This Could Land You in the ER on Your Cape Vacation

HYANNIS – Gallbladder surgery is one of the six most common operations performed in the U.S., but it is the second most common for Hyannis surgeonLarry Novak, MD, FACS, who says tourists’ eating habits can send them to the emergency room with acute cholecystitis.

“We have the busiest ER in Massachusetts in the summertime,” he said. ”We expect it, and we are experienced and ready.”

High-fat foods like clam chowder, ice cream and fried foods force thegallbladderto work hard to eliminate the fat, said Dr. Novak.

“Soon, an upset stomach can become the worst stomach ache you’ve ever had, and you’re visiting the emergency room.”

Vacationers’ appetites for tasty seaside fare they don’t usually indulge in at home can result in ER doctors at Cape Cod Hospital calling Dr. Novak and other specialists to treat patients. They are usually elective surgeries, but he also operates on those with acute cholecystitis within 24 hours, which helps give tourists as much time as possible to recover before heading home.

Here’s What to Expect

Because most gallbladder surgeries are laparoscopic (minimally invasive) cholecystectomies, patients usually leave the hospital the next day after surgery.

A tiny video camera and special surgical tools are inserted through four small incisions (one is in the belly button) to see inside the abdomen and remove the gallbladder.

“After surgery, patients are sore for a few days,” Dr. Novak said. “Because gas is inserted to inflate the abdomen and patients might have pain in the shoulder or belly as the gas dissipates. They typically go back to work or normal activities in five to seven days.”

In rare cases, one large incision may be used to remove the gallbladder. This open cholecystectomy requires considerably more recovery time.

Dr. Novak explained that some surgical patients have never had symptoms related to a gallbladder problem and others have put off surgery.

“If you have gallstones and they aren’t bothering you, there is no reason to have your gallbladder removed,” he said. “The only people who get operations are the people who really need them.”

Reasons for surgery, according to Dr. Novak include:

  • Pain after eating
  • Fever
  • Infection
  • A gallstone that has fallen out of the gallbladder and is blocking a drainage duct to the liver or pancreas

It is always better to have elective surgery than wait until the symptoms become so bad it becomes an emergency, Dr. Novak said.

“Abdominal pain, epigastric pain (in the upper abdomen immediately below the ribs) and pain under the breastbone can be signs of a gallbladder problem, ulcer or heart attack. If you feel an unusual pain, get it checked out. Don’t be afraid to see your doctor, surgeon or healthcare provider. They can make the diagnosis,” he said.

Hello, Chocolate!

If your gallbladder has been holding you hostage, removing it takes away the pain and the need to eat bland foods and small meals. If you avoided things like fried foods, chocolate, steak, pizza and spicy delicacies because they caused you stomach upset and pain, welcome to a whole new world. You can expect to eat an occasional cheeseburger smothered with ketchup and onions again.

“People can be intolerant to fatty foods for the first week or months after surgery, but the body learns to adjust,” said Dr. Novak. “Of course, I recommend a low-fat, healthy diet, but I want people to realize they can eat what they want to eat after gallbladder surgery.”

People live very well without their gallbladder, Dr. Novak said. The liver makes bile, which is stored in the gallbladder, then excreted into the small intestine. When the gallbladder is removed, your body continues to digest fatty foods and secrete bile.

“You won’t miss your gallbladder,” he assures, “only the discomfort it may have caused you.”

By BETH ANN LOMBARDI, Cape Cod Health News

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