‘What’s Up Doc’ is a health column in association with The Crawley Observer, which gives you the opportunity to ask questions regarding general health and wellbeing.
Answers are provided weekly from our specialist consultants at Spire Gatwick Park Hospital, Surrey. If it’s a long-standing illness or simply a worry which you would like to get off your mind then we would like to help.
This question appeared in The Crawley Observer on Wednesday 3 July, to readers across Surrey and Sussex. The question and answer is below, as it appeared in the newspaper.
Read the response by Mr Paras Jethwa, consultant general and laparoscopic surgeon :
Dear doctor, my gall bladder was removed well over a year ago at another hospital and recently I have been getting strange pains all over. I was told it could be excess gas and could take a year to be normal, but it is still going on. I am also noticing and feeling severe pain under my ribs, both left and right side at times. Please can you help me, I just don’t understand why this is happening? Thanks. Suzy, Horsham.
Dear Suzy, thanks for your letter. I’m very sorry to hear that you’ve had problems following your surgery last year. There are a number of fairly straight forward reasons why people go on to have issues after a seemingly straightforward procedure. First and foremost gallbladder disease can co-exist with other common conditions - most frequently gastric reflux and hiatus hernia. Sometimes the symptoms that occur from these conditions can be very difficult to distinguish between. Very rarely people can form new gallstones in their liver and those symptoms often resemble the attacks of gallbladder pain that they first came to see me with.
In your case the first thing I would recommend is an ultrasound test. This is, in the hands of one of the experts at Spire, extremely accurate and can rule out the majority of post-operative complications and, newly developed stones in your biliary system. If the scan is normal I would then proceed to an upper gastrointestinal endoscopy (OGD). This is a simple and very well tolerated outpatient procedure that looks at the oesophagus, stomach and duodenum. It will very quickly tell me if you have a hiatus hernia or other pathology (including ulcers) or evidence of gastro-oesophageal reflux disease. At the same time a small sample of tissue can be removed for analysis. This can help in diagnosing conditions such as Coeliac disease which causes bloating and gastrointestinal pain.
If you have evidence of new stones then the treatment is usually not surgical and, can they can be removed as a daycase procedure by endoscopy; likewise the management of the vast majority of reflux disease has been revolutionised by medical treatment with Proton Pump Inhibitor (PPI) treatment. If you are shown to have a large hiatus hernia or have very severe reflux then surgery can be very successful and, like you first operation, is one I perform as an overnight keyhole procedure.
I hope this helps you but feel free to contact me if you have any questions whatsoever.