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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

Gallbladder iBook

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)