Gallstone- NHs won’t remove

[silverdarkness]

Anyone know anything about acute cholecystitis? I have had an awful time earlier this week and was in absolute agony in my stomach and back and unable to eat or sleep for 36 hours throwing up water even. I ended up in hospital on morphine and diagnosed with acute cholecystitis. My gallbladder is very inflamed and thickened and I have at least two gallstones the size of 50ps. I was sent home with codeine( didn’t work for his attack anyway)and told by the consultant to come back in 2 months for a check up and to never eat anything with fat in it again ( I am already a healthy weight). Unless it happens again and then I must go to a and e and then they MAY remove it. I had some awful pains just before Christmas but was not diagnosed yet so the Gp just said it was prob intigestion so this is the 3rd or fourth attack really but they won’t “ count” those ones just the ones that result in hospital admission. From what I have read online(NICE guidelines and nhs pathways)I should of been offered a gallbladder removal within a week and antibiotics as this is the standard treatment and this can be dangerous. Just wondered what others knew about this particular condition if they keep refusing to take it out what can I do??

I actually work the NHS so no work insurance 😂.
Yes it is restrictive and i am losing weight. So far no major pain after being on it but still pain like “ poking “ in the ribs every night. I dont want to eat like this for the rest of my life I’m 32 or worry like this. I’m sorry all that have to go through risk like this and go through the stress of worrying

No one has mentioned Ometprazole. I think that is how you spell it. It stops the gall bladder contracting. If you have gall stones, when you eat fat the gall bladder contracts and so you get pain.

I know all situations are different but I experienced terrible pain one evening suddenly and with peppermint tea and paracetamol, it took a few hours to wear off. Thought it was indigestion. Happened again the next day when I ate so went to doctor. She immediately suspected gall stones and prescribed the above medication (which is available over the counter, but more expensive) until I had various tests done.

Firstly a stool test for bacterial infection. Negative. Then blood tests for about eight different things. One showed up a slight infection. Then ultrasound which showed either gall stones or polyps in the wall of the gall bladder. Saw the consultant who put me on the waiting list for op for removal. I said I was prepared to go in on a last minute appointment. Even so, it meant about a nine month wait and I eventually got an appointment by ringing to query the wait and getting a ‘catchup’ appointment on a Saturday.

It was a very straightforward keyhole op. My oh insisted I rest in bed for the week and then I was absolutely fine. It was polyps by the way. I was 60.

Once I starting taking the Ometprazole I suffered no more pain. I was worried the first day I ate without taking it after the op but it was fine. I now eat normally and have suffered no further problems.

I am no medical professional but cannot understand why you were not prescribed this medication. Have you had further tests? Perhaps worth seeing your GP again and ask about Ometprazole. My GP prescribed it immediately. As you say, impossible to avoid fat altogether and you may not yet be on a waiting list for an op. Good luck.

I’ve spent the last 24 hours in terrible pain, unable to eat, retching constantly which makes the pain worse (even with anti-emetics), can’t even keep down water. It’s constant now. When I first got the pain it would wear off in a few hours with oramorph, but now not so much, and I’m constantly nauseous and retching. Can’t do anything, can’t eat, can’t drink,can’t work.

I was prescribed omeprazole today so I hope it helps. I can’t wait nine months like this, I’d die.

I'm another one with gallstones OP.

Mine are intermittent meaning I can go for a month or two without them then suddenly bam I get a pain like I've been punched under my rib cage on the right hand side.

I've got codeine for the pain, it helps a bit but not entirely.
I've lost weight too nearly two stone in a year and a few days of gallstone attack can take me to a BMI of 19.
On medical advice I cut out all fat for 6 months and it didn't make any difference whatsoever. Now there is concern that I'm losing too much weight I've been told to reintroduce fat. My symptoms haven't worsened for it.

We've got private medical insurance via DH's job. I've had a scan + an MRI, they could be seen on the MRI but the scan only showed that my gallbladder was very enlarged.

I've been offered the option of surgery but for now I don't want to take it. It can be utter agony but having had a botched appendectomy I'm not keen to have more surgery.

I quite literally feel your pain silverdarkness and hope the NHS sorts it out soon.

I had gallstones which caused pancreatitis and acute cholecystitis, and I spent 10 nights in hospital on antibiotics. It still took 11 months to get my gallbladder removed. They may refer you for an MRI to see if a stone is blocking your bile duct. If that is the case, the first step is ERCP to remove the stone.

All you can do is keep going to A&E, every time you have bad pain. Make them take notice. Good luck, it really is the worst pain imaginable!

I highly recommend BUSCOPAN for gallbladder pain (and post-op phantom pain which I got for about 6 years after my gallbladder was removed). You can buy it over the counter but I think your GP can prescribe a higher strength. It was a miracle-worker for me, and I had a severely infected gallbladder with dozens and dozens of gallstones. Sympathies to all suffering - the pain is indescribable.

As PP have said, they'd prefer to take an uninflamed gall bladder out by keyhole surgery rather than abdominal surgery which has a much longer recovery period.

My DH had a fat-free diet for quite a few months before removal and also resembled one of the Simpsons at one point.

I highly recommend BUSCOPAN

Absolutely. Get it prescribed as it's prohibitively expensive over-the-counter. Mebeverine is a great alternative (suits me better). A proton pump inhibitor, to restrict amount of acid made in the stomach, is indicated - omeprazole being preferred choice (you need two a day, regardless what your go says, and any upper gi dr will confirm), lansaprazole if problems with omep. Other drug of use is Creon 25000 to aid with digestion if diarrhoea is suffered (this is due to bile constantly dripping into intestinal tract rather than being squeezed from gallbladder "on demand"). There's also cholestyramine but the side-effects are horrid, is a thick liquid you need to make up, and tastes like shit and makes you want to vomit.

May need a low-dose px of loperamide (imodium). Must must must be px'ed rather than just bought, as careful monitoring is required on a chronic basis (and far cheaper to get px'ed than to buy).

Another one here who has 3 emergency admissions very close together before they would remove it as an emergency. The 2nd to last visit was just after Christmas, and A and E was heaving. The Dr I saw that time admitted that ideally they would remove it that day, but the time of year meant that they couldn’t as the hospital had no beds, and had even had to cancel all planned operations as they were so stretched.

The first attacks I had were cholycystitis, I was in for 3 days with that for IV antobiotics then on high dose oral antibiotics for 2 weeks. This seemed to clear the infection, and I was put on the list for the op (I’m pretty sure they prefer not to do it whilst there is active infection or severe inflammation).

However, a few weeks later I had an even worse pain, which turned out to be biliary colic. It was caused by one large stone that kept getting stuck in the biliary tract. Cholecystitis was painful, but biliary colic was absolutely excruciating, much worse than childbirth. I was given buscopan and large does of IV morphine, yet the pain remained so they ended up doing it as an emergency. By this time it was near the end of January so not quite as manic. Just as well they did remove it too, as the surgeon later told me it was so inflamed that it was on the point of rupturing.

Anyway, try and hang in there for a while if you can - it is far preferable to have it done as a planned op, it is less painful,!the recovery time is usually shorter and it reduces the risk of the surgeon having to convert to open surgery (as opposed to keyhole).

I used cider vinegar for a bit act as some think it helps pass them. I thought at the time it was helping, but in hindsight I wonder if it helped cause the biliary colic by encouraging by body to try and expel a stone that was simply too big to pass through the biliary tract.

Wish I could give you more tips on how to help the pain, but tbh, nothing at all really helped when it became severe. Good luck with it, and don’t be afraid to go back to a and e if the pain becomes unmanageable as they have a duty to try and relieve any severe pain.

As for pain level, having clearly never having suffered childbirth (Male), watching DP have an elective, recommended, was enough for me, watching her suffer :(

One HCA asked me to rate the pain from 1-10. I said 11. Was told 10 was "like having your leg cut off with no anaesthetic". I replied, oh yes, much worse I can imagine that being. She rolled eyes. It's excruciating, radiates through the back (could also be pancreatitis although I find this doesn't radiate), shoulder, central intestine with utter ferocity. It's the worst pain, and in my case persistent, I've ever felt, and had some pain probs, including chronic ongoing, and rxed a scary amount of meds. Having also had over 40 of these attacks since October 2016, you can imagine I love them...

@gingergiraffe Omeprazole prevents acid formation in the stomach. It's buscopan/mebeverine that prevent the spasms. And anyone suffering these attacks, or pre-, post-, surgery should be on both (see longer post above this one).

Oral opiates are specifically NOT to be prescribed or given to gallstone patients. They cause spasming of the billiary tree and can cause untold issues with a trapped stone.

You need to go to A&E and be seen by the upper epigastric team.

The wait can be 3-6 months but they WILL remove your gallbladder.

I had to wait 3m and that was after paying for all scans privately to speed it up.

I lost 3 stone as was surving on porridge and honey after 3x weekly trips every week to A&E in the back of an ambulance for IV morphine.

Oh saw what I did. Cholestyramine, or Creon 25000, are for post-surgery biliary diarrhoea only, same loperamide.

Just wanted to reiterate so it doesn't get lost. ive had 40+ biliary attacks since October 2016, had appendix, and gallbladder, removed. Still suffering the same attacks, been on low-fat fasting diet since Oct 2016 and diet has made no change to attack prevalence/severance.

However, a few weeks later I had an even worse pain, which turned out to be biliary colic. It was caused by one large stone that kept getting stuck in the biliary tract. Cholecystitis was painful, but biliary colic was absolutely excruciating, much worse than childbirth

Welcome to my world. 2-3 attacks of biliary colic a week, lasting up to 4 days. Suspected choledocholithiasis (bile "sludge" - you can still produce gallstones/sludge post-surgery, google Post Cholecystectomy Syndrome), and some A&E docs think I'm a drug seeker, one recently leaving me waiting 10 HOJRS for pain meds.

Once my situ is resolved, I'm seriously looking into studying cholecystitis, and it's related. Have some medical experience already, but chronic issues and disability could likely interfere...

Oral opiates are specifically NOT to be prescribed or given to gallstone patients. They cause spasming of the billiary tree and can cause untold issues with a trapped stone.

Yawn. This old nonsense. Opiates can cause the Sphincter of Oddi to spasm, causing increased pain spasms. However, opiates are not contraindicated in treatment of suspected acute cholecystitis/pancreatitis with a ppi, anti-emetic and anti-spasmodic being administered at the same time.

Please stay off Google...

So you work in the NHS OP. Talk about them scoring an own goal by making you weight.

I was bloody grateful for the oral morphine That doctor was being humane.

*wait

Yes, and no. Oral morphine has so little morphine bioavailability it's not even a controlled drug. Doesn't need administering by two nurses either. I'm investing this past few months why Oramorph is a preferred alternative to intravenous morphine in A&E in patients presenting with 8/10+ acute pain levels.

Sorry, not rtft but I had acute cholecystitis and was in hospital for almost two weeks with it.

I was basically told that they can’t take it out when it’s inflamed etc as there is a chance that it could break apart on the way out and cause peritonitis because the bile is so concentrated. They said it would be at least a few months before it would be scheduled to let it calm down and avoid the risk of it rupturing.

You can eat fat. I thought I had to go “fat free” too but they clarified that a low fat diet was preferable to avoid stomach upsets and that you need some dietary fat.

I actually eat whatever I want and have only had a few unpleasant episodes (and my gallbladder was removed over ten years ago now).

Buscopan. Go and get some. It's an over the counter drug. Just buy the normal strength as you get double the tablets - it's the same total amount of active ingredient in both packets.Take one at first twinge. Usually works. You can take another an hour later if necessary. Then stick to the instructions. Amazing antispasmodic. Even after the op, the bit they have to leave being can still spasm so have the Buscopan for then too.

Codeine/morphine gives some people gall pain and makes it worse.

why is SimpleSteve making this thread all about him?

BUSCAPAN for the win every single time. At the first hint of pain take one then another an hour later if needed

Omeprazole brings it's own side effects only take the minimum needed do not ignore your GP and take two daily!

I was already on Buscopan due to IBS It did nothing. I appreciate it can work for some though.

Recommending things is clearly making the thread "all about me". I think having medical education, over 40 incidences of this problem personally, the musings of various consultants, registrars and surgeons and other medical staff kind of gives me the personal perspective to post here, no?

Prescribed buscopan, or mebeverine (anti-spasmodica), should be tried in conjunction with a proton pump inhibitor to reduce stomach acid production such as omeprazole/lansaprazole, anti-emetics such as cyclizine/ondansetron if nausea/vomiting is indicated. HIGHLY recommend getting the above prescribed for costage (buscopan way more expensive over counter as branded), dosage, and monitoring reasons.

Do not overuse antacids and PPIs like omeprazole as they inhibit folic acid absorption which is directly linked to falling vitamin B12 levels and a whole host of issues around the decrease in stomach acid required for vitamin B12 absorption from food