Recovery Immediately After Gallbladder Surgery

Gallbladder surgery to remove gallstones
Gallbladder surgery to remove gallstones

This article answers five of the most commonly asked questions about what happens immediately after gallbladder removal surgery before discharge from hospital and during the first day of gallbladder surgery recovery at home.

What Pain Can Be Expected?
The incision sites of the cholecystectomy through which instruments entered and exited and the gallbladder was removed will be painful. This pain however will be managed initially by intravenous painkillers through a drip and then with oral pain medication. The incisions will also be swollen with some bruising. To ensure hygiene and prevent infection the incisions will be covered.

Gallbladder removal surgery usually results in pain which the majority of patients rate as mild to moderate once the general anaesthetic wears off and can be managed with over the counter medications. Either paracetamol, also known as acetaminophen or APAP, often branded as ‘Tylenol’ or ibuprofen, often branded as ‘Advil’ or ‘Motrin’ will usually be sufficient. If pain is intense narcotic painkillers may be prescribed. It is important to be aware that side effects of these drugs can include nausea, dizziness and constipation. It is reassuring for most patients to know that most gallbladder surgery pain will be able to be managed with over the counter medication.

During gallbladder surgery the abdomen is inflated with carbon dioxide gas. One side effect of this is sore shoulders. Another is feeling bloated which can be expected to pass within 48 hours. Gentle exercise, that is short slow walks, will also help the gas to be absorbed into and pass through the digestive system.

Why Might The Patient Experience Nausea?
Immediately following gallbladder removal by laparoscopic keyhole surgery the patient may feel nauseous as a result of the general anesthetic and painkillers which were administered during surgery. People react differently to general anesthetic with some having few side effects, for others however they will be quite sick including vomiting in which case anti-nausea drugs will be administered. 

Is a Wound Drain Necessary?
It is very unlikely that gallbladder removal through the minimally invasive procedure laparoscopic cholecystectomy, often called key-hole surgery, will require a wound drain.   A drain is a thin rubber tube which is inserted through the wound into the abdomen to drain bile, blood and fluids. The site of an open cholecystectomy may require ‘drain’ which  will be removed in the days following surgery. 

 When Can the Patient Leave Hospital?
For most patients recovery from gallbladder surgery is incident free and they are able to leave hospital the same day. Because gallbladder removal through keyhole surgery is considered a minimally invasive procedure it is frequently performed in outpatient surgery, which may also be called ambulatory surgery, same-day surgery or day surgery. Because of this most patients will go home on the same day as their gallbladder removal surgery.

Before being discharged from the surgery the patient will be required to have eaten soft food and had a drink and to have kept these down, that is not vomited. They will also need to be able to walk.

Patients will need someone to take them home from the surgery. Ideally someone should stay with and monitor the patient for the first 24 hours of their gallbladder surgery recovery.

What Wound Care Is Required After Discharge From Hospital?
During gallbladder surgery the incisions are most likely to be sutured, or stitched, with dissolvable stitches. These do not have to be removed but will breakdown in a week or two as the wound heals. Steri-Strip skin closures are also placed over the wounds. They are strong, slim, waterproof adhesive strips that will hold the incision together. Being waterproof the patient can shower without worrying they will come unstuck.  Steri Strips come off by themselves after 5-7 days; they will begin to peel away from the skin and then fall off. A gauze and water-proof dressing will be placed over the wound to keep the area clean and prevent infection.

During the first 24 hours of gallbladder removal recovery there may be some discharge from the incisions. If the discharge is watery, thin and a very light pinkish color this is normal and should not be of concern to the patient. If the discharge is thicker bright red blood the patient should contact the outpatient surgery.

It is also normal after gallbladder surgery for the incisions to be swollen and bruised. However if the skin surrounding the incision is red or feels warm when touched or if the discharge from the wound is thick green or yellow this many indicate an infection. In this case the outpatient surgery or doctor should be contacted.

To help prevent infection it is recommended that using swimming pools, spas and soaking hot tubs be avoided for 4 to 6 weeks after gallbladder removal surgery.

Nursing staff will provide the patient with specific information about how to care for the wound prior to being discharged from the outpatient surgery. Patients are frequently provided with a pamphlet explaining how to care for their wound and when to contact the surgery or doctor while recovering from gallbladder surgery.

Gallbladder Surgery to Treat Gallstones

Gallbladder surgery
Gallbladder surgery to remove gallstones

The main reason for having gallbladder surgery is the presence of gallstones and the complications they cause. Gallbladder removal is one of the most commonly performed surgical procedures. Removal is also a treatment option if the gallbladder becomes diseased, infected or in the rare case of cancer. Normal digestion is possible without a gallbladder.

What is Laparoscopic Gallbladder Surgery?
The removal of the gallbladder is most commonly performed using a minimally invasive technique known medically as “Laparoscopic Cholecystectomy”. Cholecystectomy means ‘surgery to remove the gallbladder’ and laparoscopic describes the slender tube which has a light and a camera that is inserted into the body to allow the doctor to see inside the abdomen. Small incisions and specialized tools including the laparoscope are used to remove a diseased or infected gallbladder. A laparoscopy is also known as keyhole surgery.

Laparoscopic surgery is categorized as a minimally invasive procedure and is preferred over open surgery because the smaller incisions reduce the risk of infection, bleeding, and recovery time. Most people recover more quickly and with fewer complications with laparoscopic surgery than with open surgery. For most people Laparoscopic Cholecystectomy is safe and effective and is the most commonly used surgery option for gallbladder removal when no complicating factors are present.

Options for Laparoscopic Gallbladder Surgery
Laparoscopic Cholecystectomy may be performed in two ways. Firstly a surgeon makes several small incisions to allow instruments, including a miniature camera (a laparoscope) to be placed in the body. When this procedure is used there are typically four small incisions made; three on the right side near the bottom of the rib cage and one slightly above the navel. More commonly now laparoscopic surgery is carried out with just one single incision at the belly button. The images from the laparoscope are projected back to a monitor to allow the surgeon to clearly view the surgical site.

Although there are many advantages to laparoscopic cholecystectomy it may not be recommended for some patients for example in the case of severe complicated gallbladder disease or if the patient has previously had upper abdominal surgery. For these patients their doctor will discuss other options.

Advantages of Minimally Invasive Surgery to Remove Gallbladder
Minimally invasive gallbladder surgery has several advantages over traditional open surgery. Firstly, and most importantly for many people, is a shortened hospital stay. This means less time away from work and other commitments. Patients can generally be discharged the same day or the next day. Following a laparoscopy to remove a gallbladder one can expect to return to usual activities, including work, in about 7 to 10 days. A shorter hospital stay also reduces the risk of exposure to other infections.

Secondly, because the gallbladder is removed through either one or only a few very small incisions as opposed to a large incision of approximately 15 centimeters there is considerably less post-operative pain with many patients reporting minimal levels of pain. Wound care is also simplified when compared to open surgery for gallbladder removal. Reduced pain levels also contribute to a swifter recovery as patients are able to be more mobile more quickly therefore returning sooner to both work and other activities after the surgery. When these reasons are considered it is clear that minimally invasive laparoscopic surgery is a good option for the removal of the gallbladder to relieve the intense pain of gallstones.

Gallbladder Laparoscopic Surgery Procedure
Firstly in preparing for gallbladder surgery an IV drip line is inserted into a vein in the back of the patient’s hand. This allows for fluids and drugs to be administered in careful doses. Once in the operating theatre a general anesthetic is administered so that the patient is asleep and pain free during the surgery. The surgery will usually last for less than two hours.

After the general anesthetic has been effective, the surgeon makes small incisions, often one sometimes four, in the abdomen. The abdomen is inflated with carbon dioxide to allow it expand so the surgeon can see clearly and has more space in which to work. A laparoscope, which is a lighted camera on a tube, is inserted through the incision into the abdomen. Cannulas are inserted and carefully separate the gallbladder from its attachments. The gallbladder is then removed through one of the openings.

A cholangiogram, which is an x-ray taken to show the anatomy of the bile ducts, may be performed during surgery. It allows the surgeon to view the anatomy of the bile ducts and identify gallstones lodged in the bile channels. A dye is injected into the common bile duct which is then x-rayed. The surgeon may choose to remove identified stones immediately or later using an endoscope via the mouth. Occasionally the surgeon may need to opt to complete the gallstone and gallbladder removal through open surgery.

Gallbladder Function

Information about the gallbladder
Information about the gallbladder

What is the gallbladder?
The gallbladder is a sac like organ attached to, and tucked under, the liver. It has an important function in the digestive system. Digestion is the process of making nutrients and energy producing substances available to body tissues and cells.

The role of the gallbladder is to collect and store bile that the liver has produced and discharge it into the small intestine after a fatty meal. When functioning correctly a person is not aware of their gallbladder. However, if something does go wrong it can be very painful. One of the most common and painful complications is gallstones.

Why does the gallbladder produce bile?
Bile is a thick, bitter, yellowish or greenish fluid made in the liver and stored in the gallbladder.  The function of bile is to neutralise the acidity of partially digested food in the duodenum, which is the first part of the small intestine. Bile is released from the gallbladder into the small intestine in response to the presence of food and is essential to the digestion of fats.

Food leaves the stomach as a thickish, acidic liquid called chyme and enters the duodenum. The duodenum makes and releases large quantities of mucus, which protects it from damage by acid and other enzymes in the chyme. The duodenum also receives pancreatic juices from the pancreas and considerable quantities of bile, which is made in the liver and stored in the gallbladder.

The liver produces approximately 1 litre of bile daily. Although over 95 per cent water, bile contains a wide range of chemicals including bile salts, mineral salts, cholesterol and bile pigments which give it a characteristic greenish colour.

How does bile move from the liver to the gallbladder to the duodenum?
Bile is made continuously by every cell in the liver. It flows from these cells and collects in minute channels between groups of liver cells called bile caniculi, which empty into bile ducts. From the bile ducts, bile drains into hepatic ducts, or exit tubes. Unless bile is needed immediately for digestion, it flows into the gallbladder.

Bile stays in the gall bladder until required for digestion. As food, especially fatty food, leaves the stomach and enters the duodenum a hormone called cholecystokinin is secreted. This hormone travels in the bloodstream to the gall bladder and makes its walls contract so that the stored bile is squeezed out.  The bile flows down to the common bile duct, which is also a tube, and through a narrow gap which allows the bile to pass into the small intestine.

Why is bile important?
Bile’s mineral salts, including bicarbonate, neutralise the acidity of the partially digested food. The role of the bile salts is to break down fats so the digestive enzymes can go to work. Bile salts also act as transporters further down the intestine firstly, enabling digested fats to transfer through the intestine wall and secondly, as carriers of vitamins A, D E and K.

The body is very conservative in its use of bile salts and recycles them as part of digestion. They are not destroyed after use but instead approximately 80-90 per cent are transported in blood back to the liver where they once again stimulate the secretion of more bile.

Bile contains the pigment bilirubin; a by-product of liver function. One of the liver’s many functions is to breakdown worn out red blood cells. As this happens, the red pigment haemoglobin splits and forms the pigment biliverdin. Biliverdin quickly converts to bilirubin, which is yellowish brown, and is the reason for bile’s colour. Bilirubin also encourages the intestine to work effectively, deodorises the faeces and contributes to the yellow colour of urine.

When the liver or gallbladder is not functioning correctly bilirubin accumulates in the blood and results in jaundice with the skin and whites of eyes looking yellow. Also, because not enough bile is reaching the intestine, faeces may be pale and greyish. Therefore jaundice and pale, greyish faeces are two symptoms that gallbladder function is not as it should be.

What are gallstones?
Even when bile production is normal other things can go wrong with the gallbladder. The most common of these is gallstones. Gallstones are small hard lumps of cholesterol, produced in the body by the breakdown of fats, which form in the gallbladder.

There are three kinds of gallstones.  The first, mixed stones are the most common. They contain a mix of the bile pigment biliverdin and cholesterol.  Mixed gallstones develop in clutches, up to 12 at a time. Secondly, cholesterol stones, as their name suggests, comprise mostly of cholesterol, grow up to 1.25cm in diameter and are large enough to block the common bile duct. The third, pigment stones are usually very small and occur in large numbers. They are made mostly of biliverdin, the green bile pigment. Pigment stones tend to form from illnesses affecting blood composition.

Gallstones are not automatically painful. Many people have gallbladder stones without being aware of them. However if a gallstone blocks the bile duct severe and repeated pain is probable. Depending on the severity and frequency of attacks, gallstones can be controlled with a healthy diet but may need surgery.

Am I having a Gall Bladder Attack?

Gallbladder attack can occur very infrequently, with sometimes years between attacks. More frequent and ongoing attacks and symptoms may be a sign of gallbladder disease but more commonly gallstones. Gallstone attacks can sometimes be prevented and controlled by diet. Sometimes, and especially when the attack is acute or attacks become frequent surgical gallbladder removal will be recommended.

Top 10 Symptoms of a Gallbladder Attack

1.  Attacks often occur after overeating.
2.  Pain will often, but not always, follow a meal with a high fat content.
3.  Moderate to severe pain under the right side of the rib cage. Pain may radiate through to the back or to the right shoulder.
4.  Severe upper abdominal pain often just below the breastbone (known as biliary colic).
5.  Pain begins suddenly and quickly worsens.
6.  Deep inhalation worsens pain.
7.  Burping or belching.
8.  Nausea and queasiness sometimes resulting in vomiting.
9.  Indigestion.
10.  Flatulence.

The frequency and severity of gallbladder attacks may be lessened by modifying food intake, especially reducing fat intake. A healthy diet can be considered an ideal gallbladder diet and consists of large amounts of fresh fruits and vegetables and a moderate intake of protein. It is also important to ensure a high water intake, ideally two liters per day.

To kick start a diet that will promote a healthy gallbladder and lessen the chance of gallbladder attack a gallbladder cleanse may be beneficial. A gallbladder cleanse will rejuvenate your taste buds and palette and leave you wanting to eat healthy nutritious foods which are kind on digestion.

Best 5 Tips for Immediate Pain Relief from Gallbladder Attack

When experiencing gallbladder pain you will want immediate relief. While there are many things you can do in the long term to prevent future gallbladder attacks, the following will help you cope with the pain immediately.

1.  Apple Cider Vinegar
Drink a 60ml dose of Apple Cider Vinegar followed by a glass of apple juice. This is reputed to provide the quickest gallbladder pain relief with pain usually easing within 15 minutes. Ideally you want to drink the vinegar without diluting it because it is the concentrated acidity that makes this work. However, if the apple cider vinegar is too acidic and tart to drink neat mix it in a half a glass of warm water sweetened with a little honey.

2.  Apply Heat
A hot water bottle will provide soothing relief. Be sure to have a layer of fabric between the hot water bottle and your skin. A pillowslip or tea towel is ideal. Soaking in a hot bath may will also sooth the pain and will help muscles that have tensed due to the pain and stress to relax. Adding Epsom Salts to the bath will make is more relaxing because the body absorbs magnesium, which is a muscle relaxant, from the salts. Epsom Salts are available from the grocer, pharmacy, hardware or Amazon.

3.  Over the Counter Pain Relief
Depending on the severity of the pain over the counter drugs may provide some pain relief during a gallbladder attack. Either paracetamol, aka acetaminophen or APAP, often branded as ‘Tylenol’ or ibuprofen, often branded as ‘Advil’ or ‘Motrin’ may have some effect, although patients have report different success rates. However trying a dose of either of these will not have any negative side effect. ‘Buscopan’ is an antispasmodic medication that may also be beneficial to relieve the abdominal discomfort and pain.

4.  Gentle Movement
Lying still and resting often doesn’t relieve the pain associated with a gallbladder attack. Gently moving, twisting and stretching the body and torso can provide relief. Try to breathe slowly and deeply and exhale all of the air in the lungs while doing this.

5.  Hot Herbal Tea
Sip chamomile or peppermint herbal tea. Both of these herbs are known for their properties to settle digestive ailments and being hot they also soothe and relax the digestive system. Sufferers of gallbladder pain have frequently reported their success.

If you are in severe pain and particularly if your attack symptoms are accompanied by fever do seek medical attention immediately. The above symptoms are typical of a gallbladder attack but may be caused by another medical condition.

“Owie Pillow!” Helps with Gallbladder Pain

Owie pillow can provide pain relief  when driving after gallbladder surgery.
Owie pillow can provide pain relief when driving after gallbladder surgery.

An ‘Owie Pillow’ is one product that may be useful in relieving  pain following gallbladder surgery or any other abdominal surgery.  Although many people will not have one readily available it may be worthwhile considering purchasing one if planning gallbladder surgery.  There will be many occasions when one will be useful, so what is the “Owie Pillow”?

The “Owie Pillow” is used to relieve abdominal pressure caused by using a safety belt when driving making it ideal for use following surgery to remove a gallbladder. It can be used by any motorist but is especially helpful to pregnant women and those who may be suffering from abdominal injuries, wounds, recent surgery or pain. When properly used, the pillow is placed between your abdomen and the seat belt. It can be used by both drivers and passengers. Additionally, this product can be used by almost anyone who simply wants a more comfortable ride. It may also be used with a seat belt  on an airplane or any public transport fitted with safety belts.

How did the “Owie Pillow” evolve? Kristine Currier designed the pillow when she was pregnant with both of her children. During the first pregnancy, she experienced pressure and discomfort when driving. This led her to think about how to make herself more comfortable because she needed less pressure and more “room” for her rapidly expanding belly. During Kristine’s second pregnancy, the same problem reoccurred only this time she was muttering to herself “I cannot be the only person that finds the seatbelt uncomfortable” . . . and this is how the “Owie Pillow” became a reality. So when she solved a pregnancy problem Kristine also solved a problem for people recovering from abdominal surgery such as gallbladder removal.

In addition to easing discomfort while driving during pregnancy there are many other occasions when an ‘Owie Pillow’ can provide comfort including:

1.  Following abdominal surgery for the removal of hernia, appendix or gallbladder.

2.  During recovery from a hysterectomy

3.  To provide comfort following bypass surgery by hugging the smaller pillow in a vertical position.

4.  People who spend extended lengthy periods of time in their car such as sales reps, travelers and tourists.

5.  During airplane trips. The ‘Owie’ pillow can be used across the stomach with the seatbelt, as a lumbar support or as a head rest.

6.  Children can also use one, the 16″ pillow is the appropriate size for most children, who have had abdominal surgery or find wearing a seatbelt uncomfortable.






Gall Bladder Disorders

This x-ray shows a gallbladder [red pear shape] with many gallstones [green].
This x-ray shows a gallbladder [red pear shape] with many gallstones [green].

Gallstones are the most common and most well-known of the disorders affecting the gallbladder. However there are other diseases of the gallbladder that may be related to a failing gall bladder and often require surgery. Diagnosis of a gallbladder disease is relatively straightforward and involves the use of non-invasive technology such as ultrasound and blood tests. It is important that if gallstones or any gall bladder symptoms are suspected a doctor be consulted as soon as possible.

A gallstone is a solid crystal deposit that forms in the gallbladder, which is a pear-shaped organ that stores bile salts until they are needed to help digest fatty foods. Gallstones can migrate to other parts of the digestive tract and cause severe pain with life-threatening complications.

Gallstones vary in size and chemical structure. A gallstone may be as tiny as a grain of sand or as large as a golf ball. Eighty per cent of gallstones are composed of cholesterol. They are formed when the liver produces more cholesterol than digestive juices can liquefy. The remaining 20% of gallstones are composed of calcium and an orange-yellow waste product called bilirubin. Bilirubin gives urine its characteristic color and sometimes causes jaundice.

Gallstones are caused by an alteration in the chemical composition of bile. Bile is a digestive fluid that helps the body to absorb fat. Gallstones tend to run in families. In addition, high levels of oestrogen, insulin or cholesterol can increase a person’s risk of developing gallstones.

Prevalence of Gallstones
Gallstones are the most common of all gallbladder problems. They are responsible for 90% of gallbladder and bile duct disease and are the fifth most common reason for hospitalization of adults in the United States. Gallstones usually develop in adults between the ages of 20 and 50 years; about 20% of patients with gallstones are over forty years of age. The risk of developing gallstones increases with age–at least 20% of people over 60 have a single large stone or as many as several thousand smaller ones. The gender ratio of gallstone patients changes with age. Young women are between two and six times more likely to develop gallstones than men in the same age group. In patients over 50years, the condition affects men and women with equal frequency. Native Americans develop gallstones more often than any other segment of the population; Mexican-Americans havethe second-highest incidence of this disease.

Pregnancy or the use of birth control pills can slow down gallbladder activity and increase the risk of gallstones. As can diabetes, pancreatitis, and celiac disease.

Types of Gallstones

Cholelithiasis is defined as the presence of gallstones within the gallbladder itself.

Choledocholithiasis is the presence of gallstones within the common bile duct that leads into the first portion of the small intestine (the duodenum). The stones in the duct may have been formed inside it or carried there from the gallbladder. These gallstones prevent bile from flowing into the duodenum. Ten per cent of patients with gallstones have choledocholithiasis, which is sometimes called common-duct stones. Patients who don’t develop infection usually recover completely from this disorder.

Disorders Often Treated by Gallbladder Surgery

Cholecystitis is a disorder marked by inflammation of the gallbladder. It is usually caused by the passage of a stone from the gallbladder into the cystic duct, which is a tube that connects the gallbladder to the common bile duct. In 5-10% of cases, however, Cholecystitis develops in the absence of gallstones. This form of the disorder is called Acalculous Cholecystitis. Cholecystitis causes painful enlargement of the gallbladder and is responsible for 10-25% of all gallbladder surgery. Chronic Cholecystitis is most common in the elderly. The acute form is most likely to occur in middle-aged adults.

Cholesterolosis, also known as cholesterol polyps, is characterized by deposits of cholesterol crystals in the lining of the gallbladder. This condition may be caused by high levels of cholesterol or inadequate quantities of bile salts and is usually treated by surgery.

Gallstone Ileus which results from a gallstone blocking the entrance to the large intestine and is most common in elderly people. Surgery usually cures this condition.

Stricture of the common bile duct develops in as many as 5% of patients whose gallbladders have been surgically removed. Stricture means narrowing. This condition is characterized by inability to digest fatty foods and by abdominal pain, which sometimes occurs in spasms. Patients with stricture of the common bile duct are likely to recover after appropriate surgical treatment.

Diagnosing Gallbladder Disease

Gallstones may be diagnosed by a family doctor, a gastroenterologist (a specialist in digestive problems], or a specialist in internal medicine. The doctor will first examine the patient’s skin for signs of jaundice and palpate (feel) the abdomen for soreness or swelling. After the basic physical examination, the doctor will order blood counts or blood chemistry tests to detect evidence of bile duct obstruction and to rule out other illnesses that cause fever and pain, including stomach ulcers, appendicitis, and heart attacks.

There are a number of imaging studies that identify gallbladder disease, but most gallstones will not show up on conventional x-rays. For gall stones to be detectable contrast agents are given by mouth and then excreted into the bile. The contrast agent will then be visible in the image.

Ultrasound is very useful and can be enhanced by administering it through an endoscope in the stomach. Ultrasound imaging has an accuracy rate of 96%. CT Scans (computed tomography scans) and MRI (magnetic resonance imaging) scans are not used routinely but are helpful in detecting common duct stones and complications.

Gallbladder disease including the most common, gallstones, causes significant discomfort and pain to the sufferer. The sufferer’s lifestyle especially diet patterns can be severely impacted causing at the very least inconvenience and possibly restricting daily activities. The diagnosis of gallstones and other gallbladder diseases allows for a medical care plan, sometimes, but not always involving gallbladder surgery, to be developed to relieve these symptoms, thus allowing the sufferer to return to pain-free lifestyle.

Digestive Wellness: How to Strengthen the Immune System and Prevent Disease Through Healthy Digestion

Digestive Wellness 4th Edition by Elizabeth LipskiBook Review
This article reviews Elizabeth Lipski’s book, Digestive Wellness [fourth edition]. This book contains a wealth of information for anyone looking for authoritative information on managing their digestive health including gallstones and improving their gallbladder diet.

About the Author
Elizabeth Lipski is a clinical nutritionist and author of several books on nutrition and digestion. Lipski has been working in the field of nutrition, holistic health, herbology, lifestyle management, relaxation and visualization techniques for over 30 years.[2] She has worked in medicine and academia and was most recently named Director of Academic Development, Nutrition & Integrative Health at the Maryland University of Integrative Health Lipski also does frequent media interviews and advises businesses on issues of employee health and wellness.

About the Book
According to Lipski, sixty percent of the population has suffered from a digestive ailment in the last three months. Acid reflux, heartburn, gastritis, ulcers, lactose intolerance, and food allergies are among the many ailments caused by faulty digestion. Digestive Wellness was written to assist the reader understand the complex relationships between gastrointestinal physiology, diet and health.

This accessible fourth edition of the popular resource has been thoroughly updated to reflect the latest information and research on digestive disorders. Here the reader will find practical advice on implementing a wellness program to promote health and alleviate a wide range of problems caused by faulty digestion.

Not only is faulty digestion directly responsible for a large number of gastrointestinal disorders, it can be indirectly responsible for a vast array of seemingly unrelated illnesses including arthritis, migraines, and auto-immune diseases.

In Digestive Wellness, clinical nutritionist Elizabeth Lipski explains how your digestive system works and what can happen when it experiences complications. She covers all the common gastrointestinal disorders and offers her expert guidance on the newest advances in testing and diagnosis, nutrition and natural therapies, including detoxification and self-care options for more than thirty common conditions.

Identify and treat digestive complications including IBS (irritable bowel syndrome),  GERD (gastroesophageal reflux disease), indigestion, gas bloating, constipation,  celiac disease,  hepatitis,  inflammatory bowel diseases  and other disorders of the digestive system.

In this edition Lipski dedicates the entire Chapter 23 to The Gallbladder, Gallstones and Cholecystectomy. The book is a reference for topics including the function of the gallbladder, diet and gallbladder, gallbladder flush, testing the gallbladder, gallstones and  testing for gallstones, healing options for gallstones and statistics on gallstones. It also includes information about cholecystectomy, that is gallbladder surgery.

Digestive Wellness offers practical information that will guide you toward better health. This new edition is extensively updated to include new sections on hepatitis, cirrhosis, Barrett’s esophagus, and Behcet’s disease. The latest information on food allergies, probiotics, prebiotics, and the use of supplements and herbs is included as a comprehensive guide for the health consumer.  Options for dietary cleansing of the digestive system are discussed. Significantly Lipski provides a wealth of advice on how healthy changes in diet and lifestyle can help  achieve a level of physical and emotional wellness not previously experienced. This book is a must read for anyone suffering gallbladder symptoms or who have experienced a gallstone attack.

From the Back Cover
Dr Lipski offers a practical toolkit to support each of us – clinicians and patients – to return to wellness by bringing our gastrointestinal system back into balance and harmony. I believe that you will deeply benefit from joining Dr Lipski on this journey toward digestive wellness.
Patrick Hanaway, MD, Chief Medical Officer, Genova Diagnostics; President, American Board of Integrative Holistic Medicine


Former Medical Technician Gets Gallbladder Surgery in Mexico; WorldMed Assist Saves Him 70%

Medical tourism is a good option for gallbladder surgery.
Medical tourism is a good option for gallbladder surgery.

Medical Tourism
Medical tourism is a growing industry with more and more people choosing to combine elective surgery with a holiday – at a cost much less than the surgery would cost at home.  As healthcare costs in the United States and many other countries spiral to an unaffordable level medical tourism offers an affordable option.

Patients Beyond Borders estimates that more than 1.4 million Americans will travel beyond the United States for medical care in 2016. Top destinations include Costa Rica, Malaysia, Mexico, India, Israel, Singapore, South Korea, Taiwan, Thailand and Turkey.

Why Choose Medical Tourism?
Medical tourism is a very real option for many people for a range of reasons and benefits in addition to the cost savings it offers. Better quality care, more inpatient friendly facilities where patients are encouraged to stay in hospital longer, shorter waiting period, access to specialty treatments that are banned in the patient’s home country and affordable access to treatments excluded, or with low benefit limits,  in some health insurance policies. For some people the excitement of a new and different way to access health care is the enticement to become a medical tourist.

Gallbladder Surgery Medical Tourism Case Study
WorldMed Assist, one such medical tourism company, offerred an affordable solution when Washington coast resident Allen Miller learned he needed gallbladder removal surgery. Even with flights and accommodation his gallbladder removal was cheaper and quicker  than it would have been at home.

When Allen Miller heard that gallbladder surgery was the solution to the abdominal pain from gallstones that he’d endured for two months, his resentment at being classified as uninsurable took on new life. Six years earlier, he’d quit a job with employer-provided health insurance and discovered when trying to get his own private-pay plan no one would cover him because he had Hepatitis C. When he learned the commonly performed and minimally invasive surgery, a cholecystectomy, to remove his gallbladder would cost a fortune he didn’t have he hit the Internet to learn how to become a medical tourist.

“I had friends who’d gone abroad for dental work, so I thought, ‘Why not see something of the world while having this surgery?’ I could afford to have the surgery in the U.S., but I knew I could get it done elsewhere for a lot less. I got on the computer, and right away found WorldMed Assist. I contacted them and two weeks later I was on a plane with my wife, headed for gallbladder surgery at Hospital Angeles in Tijuana, Mexico.” Miller had looked at options for the surgery in Belgium, Turkey and India, but because he and his wife run a Bed and Breakfast, they needed the shortest trip possible.

Both Miller and his wife recently retired from dual careers as medical technicians, so when WorldMed Assist set them up on a conference call with his surgeon, Dr Jorge Zavala Ruiz, they knew what questions to ask. “That call was very helpful,” he said. “We got all the answers we needed and felt this was the right decision. The total cost for all my medical bills plus travel and hotel for my wife and me saved around  70% on what I would have paid at home. The price included a liver biopsy to get the latest information on my Hepatitis C situation.”

“Not only was the cost of my gallbladder surgery significantly lower, WorldMed Assist got us great rates on travel and lodging. WorldMed Assist was able to get cheaper plane tickets than the best deal my wife could find,” said Miller.

On May 5, the Millers flew to San Diego. A driver from Hospital Angeles picked them up at the airport and drove them across the border. “He spoke English well, and told us all about his family,” said Miller.

Miller was impressed with the hospital. Built just two years ago, everything was state of the art, and scrubbed and polished. He liked that every patient had a private luxury room.

The morning after his arrival, he was wheeled away for his gallbladder surgery and discharged two days later. “We were driven back across the border to check into a San Diego resort for three relaxing days before heading home,” he said.

Just two weeks after his gallbladder surgery, he reported in to WorldMed Assist, “I’m off to our cabin by Ranier National Park to go hiking. Boy, do I feel good about the experience.” His wife is now looking to have WorldMed Assist arrange cosmetic surgery in Mexico, again at Hospital Angeles. “Medical tourism is a good option for anyone who can’t get insurance,” Miller said. “Thanks to WorldMed Assist, I rolled the dice and got a seven.”

Mr Miller acknowledges that all surgery carries risk and advised medical tourists to do their research and always have adequate medical travel insurance. For him though becoming a medical tourist was such a positive experience;  to stop his gallbladder pain by having gallbladder surgery and a vacation at the same time.

Best-selling Author Says Common Diseases Can Be Attributed to Gallstones in the Liver and Gallbladder

The Amazing Liver and Gallbladder Flush
The Amazing Liver and Gallbladder Flush

Book Review
This article reviews the book The Amazing Liver & Gallbladder Flush: A Powerful Do-It-Yourself Tool to Optimize Your Health and Wellbeing. Originally published in 2007 this updated and revised edition presents a natural approach to relieve gallbladder symptoms by following a gallbladder cleanse.

About the Author
Andreas Moritz a well known  internationally recognized author and healer guided thousands of people to greater vitality and improved health. A medical intuitive, a practitioner of Ayurveda, Iridology, Shiatsu and Vibrational Medicine, a writer and an artist he was born in Southwest Germany. He spent most of his life living and practicing in Europe, Asia, Africa, and the United States. Moritz  authored 15 books on books on natural health and healing:  with The Amazing Liver & Gallbladder Flush, Timeless Secrets of Health & Rejuvenation, It’s Time to Come Alive and Lifting the Veil of Duality being best sellers.  Moritz is also the artist who created the oil paintings for a new, innovative approach to healing through energized art, called Ener-Chi Art.

About the Book
An internationally acclaimed health expert Andreas Moritz claimed that most common diseases can be attributed to gallstones in the liver and gallbladder. Moritz says that most people don’t even realize that they have gallstones in these organs until they read his book. Cancer, heart disease, diabetes, joint disorders, diseases of the digestive system, and even the relatively minor symptoms of headaches, chronic fatigue, weight gain and skin blemishes all share gallstones in the liver’s bile ducts as the common origin.

If  you already know that you have gallstones in the gallbladder, but are unsure about what the causes are and how to cleanse them painlessly, without risks and without surgery, Moritz’s book, The Amazing Liver & Gallbladder Flush: A Powerful Do-It-Yourself Tool to Optimize Your Health and Wellbeing may be the answer to your problem. This thought provoking book,  is more than an eye-opener. It provides proven techniques to painlessly remove up to several hundred gallstones at a time using homemade, natural products that have been used for centuries.

Isn’t it time that we start using approaches that treat the whole person? Addressing what really causes ill health rather than merely suppressing the symptoms of disease with expensive side effect-causing drugs for which further treatment becomes necessary? Thousands of people around the world who use Moritz’s time-tested formula are proof of the medical truth that the simplest and cheapest methods are often the most effective ones. One liver flush costs less than a movie ticket. By contrast, common symptom-oriented treatments become increasingly unaffordable for most.  While at the same time driving large and small businesses into greater and greater debts. Moritz’s  Amazing Liver & Gallbladder Flush is one such holistic treatment for gallbladder disease.

Moritz provides a most thorough understanding of what causes gallstones in the liver and gallbladder and why those stones can be held responsible for the most common diseases so prevalent in the world today. He helps readers recognize the symptoms of stones and gives the necessary do-it-yourself directions to painlessly remove them in the comfort of one’s home. He also offers practical guidelines on how to prevent new gallstones from being formed.

The widespread success of The Amazing Liver & Gallbladder Flush is a testimony to the power and effectiveness of the cleanse itself. The liver cleanse has led to extraordinary improvements in health and wellness among countless people who have already given themselves the precious gift of a strong, clean, revitalized liver.


The First Ever Laparoscopic Surgery in Afghanistan to be Broadcast Live

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) takes minimal access surgery global at the 2006 Surgical Spring Week Meeting to be held at the Hilton Anatole in Dallas Texas, April 26-29, 2006.

The first laparoscopic operation ever performed in Afghanistan will be take place Friday, April 28, 2006. The surgery will be performed by a SAGES member and will be broadcast live into the SAGES meeting exhibit hall, allowing SAGES meeting participants to view this historic operation.

SAGES member, Dr. Ross Segan is currently deployed with the 14th Combat Support Hospital. He will perform a laparoscopic cholecystectomy (minimally invasive gall bladder removal) on a U.S. Soldier, who normally would have been flown to Germany for this relatively common procedure.

A laparoscopic cholecystectomy (often called lap choly) uses small incisions to remove the gallbladder. It is one of the most common procedures performed on women and is performed in the United States more than 700,000 times annually. Removing the gallbladder laparoscopically reduces post-operative pain and decreases the recovery time.

Dr. Adrian E. Park, SAGES member and Head of General Surgery at the University of Maryland Medical Center in Baltimore will moderate the broadcast live from the SAGES exhibit hall.

“This historic event is important because it paves the way for our U.S. troops and coalition forces serving in Afghanistan to have access to advanced, minimally invasive surgical techniques that will enable them to recover much faster,” says Dr. Park. “Dr. Segan has worked hard to bring this capability to the troops serving in Afghanistan and this will certainly be a significant milestone.”

Meeting attendees will be allowed to ask questions of Dr. Segan live. Dr. Park will take questions from the press after the operation. Television crews will be able to connect directly with the live feed.

The 2006 SAGES Annual Meeting will be held at the Hilton Anatole in Dallas, Texas, April 26-29, 2006 and will include multiple educational components that will advance minimally invasive surgery world wide. For more information about the SAGES Annual meeting please visit the SAGES web site

More than two decades ago a group of pioneering surgeons formed a new surgical society to address the need for education, guidelines, and research in endoscopy. They embraced emerging technology and new techniques on behalf of their patients. That group of 50 surgeons known as SAGES held their first meeting in Williamsburg in 1986 with 110 attendees and 11 exhibitors. SAGES now boasts over 5,000 members. The organization hosted more than 1,800 surgeon registrants at its last meeting. For more information, please visit