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Some patients, in whom the gallbladder was removed, i.e. cholecystectomy, for reasonable medical indications, still experience some discomfort, even though the surgery itself was completely correctly performed.
We call these ailments “post-cholecystectomy syndrome”. Often the patient himself is not able to clearly determine whether these are ailments that are a continuation of the same disease that was an indication for the removal of the gallbladder, or whether they are a new disease, or whether they are finally related to the surgery. The percentage of such patients among those operated on is small (10–15%). Everyone should be made aware that those who undergo this type of surgery avoided dangerous, sometimes dangerous and irreversible complications in the future, such as, for example, more annoying pain attacks, bothersome jaundice or neoplastic growths.
symptoms
The symptoms experienced by some people after a gallbladder excision are:
• persistent indigestion,
• moderate pain in the right hypochondrium or epigastric region,
• inflammatory complications,
• repeated attacks of biliary colic,
• recurrent jaundice of varying severity, etc.
The causes of this syndrome include:
• biliary dyskinesia,
• persistent bacterial or parasitic infection (e.g. giardiasis)
• inflammation of the pancreas,
• chronic pancreatitis,
• stones left or formed anew in the bile ducts (against individual metabolic tendencies),
• dietary mistakes,
• “less frequent” bile in people after cholecystectomy, not concentrated in the follicle and thus “less valuable”, and therefore less effective in the digestive process, ie emulsification of fats.
Taking into account these findings, patients deprived of a gallbladder should follow the general principles of dietary management in diseases of the liver and biliary tract. Meals should be eaten in small amounts at least 5 times a day, keeping fats to a minimum.
Treatment
The described syndrome of symptoms usually disappears after some time, or the symptoms are much milder. In the event of their persistent persistence and annoyance, check-up medical examinations should be made. Preferably where surgery was performed. It is then advisable to perform tests to identify or rule out inflammation or deposits in the bile ducts. In the event of their exclusion, tests are necessary to determine the proper cause of these ailments.
Prevention
Recommendations aimed at reducing these ailments at home include:
• Eating according to the recommendations given.
• Avoiding strenuous physical exertion.
• Avoiding excessive stress and emotions.
• Use of medicated diastolic, sedative and digestive preparations, especially of fats, recommended by your doctor.
Recurrences of urolithiasis in the bile ducts, the so-called choledocholithiasis, you can prevent, among others by avoiding foods with excess cholesterol (e.g. yolks) and using choleretic drugs.
Diet Tips
The diet, both in inflammation, cirrhosis and any other damage to the liver parenchyma, as well as in diseases of the biliary tract, is aimed, on the one hand, at saving the liver parenchyma and, on the other hand, at facilitating its basic physiological functions. It is a valuable and significant supplement to pharmacological treatment.
The basic principle is not to overload the liver cells and not to increase the need for bile, while providing food with a sufficient amount of carbohydrates, proteins, vitamins and the necessary amount of fats.
Acute and severe conditions usually require a hospital stay, where, depending on the severity and duration of the disease, the patient is provided with an appropriate diet.
In chronic conditions in people staying at home, it is necessary to follow the specific medical recommendations presented below in a nutshell during dietary treatment.
• Usually, dishes are served boiled and steamed or stewed without fat.
• It is forbidden to serve dishes that are fried, hard to digest, fatty, “tampered” with cream, thickened with a roux.
• Soups and sauces should be prepared with vegetable stock.
• Food products must be fresh, not preserved, not cured, not synthetic, varied, easily digestible, rich in vitamins.
• Foods that are hard to digest, bloat, and sharp spices and stimulants should be excluded.
• Alcohols, beers, wines etc. are excluded.
• Onions and garlic are also not recommended.
• Egg white is recommended as well-absorbed, with a limitation of the amount of yolk, which, having a beneficial effect by contracting the gallbladder and increasing bile drainage, may also trigger gallstone attacks as a result of the bile’s “flow” of smaller or larger deposits in the bile ducts ( not always freely).
• Meals should be enriched with B vitamins and vitamins C, A, K and E administered both in a natural form and in the form of pharmacological preparations.
• Fruit juices recommended to ensure the supply of vitamins – especially vitamin C – are served raw, slightly heated (to a temperature not exceeding approx. 40 ° C), bearing in mind that overheating too much causes a significant loss of vitamin C. Bread should be stale.
• In order to increase bile secretion, it is also recommended to consume plenty of fluids (tea, milk, juices, compotes). Meals should not be plentiful, served 4-6 times a day.
Patients with cholestasis, i.e. with cholestasis in the bile ducts (including the gallbladder) as a result of dyskinesia or deposits in their lumen – despite the risk of triggering a colic attack – may eat a limited amount of foods stimulating the motor activity of the gallbladder and other bile ducts, i.e. chocolate, cocoa, spicy spices, cream, eggs, fatty or fried foods as factors increasing bile outflow, thus reducing its retention, but provoking an attack of hepatic colic.
However, such treatment is strictly contraindicated in the case of mechanical obstruction of the bile ducts as a result of, for example, stones, adhesions, tightening or atresia of the lumen of the bile ducts, preventing the outflow of bile. The leading symptom is completely discolored stools. Such treatment may only trigger or aggravate pain.
Lifestyle
The recommended lifestyle, which would prevent exacerbations or recurrences of the described conditions, must be adapted to the severity of the symptoms and the advancement of the disease.
Detailed recommendations are each time established by a physician, and if he or she overlooks this information, he or she should be asked about it.
Among the general recommendations, the following should be highlighted:
• If you feel relatively well, bed rest is unnecessary and unnecessary.
• In the absence of subjective symptoms, patients can perform professional duties within the tolerance of the body, provided that it is not physical work that causes fatigue and triggers nervousness or nervous exhaustion.
• You must get regular, prolonged night sleep and rest in a lying position during the day.
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