Gallbladder and Pregnancy

The other night I had a gallbladder attack.  A rather bad one.  For anyone who has not had a gallbladder attack, the bad ones are easily more painful than childbirth.  I say this having given birth to my first child with no pain medication what-so-ever.  I did not go to the hospital, mainly because there’s not much they can do besides say, “yep, you’re having a gallbladder attack”.  Also, there’s a good chance that by the time anyone actually sees you, your attack will be over.  I’ve had gallbladder attacks before.  I had problems from about 38 weeks into my last pregnancy, until 8 months postpartum.  Some of the attacks are tolerable.  Some, like the one I had the other night, make you wish you were dead.  So why haven’t I had my gallbladder removed?

Well, I didn’t have it done after my last pregnancy because I wanted to try to get it under control with diet.  So I cut out foods that were high in cholesterol or saturated fats.  I increased fiber and vitamin C.  I stopped eating large meals right before bed.  I tried to drink more water.  It worked, slowly.  In the first 6weeks postpartum, I had an attack once or twice a week.  It was at my 6 week appointment when I was told about trying to control gallbladder issues using diet.  I saw an immediate change, and had only 3 attacks in the next 4 months, and finally, a mild attack in October.  That was it until just recently.

Part of the reason I’m now having issues again is hormones.  Estrogen slows the action of the gallbladder and it operates less efficiently.  This is why women are more likely than men to have issues with their gall bladder.  Being pregnant puts you at higher risk for gallbladder issues, as does, ironically, hormonal birth-control.  I guess because both screw with your natural hormone balance.  The other reason I’m having issues is because I stopped watching my diet after several months of having no attacks.  The attack I had recently followed me gorging on chinese food late at night.  So it’s back to my pre-established diet.  I won’t be giving up much, and it’s worth it to avoid the surgery.

I don’t want to have surgery now because of the risk of pre-term labor.  Sure, I’m far enough along that the baby would probably survive, but I’d rather go through a dozen more attacks than put my baby at risk.  Even if he does survive, what sort of complications would he have from being born pre-term?  Even if I don’t go into pre-term labor, what sort of side effects might come about from the anesthesia and post surgery pain medication?  As painful as the attacks are, the pain is not permanent.  So I will not risk surgery during pregnancy unless it’s a situation where my gallbladder is about to burst.

I will also, attempt to avoid surgery postpartum.  I’ve already proved that I can get it under control with diet, I don’t want to jeopardize breastfeeding, and I don’t want the risk of long term side effects that come with the surgery.  Up to 20% develop chronic diarrhea.   5%-40% develop PCS(post cholecystectomy syndrome), persistent pain in the upper abdomen.  There is a chance of injury to the common bile duct which can cause bile to leak into your abdomen and requires additional surgery to fix.  Then of course, as with any surgery, there is risk of infection and blood clots.  It’s just too much.  I mean, really, 20% chance that I have diarrhea for the rest of my life?  I’m only 23.  That’s a really long time to have diarrhea.  Significant chance that I have permanent pain in my abdomen?  Isn’t that why I’m getting the surgery, to get rid of the pain?  So yes, if I can manage to control this using just my diet, I will.

There’s a good chance that I will have more attacks during this pregnancy because of how great a roll hormones can play, as well as the fact that my expanding uterus is putting extra pressure on my gallbladder.  I hope, however, that if I’m careful I can make it without another attack.

Gallstones and Pregnancy
What Causes Gallbladder Attacks
Gall Bladder Removal Side Effects

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