Anyone have gallstones but no gallbladder? Hi protein/low carb link?

Hi

I'm 4 years post op. I lost over 90 lbs and currently are 10 pounds above my original goal.

I had my gallbladder removed 15 years ago.

About two months ago I refocused and did the 5 day pouch test and followed it to a T. It was super helpful to breaking the carb cycle I had gotten myself into. I went on to lose and keep off a total of 10 lbs. I continued with high protein and low carb.

Last month I had shoulder surgery to repair my rotator cuff and got off my eating cycle. Actually I lost my appetite and went on strong psi meds that caused nausea and constipation. Not fun. Anyway, the point of my long story was to ask you folks if you have suffered any adverse reactions due to our high protein low carb diet? I went to the ER in an ambulance twice in a week thinking I was having a heart attack. I am 44 in excellent health. My pain was sharp and I. The chest behind my breastbone. Then it became so bad I had trouble breathing. I was paralyzed with pain.
After several tests the verdict is loose gall stones. I have an MRCP scheduled for tomorrow to confirm it. My liver enzymes shot up over 600. Normal for me is like 17 and the range is under 35.

So, I did some research on low carb high protein diets and i have read they could cause liver, kidney and gall bladder/stone problems.

Have any of you experienced trouble you can tie to this type of diet? Or more uniquely do you have gall stones without having a gall bladder?

I had the vertical sleeve gastrectomy may 2007.

Thanks for reading all!

I am almost 4 years post op.  I am currently having similar issues.   I also had my gallbladder out about 14 years ago, but am having pain in my right upper abdomen.  MRI comes back normal.  My GI doctor told me, even if you have no gall bladder, you still produce bile and could have a stone in the billiarty tract.  I am being seen now to have an ERCP which they go down and look at the billiary track.  But they say it is risky because a normal person, they just take the scope straight down, I am a roux-y patient and he said they would have to go down and then back up again with a tiny camera.  And you can develop pancreatis from it.  So it is a 50-50 chance of getting to the area.  They may end of doing surgery to look at it.  My liver enzymes have been elevated for over 3 years and at one time the levels jumped up to 900 and i was hospitalized for them to get it back down, but the hospital thought it was headache medicines i was taking too many.  Anyway, that is what I am going through.  You may want to see a GI specialist and get checked for the same.  Good luck.

Thanks for your message. I'm sorry to hear about your pain. I am seeing a GI specialist and tomorrow is the MRCP, which is less invasive than the ERCP you are having. I hope they find your stones and can reach them.

Thank you for posting this.  I had my gallbladder out almost two decades ago and this is the first I heard that you can get gallstones in the ducts!!  More research to be done.  Thanks again.

Yes.  I had my gall bladder out 4 years before my RNY.  I went for bloodwork after my RNY (3-6 months out) and my PCP said my liver enzymes were high.  He was puzzled because he said it usually indicates gall bladder problems and I did not have one and I was not experiencing any pain at the time.  He scheduled a CT scan for the following Monday.  Sunday I woke up in excrutiating pain. I ended up going to the hospital where I had my RNY because I knew my bariatric surgeon had privileges there if he were needed.  It turned out I had gall stones in my bile duct which caused pancreatitis. My bariatric surgeon together with a gastro surgeon cleaned out the stones and created a larger duct to allow any other "trapped" stones to escape. I ended up in the hospital for almost a week.

I had my gallbladder out 10 years ago and gastric bypass surgery 6 years ago, last fall I had exactly what you describe a stone stuck in my bile duct.  My doctor told me that since the inception of laproscopic procedures for gallbladder surgery this is much more prevelent, that years ago when they used to open you up they would rinse out the everything before they stitched you back up and now tiny little stones can be left behind in your bile duct that grow over time.  I can tell you I don't eat high protein low carb, I eat about 60 grams of protein a day faithfully and well I love me some carbs so we don't want to report what that number is.  The point is this stuff can happen, wls or not, diet or not.  It made sense the way it was described to me, I got lucky mine passed on its own and my liver enzymes came back to normal.

Good Luck

I had my gallbladder out in 1983, and in 1989, developed stones along with jaundice.  My GI  doc said less than 1% of gallbladder patients have the chance of developing stones again, but generally not until 20 years or so post op.  I'm just so special, it only took me 6 years post-op.  An ERCP removed them.  All of this was years before I had my WLS.  Good luck...

Good fat helps prevent gallstones.

From Medscape Medical News
High Intake of Polyunsaturated, Monounsaturated Fat May Lower Risk of Gallstones 

Laurie Barclay, MD

Laurie Barclay is a freelance reviewer and writer for Medscape.

Oct. 4, 2004 -- A high intake of polyunsaturated and monounsaturated fat, particularly cis fat, is associated with a reduced risk of gallstone disease, according to the results of a prospective, population-based cohort study published in the Oct. 5 issue of the Annals of Internal Medicine.

"Monounsaturated and polyunsaturated fats act as inhibitors of cholesterol cholelithasis in animal experiments," write Chung-Jyi Tsai, MD, ScD, from Harvard Medical School and Brigham and Women's Hospital in Boston, Massachusetts, and colleagues. "Studies report that diets high in polyunsaturated and monounsaturated fatty acids relative to low-fat, high-carbohydrate diets have beneficial effects on insulin sensitivity."

In the Health Professional Follow-up Study, 45,756 men, aged 40 to 75 years in 1986, who were free of gallstone disease, completed a 131-item semiquantitive food-frequency questionnaire every two years starting in 1986. The primary outcome measure was self-reported newly diagnosed symptomatic gallstone disease.

During 14 years of follow-up, there were 2,323 new cases of gallstone disease. Compared with men in the lowest quintile of dietary intake of cis unsaturated fats, the relative risk for gallstone disease among men in the highest quintile was 0.82 (95% confidence interval [CI], 0.69 - 0.96; P for trend = .006), after adjustment for age and other potential risk factors.

Compared with men in the lowest quintile, the relative risk among men in the highest quintile of polyunsaturated fat consumption was 0.84 (95% CI, 0.73 - 0.96; P for trend = .010), and the relative risk among men in the highest quintile of monounsaturated fat consumption was 0.83 (95% CI, 0.70 - 1.00; P for trend = .01).

Study limitations were that outcomes were restricted to men with cholecystectomy or diagnostically confirmed but unremoved symptomatic gallstones, limiting generalizability; and lack of systematic diagnostic screening procedures for the presence of gallstones, probably underestimating the number of cases of gallstones.

"A high intake of polyunsaturated and monounsaturated fats in the context of an energy-balanced diet is associated with a reduced risk for gallstone disease in men," the authors write. "Although the optimal amount of unsaturated fat intake is still unknown, our findings support the notion that, in dietary practice, a higher intake of cis unsaturated fats can confer health benefits."

The National Institutes of Health supported this study. The authors report no potential financial conflicts of interest.

Ann Intern Med. 2004;141:514-522
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From Medscape Medical News
New vs Old Contraceptives Have Similar Gallbladder Disease Risk

Laurie Barclay, MD

Freelance writer and reviewer, Medscape, LLC

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

April 18, 2011 — The risk for gallbladder disease is virtually the same with newer and older types of birth control pills, according to the results of a retrospective, comparative safety cohort study reported online April 18 in the Canadian Medical Association Journal.

"Recent concerns have been raised about the risk of gallbladder disease associated with the use of drospirenone, a fourth generation progestin used in oral contraceptives," write Mahyar Etminan, PharmD, MSc, from the Faculty of Medicine, University of British Columbia in Vancouver, Canada, and colleagues. "We conducted a study to determine the magnitude of this risk compared with other formulations of oral contraceptives."

Using the IMS LifeLink Health Plan Claims Database, the investigators identified women who were using an oral contraceptive containing ethinyl estradiol combined with a progestin during 1997-2009 and who had been taking the oral contraceptive continuously for at least 6 months. A Cox proportional hazards model allowed calculation of adjusted rate ratios (RRs) for gallbladder disease, defined as cholecystectomy in the primary analysis, or as hospital admission secondary to gallbladder disease in a secondary analysis.

Of 2,721,014 women in the cohort, 27,087 underwent surgical or laparoscopic cholecystectomy during follow-up. There was a small but statistically significant increase in gallbladder disease risk with 3 of the newer oral contraceptives vs levonorgestrel, an older second-generation progestin. Adjusted RRs were 1.05 for desogestrel (95% confidence interval [CI], 1.01 - 1.09), 1.20 for drospirenone (95% CI, 1.16 - 1.26), and 1.10 for norethindrone (95% CI, 1.06 - 1.14). However, ethynodiol diacetate, norgestrel, and norgestimate were not associated with any statistically significant increase in risk vs levonorgestrel.

"In a large cohort of women using oral contraceptives, we found a small, statistically significant increase in the risk of gallbladder disease associated with desogestrel, drospirenone and norethindrone compared with levonorgestrel," the study authors write. "However, the small effect sizes compounded with the possibility of residual biases in this observational study make it unlikely that these differences are clinically significant."

Limitations of this study include lack of validation of the International Classification of Diseases, Ninth Revision (ICD-9), codes for gallbladder disease in most administrative databases, inability to control for body mass index and ethnicity, possible residual confounding with other known and unknown variables, and reporting bias as a possible reason for the apparent increase in gallbladder disease in people taking drospirenone.

"The surge in the number of reported cases of gallbladder disease facilitated through the media may have contributed in making drospirenone appear to be associated with a higher risk of gallbladder disease compared with older contraceptives," the study authors conclude.

The Fonds de la recherche en santé du Québec (FRSQ), the Ministère de la Santé et des Services sociaux, and the McGill University Health Center supported this study. Coauthor James Brophy, MD, PhD, is the recipient of a career award from the FRSQ. The remaining study authors have disclosed no relevant financial relationships.

CMAJ. Published online April 18, 2011. Full text

Given that the OP is 44 and chances are very good she is on BCP, I'd give this one more crediance than low carb.
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Dieting & Gallstones

Experts believe weight-loss dieting may cause a shift in the balance of bile salts and cholesterol in the gallbladder. The cholesterol level is increased and the amount of bile salts is decreased. Following a diet too low in fat or going for long periods without eating (skipping breakfast, for example), a common practice among dieters, may also decrease gallbladder contractions. If the gallbladder does not contract often enough to empty out the bile, gallstones may form.
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Fats

Fat is essential for the proper functioning of the body. Fats provide essential fatty acids, which are not made by the body and must be obtained from food. The essential fatty acids are linoleic and linolenic acid. They are important for controlling inflammation, blood clotting, and brain development.
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Of the following list, I had FIVE of the issues listed. Over 40, female, diabetes, and rapid weight loss. Apparently I also have a sluggish gallbladder. (That makes 5 out of a possible 11 causes).
Add use of birth control for almost 2 decades (see earlier article).

Causes of gallstones:

Gallstones are more common in women, Native Americans and other ethnic groups, and people over age 40. Gallstones may also run in families.

The following also make you more likely to develop gallstones:

Failure of the gallbladder to empty bile properly (this is more likely to happen during pregnancy)

Medical conditions that cause the liver to make too much bilirubin, such as chronic hemolytic anemia, including sickle cell anemia

Liver cirrhosis and biliary tract infections (pigmented stones)

Diabetes

Bone marrow or solid organ transplant

Rapid weight loss, particularly eating a very low-calorie diet.

Receiving nutrition through a vein for a long period of time (intravenous feedings)

My take on this is that while fat, the WRONG kind can cause gallbladder issues, a low carb/high fat if you eat the RIGHT kinds of fats, is not an issue.

So as long as we eat the right kind of fat, high fat isn't a problem.

Liz