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Is it My Gallbladder or Heartburn? An Overview of How You Know, and What To Do.
By Jeffrey Eakin M.D.
Brought to you by
Gallbladdder
Anatomy
Anatomy
Ballbladder
Bile
Bile Helps Absorb Fats
Bile
• Bitter-tasting
• Dark green to yellowish brown fluid
• Produced by the liver
• Aids the digestion of lipids in the small intestine.
Bile
• Cholesterol
• Bile Acids
• Other Lipids
Gallstones Risk Factors
• Obesity
• Female
• Multiple pregnancies
• Family History
Gallstones
• They come in all shapes and sizes
Gallstones
Gallstones
Gallstones
Diagnosis
Complications of Gallstones
Gallbladder Pain
Gallbladder Inflammation
Liver Infection
Medical Treatment
• Often hospital
• Pain Control
• IV Fluids
• Nothing to eat
• Sometimes antibiotics
Surgical Treatments
• Gallbladder removal
• 4 Techniques
4 Types of Surgeries
• Open Surgery
• Laparoscopic
• Traditional Robotic
• Single incision robotic surgery
Open Gallbladder Surgery
• 3- 5 Days in Hospital
• Increase risk of hernia
• Sometimes absolutely necessary
Laparoscopic Surgery
• Sometimes same day surgery
• 4 incisions
• Right shoulder pain common
Laparoscopic Surgery
Robotic Multiport Surgery
• Same as Laparoscopic gallbladder removal
Robotic Multiport Surgery
Single Incision Robotic Surgery
Single Incision Robotic Surgery
Recap Surgery Types
After Surgery
• 6 weeks no heavy lifting - increased hernia risk
• Less than 8% difficulty eating fatty foods
Gastroesophageal Reflux Disease
Symptoms
• Burning in my chest
• Stomach burning
• I feel bitter acid taste in mouth after meals
• “I have heartburn”
• Food and liquid regurgitated
Diagnosis
• Clinical (Most common in America)
• Endoscopy
• Specialized reflux studies - imaging and acid test
Clinical Diagnosis
• Most people already on medications - self diagnosis
• Clinical symptoms usually tell tale
• If you have had it for three or more years need and EGD
Endoscopic Diagnosis
• What is endoscopic?
Endoscopic Diagnosis
Endoscopic Diagnosis
Special Diagnostic Studies
• Esophagram
• Bravo probe study
Special Studies - Esophagram
Special Studies - Acid Test
Special Studies - Acid Test
Special Studies - Acid Test
Special Studies - Acid Test
Complications
• Respiratory infections
• Chronic Cough
• Narrowing from chronic acid damage
• Ulcers
• “Pre-cancerous changes” - Barrett’s Esophagus
• Cancer
Chronic Cough
Esophageal narrowing - from scar
“Pre Cancer”
Esophageal Cancer
Medical Treatment
• Acid Reducing Medications
Acid Reducing Medications
Which one should I use?
Which one should I use?
• It is different for everyone
• Use whatever works best for you - even if it is the cheapest option
Sometimes Medications Don’t Work
• Cannot control symptoms
• Chronic respiratory infections
• Narrowing of esophagus
• Barrett’s esophagus
• Esophagitis
Surgical Treatment
Laparoscopic Surgery
Robotic Nissen Fundoplication
Hiatal Hernias
GERD and Gallstones
• Which one do I have?
GERD and Gallstones
• The most common overlap is the following: “I have been having stomach issues for years. I get nauseated when I eat, and I often have pain after meals.”
Conclusion
• Gallstones with Symptoms - Remove Gallbladder
• Many surgical options
• GERD - can be treated with medications or surgery
• GERD - some people absolutely need surgery
• The two diseases present the same way (somewhat)
