Reflux Problem after Removal Of Gallbladder
Is it psychological or does it have treatment?
Sometimes when we witness a situation that disturbs us, we may say ‘I feel sick to my stomach’. However, we do not have anything that comes in our stomach and mouth, but we often use this statement to describe the discomfort we experience. However, some people experience this expression in reality. Many of these people are gastroesophageal reflux (stomach reflux) patients. Although it is uncomfortable, it is easy to diagnose and treat. However, I would like to talk about another reflux that is often overlooked and confused with this, which is partially treated by the treatment of gastric reflux or left untreated at all: Bile reflux or alkaline reflux gastritis.
Today, social life is like a river flowing rapidly with intense stress. In this turmoil and rush, we are lost as if we were caught in the vortex. But this intense stress also affects our health significantly. We physicians experience that many problems are easier to come by, especially when we consider that we also have a bloated diet with unbalanced and unhealthy ready-to-eat foods. Of course, obesity and diabetes come first. The accompanying heart diseases, sleep disorders and, of course, stress-related stomach diseases have to be remembered. As we emphasized in the introduction, today we will try to explain to you a disease that is not very important but that patients seek treatment door-to-door with very serious complaints and that is sent many times either with cursory prescriptions and regulated treatments or it is thought that it is psychological.
Since the stomach is a powerful organ that is engaged in hard work, it also has its own protection mechanisms. The stomach wall, in particular, has a very strong resistance to acid. The weakest point of an organ this strong is bile secretion from the small intestine!
Bile is a solvent that acts as a detergent for the digestion of complex fats produced by the liver and especially taken with foods. Bile is an alkaline (basic opposite of acid) secretion as opposed to gastric fluid. Each person has a cycle that continues continuously day and night and is stored in the gallbladder to a large extent in normal individuals, passing through the intestine during meals. In this respect, the gallbladder is also seen as an organ that has an important role in regulation.
However, tens of thousands of people get their gallbladders removed every year because of gallstones and these people continue their normal lives. Because the bile produced in the liver naturally flows through the bile to the intestine and continues to function even without the gallbladder.
So Why Do Some People Have Bile Reflux?
Although everything goes in their natural course, some people experience very serious complaints due to bile reflux. When we look at people with bile reflux, we see that some of them start complaining after the removal of their gallbladder. Gallbladder stones are a disease that is close to 30% of the population and whose treatment results in surgical removal of the gallbladder at the last point. Therefore, these surgeries are commonly performed by general surgeons. Although there is currently no data on how many patients with all gallbladder surgery develop bile reflux, there is one thing we can say for sure. That is, almost half of the patients who admitted us with alkaline reflux gastritis (bile reflux) had previously had gallbladder surgery. Is that a coincidence? Or are there other possible underlying pathological mechanisms? We are far from being able to respond to them clearly. However, we need to express that the removal of the gallbladder can lead to these problems.
Is gallbladder surgery harmful?
It is very normal for patients to come up with questions such as “Would it be better if didn’t have surgery, even if I have stones in my gallbladder?”. Let’s answer this question right away:
Patients with gallbladder pain, infection and attacks due to these stones are candidates for surgery. Because the stones in the gallbladder are not only present there, they also begin to disrupt the function of the bladder and, even worse, they have the risk of falling into the bile duct and causing severe vital problems. Therefore, we have to make it very clear that if gallstones cause a complaint, you should definitely have your gallbladder removed with gallbladder surgery. This is the only form of treatment that will save you from bigger problems than bile reflux.
Alkaline reflux unrelated to gallbladder
Half of the patients have gallbladder but they still experience bile reflux this problem. Endoscopic examinations in these individuals often show that gastroesophageal reflux is also present in the stomach along with dense bile. Sometimes this bile may not be seen in recurrent endoscopies. To be sure in these cases, it is necessary to evaluate the course of the day by conducting a 24-hour acid-base determination with the pH meter and lower esophagus pressures with esophagus manometry.
It is recommended that these patients be followed up with at least 3-6 months of diet and medical treatment. Unfortunately, in cases where bile escapes into the stomach anatomically, medical treatments partially reduce complaints but do not eliminate the origin of the problem. Long-term bile irritation can progress to a scenario heavy enough to cause cancer in both the gastric mucosa and the esophagus mucosa.
For this reason, surgical treatment of bile reflux was defined many years ago and is the only treatment with 100% effectiveness in eliminating bile and irritation to the stomach.
Bile Reflux Surgery
When it comes to bile reflux, the ideal surgery is Meester Switch surgery. This surgery is a metabolic surgery method described by Dr. De Meester, from which it was named in 1982.
It is a method that closes the connection between the duodenum and the stomach and allows the bile in the duodenum to be discharged 150 cm away from the stomach. This method does not interfere with the stomach at all. The pyloric muscle, which controls gastric outlet, is protected completely naturally. There’s never an absorption disorder. Food is not restricted. Life goes on as normal as it should.
De Meester Switch surgery is an experience-seeking and sensitive surgery. Gastric Bypass surgery is the most common treatment for patients with gastric bypass surgery. These surgeries are generally successful in eliminating symptoms in patients with accompanying gastroesophageal reflux. However, it is necessary to make this very clear. Our goal in treating your bile reflux is not only to eliminate your complaints, but to eliminate bile reflux in your entire stomach.
For this, it is absolutely necessary to separate the duodenum and deflect the bile at its source.
These approaches, which can sustain bile irritation with small pieces in the stomach that can be left behind in gastric bypass, may increase the occurrence of unwanted conditions such as cancer in the future.
For this reason, Meester Switch surgery is the ideal bile reflux surgery, which removes the problem anatomically and physiologically, precisely. If you can’t get results despite lifestyle changes, drug treatments, long-term follow-up, then it’s time to start doing research for the De Meester Switch.