis and stopping the lipitor has only relieved you of the usual GI side effects. Or...maybe not. Nothing is "always" in medicine. I've had patients that have decided against cholecystectomy for symptomatic gallstones and have done fine. OTOH, it's far more common that they end up at some point with acute suppurative cholecystitis or maybe pancreatitis. I have to base my recommendations on the liklihood of the least potential harm. HMc > >I am asymptomatic. Yes I had a diseased gall bladder. No I have not had > > symptoms since stopping Lipitor. [quoted text clipped - 20 lines] > > HMc Of course you do and I am grateful for that, and for your knowlege and willingness to share it with us. I was slated for surgery; there was an organ filled with sand. The surgeon was a specialist in this procedure at a university hospital medical school. All of the problems I mentioned were diagnosed, x-rayed, tested, validated. But no one then or now is admitting the disease and adverse effects were caused by the Lipitor beyond saying yes, statins can cause gastrointestinal difficulties (as though I had perhaps burped once too many.) Thanks again, HMc. |
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