Gallstones - diet vs surgery

[Reiltin]

My wife has gallstones and she's waiting for a surgical consult, which will probably be around the end of September. We're a little worried that the surgeon, being a surgeon, will want to cut. (We're going private so there's no 'saving the health system money' issues!) Is there someone else we can talk to in the interim who might be more interested in helping us explore non-surgical options? Which doctor looks after the gallbladder? Has anyone worked with a specialist to not have to remove the gallbladder? Thanks 😀

Is she having painful attacks? If she is they will want to remove it. You can't currently gallstones with diet although you might be able to suppress the symptoms. If she has gallstones the gallbladder is already functioning incorrectly so chances are it will have to come out eventually tbh.

I'm a gallbladder (amongst other organs!) surgeon so can answer some of your questions! In terms of diet, gallstone attacks tend to be brought on by eating fatty food, which causes the gallbladder to contract, so many people find that eating a fat free diet will prevent/reduce attacks and I certainly advise all my patients to do this whilst awaiting surgery. Unfortunately there is no effective long term treatment for gallstones other than surgery. Once gallstones become symptomatic we know that the attacks tend to become more frequent and more severe as time goes on. People usually become less fit with age so I tend to recommend removal as soon as possible. Depending on the size and type of stone, gallstones can also lead to more serious issues such as pancreatitis and jaundice, another good reason to get them removed. It's a straightforward operation, usually done as a day case. If you're going private just make sure that you are seeing someone who specialises in that area in their NHS work. It's uncommon now but there are a few surgeons still doing small amounts of gallbladder surgery privately but specialising in something else entirely in the NHS.

Cure not currently!

I'd have it out if it is causing pain.

I had keyhole surgery to remove my gallbladder 3 years ago. It was day surgery, no complications, felt completely normal within a few days and haven't suffered any pain or issues since. Its a very straightforward procedure.

I didn't have a fatty diet, though, so no idea why I suddenly developed gallbladder issues. Mine came on during pregnancy and got very bad very quickly. I couldn't tolerate any fat, not even love oil to cook food. Was horrendous! So diet wouldn't have really helped with me...

*olive oil

Welshweasel, thanks for that. We're feeling quite lacking in information! Is removing the gallbladder the only way of dealing with them? Kidney stones can be broken up with an ultrasound (or something!) - are gallstones different?

Also, the low-fat diet: does that include healthy fats? Ie should she be staying away from avocados, etc? (I think the answer is yes but want to check!)

Finally, can you recommend any good websites for diet? We've been given the patient.info one which is great but what she's having the most trouble with is low-fat snacks. She can't find anything to fill her up, as her usuals (nut butter, for example) are off the menu.

Thanks again. I do most of the cooking so my head's pretty wrecked over it 😀

No unfortunately gallstones can't be broken up like kidney stones can, and even if they could it would be very dangerous as with kidney stones the small fragments get washed down the ureters and pass out in the urine but gallstones once fragmented would pass down the bile duct and could cause pancreatitis or get stuck and cause jaundice.

With regard to the diet, everyone is different in how much fat they can tolerate. Fat free is very restrictive hence most people are glad to have surgery as soon as possible. If your going private you should be able to get seen and operated on within a fortnight, if it were me that's what I'd do. Or live on haribo and wine...

I had mine out a few years ago and I would do it again in a heartbeat rather than have another attack. That was horrible! And seriously, a short surgical procedure vs a long life without delicious food which probably won't even prevent an attack? Just get it done. It's keyhole surgery and she'll be up and around in no time.

I would add though, make sure your surgeon is going to prescribe proper painkillers. My awful surgeon sent me home with Panadol. Not happy. My friend had it done add she got endone. She was fine. Your partner won't need painkillers for long but just for the first 2 or 3 days it would have made walking to the bathroom much more doable.

Just to add to the helpful posts already here, I was suffering with gallstone problems and my GP told me that it would be virtually impossible to stick to the sort of completely fat-free diet you would need to stop attacks happening. It's no way to live, being terrified after every meal that you're about to end up in agony: the operation to remove it entirely was far and away the best thing to do and by the time I had it I was extremely grateful for it! Wishing your partner well with this.

I had mine out 6 years ago and have had no problem since. I've gone on to have a baby and a csection! Prior to my op I lived in fear of an attack it was completely debilitating when it happened for up to 12 hours solid pain for me, I dreaded it happening. I also didn't eat a hugely fatty diet and it didn't matter really what I'd eaten it felt like pot luck I could think 'sod it' and tuck into a pizza with nothing then another time a low fat salad and have a terrible attack.

My op was the best thing I've done. Went in at 7am, down for surgery about 11, back by about 1ish, by 6pm I was in the supermarket nipping in to grab some grapes (had a real craving). I had 2 weeks off work but could probably have worked the week after if I had to (but I'm a desk based person). Seriously I'd recommend the op every time. And I was very nervous beforehand, my heart on the monitor sounded like a dance record the anaesthetist was joking around with me about it. Hope your wife makes a swift recovery, if she does have the op - don't make her laugh straight away, my DH suddenly became very funny and it hurt!!

Thank you all for your helpful comments. One more question, I'd that's ok! Is there a particular diet you have to stick to after the surgery?

No you can eat whatever you like. Some people find they get diarrhoea after a very fatty meal but this usually settles with time.

No, I eat what I want with no ill effects at all.

I think I posted on your other thread - I'm a doctor but not a surgeon and I have had my gallbladder out.

My surgeon said as welshweasel has, that the only treatment is surgery. And frankly, having seen gallstone pancreatitis, including someone dying from it, myself as a junior doctor I was fucking terrified of it and wanted the blasted thing out.

My understanding was that the risk was higher if the stones are small as they are more likely to move out of the gallbladder down the duct and cause problems, while a big fat gallstone will just sit in the gallbladder causing excruciating pain while the gallbladder contracts around it.

From personal experience, no fat was any good at all while waiting for the gallbladder to be removed. There were no good fats, all of them caused pain but I did lose loads of weight As others have said, it was doable as a diet, but no way to live in the long term as a diet consisting solely of dry toast, fruit, grilled fish and steamed veg day in and day out becomes grindingly miserable.

Surgery was fine, day case and completely back to normal within a week. You get told 2 weeks off work as standard.

Post surgery there have been no restrictions on my diet at all but if I do eat something really fatty - think gooseberry fool made mainly of double cream - I will get a bit of abdominal pain. Some friends who have had theirs out have said they might get some diarrhoea with very fatty foods but that doesn't happen to me. Basically we eat what we want with some v minor restrictions around treats but not so much that we don't eat them

Another one here who can now eat pretty much as I wish but do find anything particularly fatty can result in a quick trip to the loo. But this is a tiny, tiny occasional inconvenience in comparison to always carrying round horse-strength painkillers in anticipation of the next gallstone attack.