Gallbladder/IBS & Diarrhea issues

iVillage Member
Registered: 07-23-2006
Gallbladder/IBS & Diarrhea issues
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Sun, 07-23-2006 - 10:36pm

Hi I am new here and I would like to hear from anyone who is dealing with this and how they are coping since this is ruining my life - I can't work, can't leave the house and since it's been 9 months and no change I do not believe that this will resolve itself in a year (it would be a miracle I believe). Here's my story:

Last September/October I had three surgeries. The first removed my gallbladder, the second removed adhesions around my small intestine and abdominal wall and the third was for a small bowel resection because of bowel obstruction. I was in the hospital the third time for 17 days including 2 days in the ICU for blood pressure/heart rate problems. Since that surgery I have consistent persistent diarrhea - average is 10-25 times a day but I have had as many as 32 times in one day. I had vomiting for about 6 months but that has passed. I have lost over 80 lbs because of this and now am unable to eat most days. I have had numerous tests including a colonoscopy, barium upper and lower GI studies, blood work. I don't have anything apparent (Crohn's, diverticulitis, etc) and the GI doctor believes that I have the diarrhea because of the bile from the liver being passed into the intestines. I have had IBS for about 20 years but always tended towards constipation, not diarrhea. I am having a problem also with keeping potassium - I have been hospitalized for IV fluids and potassium because of this problem. Medications we have tried Lomotil (2x), Immodium, Colestid, Cholestrymine powder, pamine forte and opium tincture. Also have tried every fiber combination out there (benefiber, metamucil, etc) and all of them cause intense pain and worsening of diarrhea. I am either allergic to or have no results (diarrhea continues regardless) from them except the opium which worked but caused hives. My GI doctor called on Monday to tell me that he is out of treatment options for me.

My questions are - why is this happening (is it common for bile to do this)? Will this correct itself or am I dealing with a life long problem? How can I make sure that I am not dehydrating and doing damage to my body when I cannot keep anything in my system (water and food passes very quickly)?

thanks.
Meg

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iVillage Member
Registered: 03-04-2005
Sun, 07-23-2006 - 11:03pm

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I am so sorry to hear what you've been dealing with Meg! From everything I've read, once the gallbladder is removed, the amount of bile that drips from the liver is constant, but not huge amounts, like your doctor seems to be implying. Have you considered getting another opinion? If this doctor has run out of options, you definitely should be seeking help elsewhere.


Are you taking any type of potassium supplements? I'm sure you don't need to be told to continue drinking as much water as you can, to avoid becoming dehydrated.


Please seek another opinion and keep us updated on how you are doing, OK?

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iVillage Member
Registered: 07-23-2006
Sun, 07-23-2006 - 11:13pm

Thanks Elise. I am working really closely with my primary care who is fantastic and the top GI doctor in the area. I know that these two doctors will keep working to try to find a solution but I think the GI doc was trying to let me know that right now he is out of options. I am not taking potassium supplements as my primary doesn't want me to - he is very concerned with me getting too much potassium which is as dangerous as being too low. I do try to drink a rehydration water that my doc told me should keep me rehydrated (quart of water, tsp salt & sugar, juice of lemon or lime) but it shoots right out of me. My biggest challenge that my primary is focused on is keeping my weight steady for awhile - I drop 10 lbs in a couple of days if I don't force myself to eat.

I really am trying to find anyone who has had a similar experience after surgery. I have no idea how long to expect this to continue & am hoping to find someone who got better.

My GI thinks it's too much bile but the Colestid and the Cholestyramine did nothing so I am not sure. I think it's Gastric Emptying Syndrome because everything just goes right out the other end.

Anyways thanks for the welcome and the wishes. I am glad I found this board!

Meg

iVillage Member
Registered: 08-08-2006
Tue, 08-08-2006 - 2:54am
Let me start off by saying I am so happy I found this board. I am 22 years old and I had my gall bladder removed when I was 18 and I have been having the same problems as you. After my gall bladder was removed I had a bile leak which was correct and I thought maybe that was the cause of my problem. I have been to several doctors and tried countless medicines everything from perscription powders to herbal remedies nothing seemed to help. Doctors kept giving me a strict diet and did not seem to understand that no matter if I ate fruit or greasy pizza it happened. I tried anti-diarrhea medicines and that caused a pain in my upper right side that felt exactly like gall stones. I wanted to let you know that time does help! At first I was like you and could not go out with friends or on dates because I had to run to the bathroom within 10 minutes of eating ANYTHING! In the past year in has gotten better far from how I was before surgery but its not wrecking my life anymore. My major change in diet was reducing carbs and increasing protein. Whenever I have to use the bathroom it is still diarrhea but atleast its not within 10 minutes of consumption. I also eat very slowly. I find by doing this it buys me a lot more time before I have to use the bathroom. All in all my best advice is give it time because it does become something you can live with and adjust to.
iVillage Member
Registered: 03-04-2005
Wed, 08-09-2006 - 8:07am

I'm glad you found us and are sharing your personal experience too. Sometimes knowing that others have dealt with a similar issues helps the most. Like you, it took me a while to adjust to what I could eat and I think we all adjust and figure out a 'pattern' that works for us.


I do know some folks never have a problem and go right back to eating the same way they were before GB removal, but most have to find a few adjustments and then are able to live a pretty normal life. I had IBS issues before surgery and they really haven't changed all that much afterwards.


Please visit often and share what works for you!

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iVillage Member
Registered: 04-14-2003
Fri, 08-11-2006 - 12:08pm

Bile salts diarrhea is what you may be suffering from. And you may say you had this before you gall bladder was removed but who is to say the gall bladder was not working for some time before you found out. I have been able to control this with calcium carbonate taken with my meals for over 8 years and like you I almost could not leave the house and suffered for almost 20 years. Just email me and I can send you the info or I might have alread did so. Do not pass this off as it could not work because it really does.

Linda

iVillage Member
Registered: 08-11-2006
Fri, 08-11-2006 - 1:55pm
After gallbladder surgery I also got chronic diarrhea, right now I am taking levbid and evavil. It helps most days, I was like you with not leaving the house because I went 20-30 times a day. Hope this helps, it has caused alot of depression in my life.
iVillage Member
Registered: 03-04-2005
Fri, 08-11-2006 - 3:47pm

Thanks for offering to help Linda. Would you mind posting what helps you here, so that we can all see what it is? Maybe others will benefit too, plus your email isn't set up to allow anyone to send a message to you.

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iVillage Member
Registered: 04-14-2003
Fri, 08-18-2006 - 2:05pm

Here is the calcium information. I know it is a lot to take in but it may be will worth it to see if this simple solution can offer you the relief it has me and many others. You need to follow it as close as you can to get the best results. I know it sound too simple to work but it really does help a lot.

This is what has helped me for more than 8 years with almost daily attacks of urgent diarrhea after having my Gall Bladder removed. Calcium is known to be constipating so if you are that IBS type do not take it. All calcium is not the same. Here is the what and how to take the calcium information if you suffer from diarrhea.

Calcium is an OTC supplement we all do not usually get enough of. No Rx is needed to purchase this.

When you take calcium about 40% of the dose gets to the bones the rest is eliminated in our waste. The calcium goes to the intestines and soaks up excess fluids and binds them together and they are gotten rid of in our waste.

This is a process that can be continued by taking the calcium carbonate on a daily basis thus giving a more formed BM.

There is calcium carbonate which helps us with diarrhea and there is calcium citrate which is more easily absorbed by the body and gets to the bones but is not as helpful in controlling diarrhea.

A lot of the calcium supplements contain a 2 to 1 ratio of calcium to magnesium. Magnesium is not helpful for us with diarrhea only causing more in most cases. So, do not purchase this combination. It will only make things worse. Also if you are taking a multi vitamin with magnesium this may be a source of some of the problem if you are having diarrhea. Also for me vitamin A, C, and E seemed to cause me stomach upset. If you check this out your will see they too can cause diarrhea. It is better not to take a multi vitamin while trying to get the calcium to help.

The dose to take is different for everyone. I must take 3 a day one at each meal and it does not make a difference if I take it before during or after just take it regularly. Taking them at least 4 or 5 hours apart is also necessary so the calcium has time to go through the system and soak up excess bile and water. Sometimes, because of the long number of hours between dinner and breakfast it may be necessary to adjust your timing to taking one at bedtime with a small snack to get better results if you are a person who usually suffers from diarrhea in the mornings. I think the way it works is the dose you take prior helps with the current meal and the distress it may cause.

The most success has come from using any formula of calcium supplement that is like Caltrate 600 Plus with Vitamin D and Minerals in the purple and white box. This information is from the many users that have sent me emails and of the posters on the web sites I have dealt with. I hope this will help anyone wishing to try it and I am always here to answer any questions for you. I have a lot of feed back form many users.

You must also have some testing done to be sure you are not dealing with anything more serious. This is most important.
There are other things to consider. If you take any other meds check the side effects and also check with the Doctor or Pharmacist to see if taking calcium will interfere with your other medications and how you might take them. I know if you take thyroid meds it is important not to take the calcium at the same time but you can take the thyroid meds one hour before you take calcium or 4 hours after taking the calcium. The calcium will soak up the thyroid medication and you will not be getting the benefit from it. You should also look at the side effects of any other meds you may be on this can contribute to the success or failure of using calcium to help to control your diarrhea. You may also consider if you are constipated and taking calcium this may be the reason for your constipation. You can most likely switch to another form of calcium to relieve this also.

The only side effect is at the beginning of taking the calcium, you may have some gas or indigestion but this usually goes away soon after taking a regular dose for a few days as your body adjusts to the added calcium. For most it is about 3 days and it is important to start with the lower dose so you don't have the added distress and think the calcium is not helping but making you worse.

Starting with 1/2 tablet doses with each meal will lessen this problem and it may be enough to control the diarrhea attacks without making you constipated.

Constipation can be a problem so be careful not to take too much. It is safe for most of us to take 1800 mg a day as long as your body processes calcium correctly and you do not have some underlying problem. Check with your Doctor.

I had my gall bladder removed in 1976 and from that time on I had suffered urgent attacks of diarrhea. It is now known to me that is called Bile Salts Diarrhea. This happens to a good percent of people who have had their Gall Bladder Removed. I Went through a lot of test but nothing else could be found. I took many of the meds for bowel spasms and cramps over the years but nothing ever seemed to help. I started to take a calcium supplement to help prevent bone loss in later years and from the first day I felt relief. I was pretty much a prisoner to the bathroom or had to go without eating to be able to leave the house.

I must take 1 tablet with each meal and the diarrhea does not come back if I miss taking it I get diarrhea. It is a trial and error situation to find the right amount that may help you.

The way it works is the calcium carbonate it a binder and when you take it only about 40% of the calcium gets to the bones and the rest is gotten rid of in our waste. During that process it gets to the intestines and soaks up excess bile and water and helps give a more solid BM. Now that you have no gall bladder the bile fluid goes directly into the intestines and causes irritation and diarrhea. That burning yellowish color that you may see is the bile. The calcium carbonate soaks this up and no more diarrhea. It works great for a lot of us and you just have to take the calcium regularly and do not miss.

I started with Caltrate 600 Plus with vitamin D and minerals and it does seem to make a difference in the ingredients of calcium... This one seems to do the best job for most. You can buy other store brands of calcium with the same ingredients that work just as well but they need to have the same ingredients. I get Member's Mark Brand from Sam's Club you get 300 tablets for 8.99. I know Walgreens has their brand with the same ingredients and if you live in the UK Boots has been reported to have something similar. Let me know if you need more help. You won't be sorry if you try it.

I suggest starting with 1/2 tablet with each meal at first this may be enough to control the diarrhea if not in a few days up the dose to 1 tablet with each meal or any combination there of. The side effect is constipation so if you feel it coming on just stop taking it until you have a BM then start back on a lower dose. It is important to use a calcium that is as much alike as the Caltrate brand from the feedback I have gotten.

Let me list the ingredients:

Vitamin D 200 IU (The sunshine vitamin needed to help the body absorb calcium)

Calcium 500 or 600 MG (This should be calcium carbonate form) (Calcium is the most abundant mineral in the body. It is essential for maintaining strong bones and teeth. Calcium is vital to muscle and nerve function, blood clotting and metabolism.)

Magnesium 40 MG (No more than this amount because magnesium will cause you to have diarrhea but because calcium is constipating the magnesium helps to counter act that effect) (Magnesium is essential to build bones and is needed for muscle function, energy metabolism, trans-mission of nerve impulses and to make genetic material and protein.)

Zinc 7.5 MG (Zinc is necessary for some metabolic processes, normal growth and sexual development, and proper immune system functions.)

Copper 1 MG (Copper promotes iron absorption and is essential to red blood cells, connective tissue, fibers and skin pigmentation.)

Manganese 1.8 MG (Maganese plays an important role in metabolism and is also needed to build bones and tendons.)

Boron 250 MCG. (Improves calcium and magnesium retention. Similar improvements can also be seen in Vitamin D deficient post menopausal females.)

There are other brands with the same ingredients so get something as close as you can. Then start with 1/2 tablet with each meal and in a few days if this is not enough to control your diarrhea then up the dose to 1 tablet with each meal. If you feel you are becoming constipated then cut back on the dose. You may have to stop the calcium completely then start back after you have a BM at a lower dose.

It has been working since the first day I started taking it July 1998 and as long as I take 3 a day (this is the amount I must take it may be different for you) I remain diarrhea free. No cramps, bloating or diarrhea. No stomach noises, gas or pain. If I should happen to have a case of diarrhea for who knows what reason it is very short lived and not the pain involved like before and this I am sure happens to even normal people. It is usually a one shot deal and it is over.

The dose you take with each meal is not the dose that is helping you at that meal it is the prior ones that have time to works their way through you system to soak up excess bile and water in the intestines.

It also works for those of you who still have the gall bladder.

Take Care,

Linda

LNAPENTS@netscape.net

iVillage Member
Registered: 07-25-2004
Fri, 08-18-2006 - 11:24pm

Hi Linda,

iVillage Member
Registered: 04-14-2003
Sat, 08-19-2006 - 9:58am

It seems logical to put a person with kidney stones on a low calcium diet, but that actually encourages more stone formation. As calcium levels drop, oxalate levels rise, and high oxalate concentration in the urine promotes stone formation. Sometimes doctors tell their patients to avoid foods like chocolate, nuts beets, rhubarb, spinach strawberries and wheat bran the foods that are high in oxalates.

Drinking water is important for stone prevention just sip water throughout the day.

Linda

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