Cholecystitis - Liver And Gallbladder Disorders - Merck Manuals Consumer Version
Cholecystitis is inflammation of the gallbladder, usually resulting from a gallstone blocking the cystic duct. Typically, people have abdominal pain that lasts more than 6 hours, fever, and nausea. Ultrasonography can usually detect signs of gallbladder inflammation. The gallbladder is removed, often using a laparoscope. Cholecystitis is the most common problem resulting from gallbladder stones. It occurs when a stone blocks the cystic duct, which carries bile from the gallbladder (see Figure: View of the Liver and Gallbladder ). Cholecystitis is classified as acute or chronic. Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. The pain usually lasts more than 6 hours. At least 95% of people with acute cholecystitis have gallstones . The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken. Rarely, a form of acute cholecystitis without gallstones ( acalculous cholecystitis ) occurs. However, the gallbladder may contain sludge (microscopic particles of materials similar to those in gallstones). Acalculous cholecystitis is more serious than other types of cholecystitis. It tends to occur after the following: Critical illnesses such as serious injuries, severe burns , or a bloodstream infection ( sepsis ) Acute acalculous cholecystitis can occur in young children, perhaps developing from a viral or another infection. Chronic cholecystitis is gallbladder inflammation that has lasted a long time. It almost always results from gallstones and from prior attacks of acute cholecystitis . Chronic cholecystitis is characterized by repeated attacks of pain (biliary colic) that occur when gallstones periodically block the c Continue reading >>
Diabetes Drug Class Linked To Bile Duct And Gallbladder Disease
A popular class of drugs used to treat type 2 diabetes may increase the risk of bile duct and gallbladder disease. The class, GLP-1 (glucagon-like peptide 1) receptor agonists, is given via an injection and includes Byetta (exenatide), Victoza (liraglutide) and Trulicity (dulaglutide). Health records of more than 1.5 million patients with type 2 diabetes in the United States, the United Kingdom and Canada who were taking an antidiabetic medication were examined in the study, which was published in JAMA Internal Medicine. GLP-1s were shown to cause a 79% increased risk of developing symptoms associated with bile duct and gallbladder disease compared to those not on any diabetes drug. Put another way, about 3 more patients per 1,000 exhibited symptoms compared to those not taking the medication. The most common adverse effect seen in this population were gallstones. Another class of diabetes drugs, DPP-4 (dipeptidyl peptidase 4) inhibitors, which are given as a pill and act in a similar way as GLP-1s, did not have the increased risk of bile duct and gallbladder disease. DPP-4s on the market include Januvia (sitagliptin), Onglyza (saxagliptin) and Tradjenta (linagliptin). However, both GLP-1s and DPP-4s were not associated with an increased risk of acute pancreatitis. “It’s important that clinicians and patients alike be well informed about possible adverse effects,” Laurent Azoulay, PhD, a senior investigator at the Lady Davis Institute at the Jewish General Hospital in Montreal and the study’s lead author, said in a statement. “As a result of the gallbladder finding, it would be prudent for doctors to warn their patients to seek treatment if they experience symptoms, such as pain in their right side.” Jonathan Block is MedShadow’s content editor. He has pre Continue reading >>
Possible Medication Induced Pancreatitis?
Hi all, I'm new here. So, about 4 years ago I was diagnosed with polycystic ovarian syndrome, and educated to lose 50 pounds, and I was put on metformin for insulin resistance. About 6 months after starting metformin, I began having random pains in my mid chest, right under my sternum that would radiate around my right side, up my esophagus and into my right jaw, and pierce through my back. I let this pain go on for about 2 years because it would only last a few days. About 2 years ago, I got sick of it, decided it was my gallbladder and had that removed. I felt great for about 9 months, then I had all the same symptoms come back, and I thought this cant be, I had my gallbladder out... why in the eff do I feel this pain again. Once again, it lasted about 4 days, I wouldnt eat anything then the pain would go away. I went to the doctor, drew some labs, had an ultrasound, upper endoscopy...the works. They decided I must be having esophogeal spasms. SO... I have had about 4 attacks since then, they all last for about 3-5 days and as long as I dont eat or drink carbonated things I'm ok. This last one started 4 days ago, and it dawned on me that I am horribly nauseated and have pain that goes onto the left and right side now, and have nasty loose stools that are bright yellow. I'm also very, very tender under my sternum and along my bottom left rib cage (not to mention fatigued). Holy crap, maybe I have pancreatitis. I am a nurse, and I dont know why it took me so long to realize that! *worlds worst patient right here* Anyways, I got to researching about how different medications can cause pancreatititis, and I ran into a few articles on how people developed pancreatitits due to taking metformin because it overstimulates the pancreas. I rarely drink (maybe a few drinks 1-2 t Continue reading >>
What Causes Gallstones? | Gallstones - Sharecare
David A. Terschluse, MD on behalf of Oak Hill Hospital David Terschluse, MD from Oak Hill Hospital, says that gallstones are usually more of a genetic disease, rather than diet affecting it. The gallbladder is a small organ just under your liver on the right side of your abdomen. Its function is to release bile, which breaks down fat. Gallstones are formed by the gallbladder. While we dont know the exact reason that theyre formed, we do know that certain people are at higher risk: people who are obese, older than 40, have diabetes, dont get physical activity, are pregnant or have rapid weight loss or frequent fasting. Normally, the gallbladder makes and stores bile. Then, when you eat a meal with fat, it releases that bile into the intestine.If someone has gallstones, when the gallbladder squeezes to release the bile, the gallstone blocks it -- sort of like trying to squeeze out a tube of toothpaste while youre blocking the opening.One of the older tests of gallbladder function involved drinking a really high-fat liquid to cause it to contract and release bile. This can trigger pain if you have gallstones.Over time, the stones can lead to a gallbladder infection and inflammation. To prevent gallstones, you need to avoid the main risk factors for them. That means sticking to a healthy diet and weight, and getting exercise regularly. If you already have gallstones but want to prevent more attacks, you should try to avoid high-fat meals (think fried foods, processed foods such as donuts and cookies, whole-milk dairy products and fatty red meat), as these are what would trigger the gallbladder to release a large amount of bile. Also avoid crash diets, as the sudden weight loss can trigger worsening stones. Gallstones affect up to 20 million Americans and are twice as commo Continue reading >>
Can Metformin Cause Gallbladder Pain?
Metformin question? Hi everyone,Has anyone had ... Hi everyone,Has anyone had rigth upper quadrant cramping, like gallbladder pain (that is no longer in there - YEAH!) after stopping Metformin? I had a my first stubborn BG low yesterday of 61 (I waited too long to eat lunch). Ate four little pieces of chocolate (15 carbs), waited 15 minutes and BG went to 55. Drank chocolate Silk milk, waited 15 minutes and it went to 64. Ate a small banana, waited 15 minutes and it went to 69. Drank more Chocolate Silk milk and it went to 74. read more... Ate an orange and waited 15 minutes and it went to 94, WHEW!! I was so full by then I didn't want to eat anything else. One hour later ate a big mac and didn't take my Metformin then. Two hours later BG was only at 119. Ate late dinner of grilled cheese on cracked wheat sourdough and low carb soup and didn't take Metformin then either. Four hours later BG was 121. Thought it was safer to be a little high then hit another low. Anyway, after I ate the big mac (definitely a big no, no and haven't had one since diagnosed) I began having right upper abdomen cramping similar to gallbladder problems, but like I said I know longer have my gallbladder. Had cramping all night. Back on schedule today with all meds, still a little crampy. Has anyone who stopped taking metformin, even temporarily, had any liver pain or cramping or colic????My blood work a month ago was ok, and my liver biopsy when I had the gallbladder out and was REALLY jaundice came back ok.Thanks everyone, happy holidays.Char" Continue reading >>
Metformin Induced Acute Pancreatitis
Go to: Case Report Nineteen year-old-man, known case of Type 2 Diabetes mellitus for 4 y on 1 g metformin twice daily since diagnosis of his diabetes. He was in his usual state of health till he presented to the emergency department reporting nausea, vomiting and epigastric pain for 3 d. On physical examination, his height was 170 cm and body weight 99 kg; body mass index (BMI) 34.3 kg/m2, looked mildly dehydrated. Vitals signs were stable. Systemic examination was unremarkable, apart from mild epigastric tenderness. Laboratory investigations showed HbA1c 7.7%, Creatinine 58 µmol/L, Amylase 462 units/l (normal range < 100), Lipase 1378 units/l (0–60), white blood cells 16.8/mm3 (4–11) 80% of which was neutrophils, CRP 258 mg/l (0–5), Mg 0.76 mmol/l (0.7–1.05), Ca 2.17 mmol/l (2.2–2.6), AST 18 units/l (< 39), ALT 34 units/l (< 41), TG 0.95 mmol/l (< 2.3), Lactate 1.4 mmol/l (0.5–1.6). Abdominal Ultrasound and ERCP were done for the patient, results showed no gallstones and clear biliary tract, respectively. CT confirmed the diagnosis of acute pancreatitis, with no identifiable cause. The patient was admitted to ICU for close monitoring and further investigation. Normalization of Amylase and Lipase was reached after Metformin cessation, and Supportive treatment in the form of IV insulin and IV fluids. Other potential causes of pancreatitis were excluded. Patient was discharged home in stable condition after 2 weeks. Few days later, after re-exposure to Metformin, he presented with recurrence of his previous symptoms, and elevation of Amylase and Lipase was documented. As a result, Metformin was suspended with improvement of his symptoms and biochemical profile. Continue reading >>
Anyone Experiencing Pain From Taking Metformin?
Anyone Experiencing Pain From Taking Metformin? Thank you. I've tried time release, regular & the liquid, Riomet. I seem to have trouble no matter the version. HEALTH_NOW There is another post on here, she said she was giving time release and that almost completely took care of her problems. Yes I've had some of those symptoms & others. Problem with taking many medications is figuring out the ones causing the problem & wondering if it is the combination rather than just one med. Very frustrating especially since no doctor helping so I'm trying to do it on my own. This has been an interesting week. I had my diabetes class tuesday and it was really good. I ended up asking about all of these symptoms I have been having for 3 years and the doctor said all these symptoms aren't from diabetes..He told me to stop Metformin for 2 weeks and see how I feel? The next day a lot of the symptoms went away! Wow! I have been going through this for 3 years. Since I have been eating good and have lost 7 lbs now, my A1C went from 7.5 to 7. I went to the doctor today and that was an interesting experience, different doctor than the doctor at my diabetes class. It turns out I have asthma. My echocardiogram was good. Here are some of the symptoms I was having numb or cold feeling in your arms and legs feeling dizzy, light-headed, tired, or very weak diarrhea, or a metallic taste in the mouth may occur. actic acidosis. Symptoms include: tiredness. unusual muscle pain. trouble breathing. unusual sleepiness. dizziness or lightheadedness. ... low blood sugar. Symptoms include: headache. weakness. confusion. shaking or feeling jittery. drowsiness. dizziness. I know this is an old post, but I've been suffering all year with feeling hot even in winter & with ac in summer, burning back sensation, b Continue reading >>
Metformin And Gallbladder Problems
If this is your first visit, be sure tocheck out the FAQ by clicking thelink above. You may have to register before you can post: click the register link above to proceed. To start viewing messages,select the forum that you want to visit from the selection below. I just want this out there to maybe help others avoid surgery. I had a lot of stomach problems with met from day one (such as diarhea, stomach spasms, extreme admoninal pain and cold sweats in middle of night followed by explosions (use your imagination). I tolerated this all for the overwhelming desire to conceive. About 8 weeks into taking this I experienced terrible pain in my chest, neck, throat and back. I went to pcp and told him I suspected the met but he said no and ordered, bloodwork, xrays and ultrasound. (about $5000 plus in tests) I was told I had sludge in my gallbladder and immediately sent to a surgeon to have it removed. He also said that the ultrasound revealed I had complex cysts in my left ovary and needed a MRI (another $4000 ) I told him that it was normal for me to have cysts due to PCOS but he isisted on the test. He had nurse call me back in a week to reveal that OMG, I have PCOS!!!. I told him before he did this 2 hour MRI that I had PCOS. Now to the surgeon, The week before I saw him, I stopped taking the Met because I figured if I really had to have surgery, I didnt want to get pregnant yet anyway and for my own peace of mind, I wanted to rule out the Met as cause of the intense pain. The pain went away 3 days after I stopped the met and has remained gone since. The surgeon scheduled another ultrasound and a hapabilary scan (spelling stinks) (another $3000. in tests) that revealed that sludge was gone and my gallbladder function was fine. My advise is that if you have terrible chest Continue reading >>
Will You Have Gallbladder Attack With Metformin - From Fda Reports - Ehealthme
A study for a 53 year old man who takes Suboxone, Nitrostat NOTE: The study is based on active ingredients and brand name. Other drugs that have the same active ingredients (e.g. generic drugs) are NOT considered. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only, and has not been supported by scientific studies or clinical trials unless otherwise stated. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk. You may report adverse side effects to the FDA at or 1-800-FDA-1088 (1-800-332-1088). If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date. Continue reading >>
A Diabetic Diet After Gallbladder Removal
Gallbladder problems occur fairly frequently in people with diabetes, so if you're a diabetic and you've recently had your gallbladder removed, you're not alone. While you tried to cope with your diseased gallbladder before your surgery, you probably needed to cut back on fat in your diet to minimize symptoms. After gallbladder removal surgery -- known in medical parlance as cholecystectomy -- your doctor may tell you to gradually return to your previous diet, perhaps with an emphasis on certain nutrient groups. However, because you have diabetes, you'll need to continue to carefully watch what you eat. Fortunately, the diet for gallbladder removal patients and the diet recommended for diabetics contain many of the same elements. Video of the Day Following your gallbladder removal surgery, you may find you have difficulty digesting meals that contain a lot of fat. That's because your gallbladder's primary function was to help you process fats. You may experience diarrhea following meals, especially particularly fatty ones. So, steer clear of fried foods to prevent digestive problems, and skip fatty sauces and gravies, as they contain too much fat. Because you're diabetic, stick with healthier fats in small quantities. For example, choose olive oil instead of butter for stir fries, and consider having fish for dinner instead of meat, because fish contains healthy fats known as omega-3 fatty acids. Limit your fat at each meal to 3 grams or less to avoid digestive problems. You may know that a high-fiber diet can help you manage your diabetes by stabilizing and normalizing your blood sugar levels. In addition, getting plenty of fiber may help your digestive system normalize your bowel movements following gallbladder removal surgery, reducing the incidence of diarrhea and c Continue reading >>
Metformin And Pancreatitis | Diabetic Connect
I was misdiagnosed with type 2 diabetes and prescribed metformin. 4 days after starting the prescription I ended up in hospital fighting for my life with pancreatitis. Doctor should have advised me not to eat or drink after midnight before taking the test. I've had 3 other Doctors agree I never had type 2 diabetes. Now the tail of my pancreas is necrotic. They are trying to say it wasn't the metformin, but when I drank alcohol 25yrs earlier was the cause. I call B.S. can't get a real diagnosis of reason I got pancreatitis. Then I read this article, any help would be appreciated since my pancreas will continue to die slowly. I was diagnosed with type 2 diabetes in 2009. I was started on 500 mg Metformin twice daily but had a bad reaction to it so was taken off it. Five years later, a new doctor wanted me to try taking it again, this time extended release. I only took 500 mg once daily as I was afraid to approach my previous dosage for fear of the same reaction. I was on Metformin for only a year, at which time I contracted acute pancreatitis and sepsis. Was admitted to the hospital, had a seizure (presumably because of the sepsis) and I experienced cardiac arrest. My heart was restarted with CPR. I experienced kidney failure and my lungs started to fill up with fluid. Was on a respirator for several days then when they tried to extubate me. I went into cardiac arrest again. I stayed on the respirator for several more days until they were finally able to get me off it and I started to wake up and kidneys started to function again. Since that time I have been on only insulin, no oral medications of any kind. I had NONE of the risk factors for pancreatitis, except oral medications for diabetes (which IS a risk factor). But I didn't know it at the time. I just trusted the d Continue reading >>
What You Need To Know About Diabetes, Gallstones And Kidney Stones
Kidney stones and gallstones both occur more frequently in people with diabetes and metabolic syndrome, which causes insulin resistance. Kidney Stones and Type 2 Diabetes Kidney stones or nephrolithiasis are small pebble-like pieces of material that form in one or both of your kidneys from minerals in the urine. While most kidney stones exit the body without the help of a doctor, some stones get caught in the urinary tract where they can block the flow of urine and cause great pain. Kidney stones come in several types. The most common are uric acid stones, calcium oxalate stones, and infectious stones. People with diabetes or metabolic syndrome are particularly susceptible to developing uric acid kidney stones. Causes & Symptoms One reason why people with diabetes have a higher chance of having a kidney stone is that they often have highly-acidic urine, which puts them at risk for developing uric acid stones. Behind this acidic urine is poorly controlled diabetes. “When the body doesn’t have enough sugar for metabolism because either it isn’t producing insulin or not responding to insulin it’s forced to metabolize fat and that can make your urine acidotic,” says Phillip Mucksavage, MD, director of endourology and stone disease at Pennsylvania Hospital in Philadelphia. “This condition, called ketoacidosis, can change levels of the pH in urine.” Diabetes patients also have more calcium oxalate stones than the general population. Once again, uncontrolled diabetes is the culprit. “Uncontrolled diabetes can cause dehydration which is a prime risk factor for calcium oxalate stones,” says Dr. Mucksavage. Other diseases such as high blood pressure and obesity may also increase the risk of developing kidney stones. About 10% of people with kidney stones never k Continue reading >>
Metformin, The Liver, And Diabetes
Most people think diabetes comes from pancreas damage, due to autoimmune problems or insulin resistance. But for many people diagnosed “Type 2,” the big problems are in the liver. What are these problems, and what can we do about them? First, some basic physiology you may already know. The liver is one of the most complicated organs in the body, and possibly the least understood. It plays a huge role in handling sugars and starches, making sure our bodies have enough fuel to function. When there’s a lot of sugar in the system, it stores some of the excess in a storage form of carbohydrate called glycogen. When blood sugar levels get low, as in times of hunger or at night, it converts some of the glycogen to glucose and makes it available for the body to use. Easy to say, but how does the liver know what to do and when to do it? Scientists have found a “molecular switch” called CRTC2 that controls this process. When the CRTC2 switch is on, the liver pours sugar into the system. When there’s enough sugar circulating, CRTC2 should be turned off. The turnoff signal is thought to be insulin. This may be an oversimplification, though. According to Salk Institute researchers quoted on RxPG news, “In many patients with type II diabetes, CRTC2 no longer responds to rising insulin levels, and as a result, the liver acts like a sugar factory on overtime, churning out glucose [day and night], even when blood sugar levels are high.” Because of this, the “average” person with Type 2 diabetes has three times the normal rate of glucose production by the liver, according to a Diabetes Care article. Diabetes Self-Management reader Jim Snell brought the whole “leaky liver” phenomenon to my attention. He has frequently posted here about his own struggles with soarin Continue reading >>
Avoid The Metformin Bandwagon
From diabetes to cancer, berberine matches - or beats - this patent medicine every time! As many know, metformin is the number one prescription medication for type-2 diabetes. The patent for the name-brand of this patent medicine, Glucophage®, expired years ago and as a result generic-brand competition (metformin) brought this patent medicine’s price down so that it’s relatively inexpensive, especially when compared with nearly any other medication still covered by a patent. Mainstream medical research has found other uses for this un-natural molecule, including (but not limited to) lipid, blood pressure, and insulin resistance lowering effects, anti-cancer effects, improvement of polycystic ovarian syndrome, combatting Alzheimer’s disease, and extending life span in mice. Surprising guests on the metformin bandwagon Some proponents of natural therapies – including, surprisingly, two nationally and internationally circulated health magazines – have climbed on the metformin bandwagon, writing articles about the “health benefits” of metformin, and even advocating that otherwise healthy people take this patent medicine every day as a preventive. They admit that there are known side effects, but write that these are few, and that the benefits outweigh the risks. If there aren’t any natural treatment alternatives that are as effective, or more effective, than a patent medicine or other un-natural molecule – especially in serious or life-threatening situations – then the use of a patent medication of course makes sense. But when there are natural alternatives that work just as well or better, the rule is – and always should be – to “Copy Nature.” Human bodies are formed from the molecules of planet Earth, and powered by the energies of this planet Continue reading >>
Metformin (glucophage) Side Effects & Complications
The fascinating compound called metformin was discovered nearly a century ago. Scientists realized that it could lower blood sugar in an animal model (rabbits) as early as 1929, but it wasn’t until the late 1950s that a French researcher came up with the name Glucophage (roughly translated as glucose eater). The FDA gave metformin (Glucophage) the green light for the treatment of type 2 diabetes in 1994, 36 years after it had been approved for this use in Britain. Uses of Generic Metformin: Glucophage lost its patent protection in the U.S. in 2002 and now most prescriptions are filled with generic metformin. This drug is recognized as a first line treatment to control blood sugar by improving the cells’ response to insulin and reducing the amount of sugar that the liver makes. Unlike some other oral diabetes drugs, it doesn’t lead to weight gain and may even help people get their weight under control. Starting early in 2000, sales of metformin (Glucophage) were challenged by a new class of diabetes drugs. First Avandia and then Actos challenged metformin for leadership in diabetes treatment. Avandia later lost its luster because it was linked to heart attacks and strokes. Sales of this drug are now miniscule because of tight FDA regulations. Actos is coming under increasing scrutiny as well. The drug has been banned in France and Germany because of a link to bladder cancer. The FDA has also required Actos to carry its strictest black box warning about an increased risk of congestive heart failure brought on by the drug. Newer diabetes drugs like liraglutide (Victoza), saxagliptin (Onglyza) and sitagliptin (Januvia) have become very successful. But metformin remains a mainstay of diabetes treatment. It is prescribed on its own or sometimes combined with the newer d Continue reading >>
