A gallbladder transplant is possible

Trouble with the bile

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  • Moderator: Good evening and welcome to the chat. Tonight, the focus is on the bile and above all on what can cause it problems. I would like to welcome two recognized experts from the Dresden University Hospital: Prof. Dr. Jürgen Weitz and PD Dr. Christoph Reissfelder. Nice that you are here!
  • Moderator: Both of them will now answer your questions. Here we go!
  • Audience questions: Dr. Kugel How do I know that I might have gallstones if I don't have collics. Is there a hint, e.g. food intolerance, nausea, etc.?
  • Jürgen Weitz: First of all, the most important thing is that gallstones that do not cause any symptoms almost always do not have to be treated. There are so-called unspecific complaints that can be caused by gallstones, i.e. pressure / fullness in the right upper abdomen, food intolerance, flatulence. An ultrasound examination can make the diagnosis here.
  • Audience questions: Uwe Steinberg: When can an infection of the abdomen, inflammation of the pancreas or chronic liver damage occur?
  • Jürgen Weitz: Infection of the abdomen: In the case of severe gallbladder inflammation or a rupture of the gallbladder. Inflammation of the pancreas: When a gallstone comes off the gallbladder and gets stuck in the main bile duct in front of the pancreatic duct. Chronic liver damage: Gallstones are very unlikely to cause such a problem.
  • Audience questions: Hansi: What is the advantage of having a gallbladder when you can live without it?
  • Christoph Reissfelder: The gall bladder is the storage organ of the bile. The bile helps, among other things, to digest the fat in food. If the food is particularly high in fat, it helps to be able to shed a lot of bile all at once, so that digestion is easier.
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  • Nick: Can you get stones again without a gallbladder?
  • Christoph Reissfelder: You can also get stones in the bile ducts, but this is rare.
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  • Audience questions: Gini83: What is artificial bile acid made of and what is it used for?
  • Jürgen Weitz: The so-called artificial bile acid consists of ursodeoxycholic acid, which is used in certain diseases to improve the flow of bile from the liver
  • Audience questions: Brigitte (54): Can you notice that you have gallstones even without a diagnostic procedure?
  • Christoph Reissfelder: One can assume it, but it can only be proven with certainty with an ultrasound examination or a computed tomography / nuclear spinning. The symptoms are classically pain in the right upper abdomen that is coliform.
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  • Spectator questions: My mother had an endoscopic gallbladder operation 13 years ago. At that time the gallbladder was extremely inflamed. At intervals she has pain and gallstones form even though the bile has been removed. She then has to go to the hospital and the gallstones are removed using an ERCP. How can it all be like that? Can you do anything there?
  • Jürgen Weitz: It is essential to examine whether there is a narrowing of the biliary tract (should actually be able to be found out with the ERCP), there are also other diseases that can be associated with increased formation of stones in the biliary tract, ie please go to a gastroenterologist to have them Diseases are excluded.
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  • Katy: I still have colic after removing the gallbladder. What can I do against it??
  • Jürgen Weitz: There may still be symptoms after the gallbladder has been removed, i.e. other causes of colic (e.g. kidney stone) or pain (e.g. stomach) must be ruled out. You also have to clarify whether there are still gallstones in the main bile duct (ultrasound, MRCP or ERCP if necessary).
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  • Audience questions: Uwe Steinberg: When can cancer develop in the gallbladder? Why is gallbladder cancer usually discovered very late? How many years can the patient still live after the discovery of this cancer?
  • Christoph Reissfelder: That is why gallbladder cancer is usually discovered very late because it does not cause any symptoms for a long time. It can therefore grow without the person concerned noticing. Survival always depends on whether the tumor was discovered early and can be operated on or not. This is very different from person to person
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  • peter b: Hello dear doctors. I was recently diagnosed with several polyps over 2.5cm in size in the bile during an ultrasound. Now I have been advised to have the bile removed by surgery as a precautionary measure. Should that really be done. Thanks in advance for your answer.
  • Jürgen Weitz: Yes, absolutely, polyps should be removed from a size of 1 cm, as there is a certain risk of developing a malignant disease.
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  • katze: I had a biliary operation a few years ago. Since then, I've always had problems when I eat very fat things. Is that due to the non-existent hall?
  • Jürgen Weitz: That can actually be the case, actually there are no symptoms after the gallbladder has been removed. But: There are patients who have problems with very high-fat meals, so you have to adjust to the food intake. If in doubt, please go to a gastroenterologist so that other causes can be ruled out.
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  • firebird: Good evening :-) My partner, 22 is very overweight, complains from time to time of pain in the liver, since his liver values ​​are okay, but a fatty liver was detected in the ultrasound, I suspect that his bile is causing problems. ..or is it the liver liver that only causes pain?
  • Christoph Reissfelder: The liver rarely causes pain. Most often there are gallstones that are causing the discomfort. An ultrasound scan should bring clarity.
  • frank: My LDL cholesterol is very high, I had CA. Cholecystectomy for 20 years. Now I have read that the increased blood fats are related to the so-called postcholecystectomy syndrome. What can you recommend to lower cholesterol?
  • Jürgen Weitz: You should go to your family doctor so that he can look at the values. In case of doubt, we recommend taking so-called lipid-lowering drugs.
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  • Otaku1982: Can stones also arise in the bile ducts of the liver? How are these treated?
  • Jürgen Weitz: Yes, stones can develop in the bile ducts. If there are problems, try to remove them using the ERCP (endoscopic method).
  • Katy: Can you use medication except e.g. Take something else with buscopan for acute colic?
  • Jürgen Weitz: Yes, there is the option of taking other painkillers.
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  • marty: I'm 42 years old and haven't had a gallbladder since 1994. After about 7 years came the not entirely unusual symptoms such as frequent diarrhea, etc. Recently, sometimes pain under the costal arch with inconspicuous ultrasound. But do remind me of mild biliary complaints. I have now read that artichoke products could help? Do you also advise?
  • Jürgen Weitz: I would just try that out and see if it works. Please go to a doctor once, at least an ultrasound of the abdomen, in order to rule out other causes.
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  • Otaku1982: How fast do stones grow and how long does the crystallization process take?
  • Jürgen Weitz: That is a very interesting question that I cannot answer for you. That is certainly different for every patient / situation. Probably also depends on the type of gallstone.
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  • Otaku1982: Can you smash stones with sound impulses similar to kidney stones?
  • Jürgen Weitz: Yes, you can. However, this method has largely been abandoned, as this method is associated with many other problems.
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  • Moderator: I would like to introduce our two experts to everyone who has joined the chat in the meantime: Prof. Dr. Jürgen Weitz is the director of the Clinic and Polyclinic for Visceral, Thoracic and Vascular Surgery, which is part of the University Clinic of the Technical University of Dresden. PD Dr. Christoph Reissfelder is a senior physician at the same clinic.
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  • Brit: I had my gallbladder removed last year because it was chronically inflamed and I had 4 small stones, this was found during an ultrasound examination. But I had no complaints, no colic or the like, but I was plagued by severe back pain that disappeared after the operation. Since the operation I have had digestive problems, often stomach pain after eating and I very often suddenly get diarrhea without eating beforehand, which often looks yellowish.
  • Jürgen Weitz: I have to ask you to go to a gastroenterologist and get a check-up.
  • marcella: Hello, I have several gallstones, but so far they are symptom-free. Should I still have the GB removed to avoid the risk of biliary cancer? Or is there no connection between gallstones and biliary carcinoma? And one more question: Can the so-called Apple juice and olive oil cure, which is touted on the internet, remove gallstones from drainage? Thank you.
  • Christoph Reissfelder: In the case of symptom-free cholecystolithiasis (gall bladder stones), there is no indication for an operation. There is a connection between stone and cancer, but only with very large stones. The regimen you mentioned can indeed drain gallstones, but it also carries some risks. On the one hand, small stones can "get stuck" in the bile duct, which can lead to severe inflammation.
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  • Peti 65: I have severe reflux problems 2-3 times a year, some of which last for 2 weeks. I also have gallstones, which can trigger my reflux problems.
  • Christoph Reissfelder: The gallbladder / gallstones do not cause reflux symptoms.
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  • Mandy: Hello, I have a daughter, she is nine years old. She has been complaining of inexplicable abdominal pain for two years. Had two times ultrasound done, with the emphasis that her papa had already been operated on the bile when he was fourteen. Nothing was found both times. About 5 weeks ago we had terrible days and nights, couldn't find any rest, no sleep. Two days later it looked all yellow. Should we have an operation? Or is she too young?
  • Jürgen Weitz: No, your daughter is not too young for an operation. BUT: It must first be found out what the cause of the complaints is.
  • yvi: What does. The gelatinous wall is chronically inflamed. So it is for me this month. To be operated on
  • Christoph Reissfelder: That means that the wall already has a different structure due to multiple inflammations. The gallbladder can no longer contract properly and no longer functions. It only causes discomfort.
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  • nici: Hello dear doctors, I think that I have problems with the bile, I can no longer eat a hard egg, no salad, quark, cream, I immediately get a stomach ache right into the back, that goes on for half the night, Has already been to the doctor, have no gallstones, but the pancreas is always inflamed, can it be that I have too few gallstones? What can I do there, how can I get hold of the pain so that it doesn't go for hours. LG nicol
  • Jürgen Weitz: You should go to a gastroenterologist, you have to take a closer look at this region of the bile ducts / pancreas (e.g. with a so-called endosonography = Schuckecho).
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  • birgit1705: Hello, I have a gallstone and have already had pain from it .... but there were no inflammation values, etc. I suffer from a sluggish bowel and have to take the drug Resolor every day so that my digestion works. In addition, I often have a bloated stomach; would a gallbladder removal be a solution, or could the problems come from the stone?
  • Jürgen Weitz: Unfortunately, that cannot be predicted and certainly no guarantee can be given. It may be that after the gallbladder removal, at least the pain and possibly the flatulence will improve, but that is not certain.
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  • hummelchen: Hall, I had my son in November 2004. Five months later I was limp, tired and suddenly all yellow. I had a great family doctor who immediately said stop breastfeeding and go to the kh. I had gallstones in the ducts that were surgically removed and a bad inflammation of the pancreas. Later the gallbladder was also removed. Unfortunately, even now I can't drink coffee or eat certain foods. Is that normal?
  • Jürgen Weitz: Yes, unfortunately it happens that such complaints occur after a gallbladder removal, but I would recommend that you have the bile ducts examined to make sure that the bile ducts are not narrow.
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  • moni62: In 1988, at the age of 25, my bile was removed with an incision in my stomach, from which I still have a long scar. Since then I have had colic again and again, often after certain foods. I also had another x-ray a few years ago, but nothing was found. What could that be? Where does the colic always come from?
  • Christoph Reissfelder: Colic can be triggered, for example, by particularly fatty foods. Therefore, it makes sense to know the foods that cause these ailments. An X-ray is usually not the ideal way to detect stones in the gallbladder or bile ducts. An ultrasound scan should be done first. If nothing is seen, an X-ray examination of the bile ducts (ERCP) can also be carried out.
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  • Ulrike: Had a Gallen Op. I've had urination problems for a week now, but urine is fine. I didn't have a cat at the Op. Is that normal?
  • Jürgen Weitz: No, that is not normal, have you already been to the urologist?
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  • Susann: Good evening, I had a gallbladder removal in 2007 and a stone was also removed. About 4 weeks after the operation I started the following problem. I had diarrhea that continued until 2011 and some of it is still there today.
  • Jürgen Weitz: Yes, unfortunately, diarrhea occurs very rarely after the gallbladder has been removed. Please observe carefully whether this occurs with certain foods.
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  • Otaku1982: When you talk about inflammation of the gallbladder, do you mean a bacterial infection?
  • Christoph Reissfelder: Usually not. Most of the time, the stimulus is not caused by bacteria but by the stones. However, bacterial inflammation can also occur.
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  • yvi: What should you do with. Gallbladder infection and do not eat to avoid pain
  • Jürgen Weitz: Yes, with an acute gallbladder inflammation you try to "protect" the gallbladder by not eating. Otherwise, pain medication and, if the inflammation is severe, surgery or antibiotics.
  • Nothi: Can Diabetis2 develop after the operation?
  • Jürgen Weitz: I am not aware that DM type 2 is related to the removal of the gallbladder.
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  • birgit1705: is milk thistle good for gallstones?
  • Jürgen Weitz: I can't tell you that, usually things like dandelion salad, grapefruit and chicory are recommended. A low-fat diet is also good.
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  • Claudia EC135: Can recurring abdominal pain also have something to do with it? So could a biliary problem also be the cause?
  • Jürgen Weitz: Yes
  • Katy: You should avoid excessive consumption of protein if you no longer have a gallbladder !!
  • Christoph Reissfelder: In general, you should pay attention to a balanced diet.
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  • ellen: Good evening, is it possible that after an untreated biliary colic, the ferittin level in the blood increases significantly?
  • Christoph Reissfelder: Yes, that is a sign of a severe infection
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  • Susann: I often suddenly have diarrhea without eating beforehand, which often looks yellowish. According to the test, I excrete 3 to 4 times the amount of bile acid. Is that a bile acid loss syndrome? what helps there?
  • Jürgen Weitz: The problem is that the bile acid in the colon leads to diarrhea. This is a very special problem and I have to ask you to see a gastroenterologist.
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  • Maria: The doctor discovered a polyp in the bile duct. I have pain every now and then. What can you do with biliary polyps, surgery? Do people with biliary problems have slightly yellow or brown complexions, especially around the eyes? thanks
  • Christoph Reissfelder: Polyps can degenerate in the further course, so the gall bladder should be removed from a size of 1 cm. Yellow complexion, especially in the eyes, together with dark urine is a sign that the bile is no longer draining properly and bilirubin (a breakdown product in the bile) is building up. If you experience these symptoms, you should definitely see a doctor.
  • Mandy: Various examinations have already been made, the blood examined for cell division and and, and. Unfortunately nobody can tell us why. The doctors said she should thank her papa, that was probably inherited.
  • Jürgen Weitz: Mandy, have you ever been to a children's gastroenterologist with your child, that sounds like a special problem that you have to (and can) get to the bottom of.
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  • Martina: Good evening, 8 years ago I had a gallbladder removal. Despite a balanced diet, I always have very light brown stools, regular and normal to slightly mushy consistency. Can the missing gallbladder be to blame? The liver values ​​are also always slightly elevated and are checked regularly. THANKS !
  • Jürgen Weitz: Yes, in rare cases there is a change in bowel movements after a gallbladder removal.
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  • marcella: One more question: I have gallstones (without symptoms), but often an extremely uncomfortable feeling of fullness that lasts for hours after meals that are not so lavish at all. Then take ranitidine. Can my gallstones also trigger this bloating feeling? Thank you.
  • Jürgen Weitz: Yes, that can be good, removing the gallbladder can help, but unfortunately that is not guaranteed.
  • Moderator: Don't get impatient if you don't get an answer to your question right away: Prof Weitz and Dr. Tear fields each have a whole pile in front of them and work through one question after the other.
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  • Andre: Why is bile removal preferred by doctors to treatment with ursodeoxycholic acid, although it has been stated that the stones were formed as a result of radical weight loss.
  • Christoph Reissfelder: If there are gallstones, the gallbladder wall does not move properly over time. You can try to dissolve the stones with ursodeoxycholic acid, but they often form again.
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  • sascha: please: what was the name of the muscle (in the program) that was severed in the patient because she continued to have collics after the cholecystectomy? What do you think of this, Doctor, and how is it diagnosed? Many Thanks.
  • Jürgen Weitz: This is the sphincter muscle at the end of the bile duct, the so-called sphincter Oddi muscle. The gastroenterologist makes the diagnosis by measuring the pressure.
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  • frank: How useful are artichoke preparations to compensate for the missing gallbladder in symptoms such as flatulence
  • Christoph Reissfelder: Artichoke supplements help digest fats. So it makes sense to try them out.
  • Brit: The ultrasound was performed again, but the examination had to be stopped because it was very painful on the left side. Then a colonoscopy and a gastroscopy were performed without any findings. I still have my complaints, especially the sudden diarrhea that worries me because it occurs suddenly and I have to go to the toilet as soon as possible. When I'm on the bus for a long time, I don't eat anything beforehand because I'm afraid that it will occur there.
  • Jürgen Weitz: As I said, please have a gastroenterologist take a closer look, not possible from a distance, all the best!
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  • Mandy B .: Why can I no longer tolerate cucumber, paprika, fried onions and fried sausages after a gall op?
  • Christoph Reissfelder: Fat-rich food is usually worse tolerated after a gallbladder operation. The same goes for spicy food for some people.
  • Nicky: Hello! My mother (68 years old) has diarrhea, liquid pale yellow stools, mainly in the morning, and she feels nauseous. The stool test did not show anything conspicuous. Could it be the bile? Why does it only happen in the morning?
  • Jürgen Weitz: It is rather unlikely that these complaints are due to the bile, please go to a gastroenterologist to try to find out the cause of this problem.
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  • Otaku1982: Why can stones reach a certain size at all that they no longer fit through the exit into the intestine? The bladder is emptied regularly during digestion, but small stones would be eliminated with it, right?
  • Jürgen Weitz: A clever question, it is exactly the case that many tiny stones are probably excreted with the bile fluid. But: The gall bladder does not always empty completely, then the stones remain.
  • Joo: I had my gallbladder removed last year in August, since the gallbladder removal I have had high liver values, the liver values ​​are sometimes over 1000 10 times as high as normal. an endosonography has already been done twice, once at the MRZP the MRZP did not reveal anything except that there are natural adhesions in the bile duct. An MRI also gave no results. Now my doctor wants to do a liver puncture. But since I am a kidney transplant, I am taking immunosuppressants
  • Christoph Reissfelder: Since you have had a transplant, the cause is difficult from a distance. The drugs you are taking for immunosuppression may cause this. Please contact the special outpatient department of the transplant clinic. They can certainly help you
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  • reinhard: Note: great show, but the cook belongs in a children's show
  • Moderator: Hello reinhard, thank you very much. I pass both praise and criticism on to the editorial staff.
  • Iris: Hello everyone, I was discovered to have a small biliary polyp that should be observed annually. Can this polyp develop back again? Can I do something to prevent it from increasing? Thank you for an answer.
  • Jürgen Weitz: If the polyp is less than 1 cm, just wait, a real polyp does not regress, but there are sometimes accumulations of cholesterol that look like a polyp and can regress. Actually, you can't do anything actively, only regular control and surgery if more than 1 cm.
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  • yvi 74: What should you avoid in food with a gelatinous inflammation in order to avoid pain?
  • Jürgen Weitz: If there is an acute inflammation, it is advisable not to eat anything, otherwise low-fat.
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  • Susann: I went to the gastrologist ... despite having diarrhea, I gained 20 kilos over the course of time. That's why I'm always put off by the words take off, then everything will be fine. But I just can't get it under control and don't know what to do next.
  • Jürgen Weitz: Susann, please go to another gastroenterologist (e.g. at a university clinic or a large hospital), there is often something that can still be done.
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  • Susi: Good evening, my mother's gall bladder was removed endoscopically 13 years ago ... THE GALL BLADDER WAS EXTREMELY INFLAMMED .... She always gets cramps and pain at intervals and gallstones still form, which you can get out with an ERCP ... How can that be ... She also has a lot of diarrhea .. I would be grateful for an answer .. My mother is 87 years old
  • Jürgen Weitz: It is essential to examine whether there is a narrowing of the biliary tract (should actually be able to be found out with the ERCP), there are also other diseases that can be associated with increased formation of stones in the biliary tract, ie please go to a gastroenterologist to have them Diseases are excluded.
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  • Gerd 63: I still have all organs, but often diarrhea after eating fatty foods. Do I have a biliary problem?
  • Jürgen Weitz: It could be natural, but it could also be a problem with the pancreas (hypofunction).
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  • Karin: Findings: shrink gallbladder, no lumen, gallbladder stone with other cholecystitis and no indication of biliary obstruction, complaints: none. Does that have to be operated on?
  • Christoph Reissfelder: You seem to have an inflammation (that means cholecystitis). This allows you to remove the gallbladder. But that is not urgent
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  • yvi: What should you avoid in jelly-like foods? inflammation
  • Christoph Reissfelder: High fat foods should be avoided. Foods with bitter substances, on the other hand, make sense like the recipe that was presented in the program.
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  • Mandy: Yes I was. The blood was examined, sonographed twice and she also went to the MRCT. Still, nobody can explain to me where it comes from. I was only told that she has a lot of stones, the gallbladder is full of them and the corridors are widened and Sina should be operated on urgently. We already have an appointment. As a mom, I'm just afraid that I'll make the right decision with the surgery. After the colic, she also had bad blood values ​​in the liver.
  • Jürgen Weitz: Well, if your daughter has stones then she should be operated on. However, it is important to take a close look at the MRCP; sometimes the cause is a congenital change in the biliary tract that can be seen. In addition, one should exclude diseases that lead to a faster breakdown of the red blood cells.
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  • Nicky: Low fat doesn't mean frying, just boiling / steaming? How good are fennel tea, alkaline diets for gallbladder problems?
  • Jürgen Weitz: It is different for every person and you should try it out.
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  • Liane: Hello, to what extent can you stimulate liver activity with dandelions, daisies and chicory, e.g. as a tea preparation or in a smothie, and do you have to do this regularly? I take MTX and rituximab, which put a strain on the liver. Can the drugs cause gallstones?
  • Christoph Reissfelder: The plants you have listed contain a lot of bitter substances and are good for the bile. The drugs mentioned usually do not cause gallstones, although there have been some case reports
  • Moderator: We still have time. Boldly ask your questions!
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  • Uschi: Hello, can meteorism be related to the bile or liver function? thanks
  • Jürgen Weitz: Yes, meteorism can actually be related to bile, but it doesn't have to be.
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  • Otaku1982: Can drugs also promote gallstones?
  • Jürgen Weitz: Yes, there are certain medications that have gallstones as a side effect.
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  • mela123: Hello, I often only excrete small, greasy puddles (can't describe it better :-). Can this be due to the bile?
  • Christoph Reissfelder: Yes, digestion may not go optimally. This could be due to the bile or the pancreas. You should discuss this with a gastroenterologist.
  • marcella: From which stone size in the case of unsymptomatic gallstones should Deie GB still be removed? thanks
  • Jürgen Weitz: According to the guidelines, you can talk about it from a height of 3 cm, because then the risk of cancer increases. But this is only a "can" recommendation.
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  • Moderator: Dear Werner, I will pass your information on to the editorial staff. Warm greetings to Bregenz!
  • erika: Hello, I suffer from constipation and constipation. Does the bile possibly also play a role?
  • Christoph Reissfelder: normally not. If the bile intake is inadequate, one usually has diarrhea
  • Nicky: Can you ask a doctor for a pressure measurement of the Sphincter Oddi muscle if you have colic in this area, or do you need special indications for this?
  • Jürgen Weitz: The pressure measurement of the M. Sphincter Oddi is always at the end of a lengthy diagnostic investigation; i.e. the gastroenterologist starts with the "usual" examinations, only when nothing comes of the more complex methods are used.
  • Maria: What causes the development of biliary polyps?
  • Christoph Reissfelder: Most of them arise randomly, similar to polyps in the intestine
  • Uschi: If meteorism has to do with bile, does that mean that too little bile juices are produced or passed on into the intestine? Or what can be the biliary-related cause of air in the abdomen?
  • Jürgen Weitz: The interaction of the various digestive functions then works more optimally. But there are also extremely many different causes for meteorism, so please see a gastroenterologist.
  • Nicky: Thank you very much!
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  • Lämmerle: Hello, I once heard that you can flush out gallbladder semolina by drinking a certain liquid? Is that correct? If so, I would like to know what to drink there.
  • Jürgen Weitz: I haven't heard that before.
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  • Erhard: I've had colic-like pain in my right upper abdomen for 1 1/2 years. Removal of the gallbladder 20 years ago, stomach and colonoscopy without findings, CT or B. Triggers are particularly fried onions, I avoid possible stimuli such as alcohol, coffee, black tea. Occasionally have gas and bulging upper abdomen and back pain. What can be the matter?
  • Christoph Reissfelder: It makes sense to keep a "diary" of the food in order to know exactly what is causing the complaints. You may have stones in your bile ducts. You should discuss this with a gastroenterologist.
  • Uschi: My "food" often comes out undigested below, i.e. very easily recognizable. Do I then have too little bile juices?
  • Jürgen Weitz: This can also indicate a serious problem, especially the function of the pancreas (which also produces digestive juice) must be taken into account.
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  • Jane18: 20 years ago my gallbladder was removed after a severe colic. Was quiet until recently, when I got severe colic again, when it turned out that a stone had grown into the bile duct wall. After an ERCP with a stent, the wall healed again. However, I have now had another stent placed for the third time. The last time I got 2 stents and next time it should be 3. If that is normal, it is possible it also different?
  • Jürgen Weitz: The question is whether there is now a narrowing of the bile ducts, if the main bile duct is narrowed, problems will arise again and again. You can then either widen the bile duct from the inside with a balloon or you have to operate.
  • Uschi: Can you measure whether you are producing enough bile? Thanks.
  • Jürgen Weitz: You don't actually do that in the clinic, but you can measure whether the pancreas is producing enough digestive enzymes (there are stool tests).
  • mela1234: How is the pancreas examined?
  • Jürgen Weitz: There is imaging (ultrasound, CT, MRT) and blood and stool tests.
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  • Spectator questions: Anna Nordmann During a 3-week Buchinger fasting cure, I got pain in my right. Upper abdomen (gall bladder). How can I avoid this on my next treatment?
  • Christoph Reissfelder: Fasting is generally associated with an increased risk of gallstones loosening. You should have a gastroenterologist check you out to see if you have gallstones.
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  • Maria: If I drink a lot of coffee, will the skin around my eyes be affected? Is there a connection with the function of the bile?
  • Jürgen Weitz: Please say exactly again, how is the facial skin?
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  • Babsi: Good evening! I have had upper abdominal pain since last autumn, like stomach ache. Nothing was found in the gastroscopy; but gallstones on ultrasound. However, according to the doctor, they shouldn't make any complaints. The pain came back, radiating into the back. Last week it got acute, but according to the ultrasound, the bile is not the cause. Nevertheless, I was advised to have surgery. What do you advise me?
  • Christoph Reissfelder: The gall bladder can be the cause of the complaints. It is important that other causes have been ruled out. The most important differential diagnosis is, in fact, the stomach. The pancreas can also cause the symptoms. Please discuss this with your doctor.
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  • Maria: the skin around the eyes turns dark brown
  • Jürgen Weitz: I can't tell you that, biliary problems can lead to jaundice, which is where the whites of the eyes usually turn yellow first.
  • Moderator: Last chance to ask. Our chat will end soon ...
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  • Maria: OK, thank you very much
  • Mandy Z.: Thank you very much for your answers 😊 it took some of the burden off me to send our daughter to the operating room. I hope a cause will be found.
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  • erika: If I don't take my Movicol, my stool is rock-hard. Should I also do a stool test. Can the Movicol's potassium level be increased?
  • Jürgen Weitz: To the best of my knowledge, Movicol does not affect electrolytes, but: Any change in bowel movements can also affect electrolytes.
  • Jürgen Weitz: Mandy Z: You are welcome to send me the MRCP images on CD, then I will look at it just to make sure that the anatomy is normal.
  • mela1234: What is "fat stool"?
  • Christoph Reissfelder: when "greasy eyes" float when defecating
  • Uschi: I've read that if you regularly use bitter substances, medical shock preparations, etc. takes, the in-house production of the bile becomes "lazy" and is "reduced" more and more. Right?
  • Jürgen Weitz: I haven't heard that yet and I can't really believe it either, the bile production takes place in the liver. If that doesn't work anymore, you get jaundice.
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  • Juliane: I have the bile acid loss syndrome after surgical treatment of an ileus. I have been taking around 6g of cholestyramine a day for 7 years. Are there any long-term risks from this?
  • Jürgen Weitz: You have to make sure that the fat-soluble vitamins are not too low. It also affects the absorption of certain drugs.
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  • Mandy Z.: Unfortunately I don't have any pictures, the hospital has them.
  • Jürgen Weitz: Mandy: Just go to the hospital and ask to have a CD burned for you, that's no problem.
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  • nicole: How often should gallstones be checked by ultrasound?
  • Jürgen Weitz: If you do not cause any problems and are not very large, the stones do not have to be checked regularly (this applies to the "normal patient").
  • mela1234: That means there are grease eyes on the chair? Or are they separate? Transparent?
  • Christoph Reissfelder: the color is mostly clay-like and the chair is very sticky (sticks to the toilet bowl). The grease eyes (similar to a broth) can then be seen floating on the water in the toilet bowl
  • Moderator: Our chat is over. Thank you for taking part! I would like to especially thank Prof. Dr. Jürgen Weitz and PD Dr. Christoph Reissfelder. You have been very hardworking and I think that tonight you were able to help some with your answers. Have a nice evening and a good night to all of you.
  • Mandy Z.: Thank you, and then send it to the Dresden University Hospital?
  • Moderator: You can read this chat again shortly at www.mdr.de/hauptsache-gesund.
  • mela12345: Thank you very much and have a nice evening
  • Moderator: You will see the next program of "Hauptsache Gesund" on May 21, 2015. Then it comes to knee injuries. And of course we chat again.
  • Jürgen Weitz: Mandy: yes
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