I had my gallbladder removed and I still have pain

Gallbladder Surgery Complications

Potential Complications of Surgery

In addition to the expected digestive side effects, gallbladder removal carries a small risk of various complications. These include:

Bile Leakage

As part of the surgery to remove your gallbladder, clips are used to seal the tube that connected the gallbladder to your main bile duct.

It’s possible, though, for bile to leak into the abdomen if the clip doesn’t adequately seal the tube.

When a bile leak occurs, symptoms may include abdominal pain, nausea, fever, and swelling of the abdomen.

Sometimes a bile leak can be drained without the need for further surgery. In more severe cases, though, an operation is needed to drain the bile and wash out the inside of your abdomen. (3)

Bile Duct Injury

In very rare cases, your main bile duct may be injured in the course of removing your gallbladder.

If your surgeon realizes this right away, it may be possible to fix the problem immediately. But if not, and in certain other cases, you may need an additional operation to fix this. (3)

Injury to Surrounding Structures

In extremely rare cases, your surgery may cause damage to nearby blood vessels, your liver, or your intestines.

These problems can usually be spotted and fixed right away, but if they’re noticed only later, another operation may be needed. (2,3)

Colicky Pain

A study published in March 2018 in the journal HPB found that among people who underwent gallbladder removal because of mild gallstone pancreatitis (inflamed pancreas), nearly 15 percent experienced an attack of pain in the area after the surgery.

Most of these attacks were single events that took place within two months of the surgery. No factors were found to predict who develops this type of pain. (4)

In some cases, pain may result from gallstones remaining in the bile ducts. Surgically removing these gallstones may resolve the pain. (3)

Blood Clots

People with certain risk factors — like prior clots, prolonged immobilization, or cancer — are at higher risk for developing a blood clot after surgery.

This type of clot, known as deep vein thrombosis, usually develops in your leg but can travel to — and lodge in — other areas of your body, causing problems such as cutting off blood flow to parts of your lungs (known as pulmonary embolism).

If you have an elevated risk for blood clots, you may need to wear compression stocking after your surgery to prevent clots from forming in your legs. (3)

Infection

After your surgery, you may develop either an internal infection or one at the incision site.

Signs of an infected wound include:

  • Increased pain at site
  • Swelling
  • Redness
  • Pus leaking from wound

To treat an infection, your doctor will prescribe antibiotics. In rare cases, it may be necessary to surgically drain fluid or pus from the infected area. (3)

Bleeding (Hemorrhage)

While it’s rare, bleeding can occur internally or externally after your operation. If this happens, you may need a further operation to stop the bleeding. (3)

Anesthesia reactions

It’s possible — though very rare — to have severe reactions to the anesthesia used for your surgery, including a severe allergic reaction or even sudden death. (3)

Heart Problems

Especially if you already have cardiovascular disease, the stress of surgery can cause or worsen heart problems. (2)

Pneumonia

During your surgery, you’ll be given a breathing tube, since you won’t be able to breathe on your own under general anesthesia. This ventilated breathing may increase your chance for pneumonia.

In rare cases, you can develop a lung infection following your surgery as a result of this. Depending on its severity, you may be prescribed oral antibiotics, or you may need to be hospitalized and given intravenous (IV) fluids and antibiotics. (2)

Scars and Numbness

It’s possible that you’ll develop scarring and a loss of sensation at or around your incision sites. (5)

Hernia

Part of your intestines or some other tissue may bulge through your abdominal wall at an incision site. This bulge may be painful, and if it doesn’t resolve on its own, it may require surgery to correct. (5)

Symptoms After Gallbladder Removal

Gallbladder Surgery Recovery Time

Some people recover quickly from a cholecystectomy, while others take longer, feeling discomfort and even pain for 2-3 months after gallbladder removal. In most cases, that will resolve over time.

Of those who tell me that they feel great right out of the gate, I often wonder if they are not just so relieved to be free of the attacks, the pain, the nausea, the tenderness and other gallbladder symptoms, that they don’t notice minor discomfort.

But maybe there just aren’t any symptoms to speak of!

For those who call me asking how long it will take for the pain to go away and if it is normal to feel pain after gallbladder surgery, I say this: “Discomfort is common for 2-3 months.”

I have seen it last for 12 months and then suddenly disappear.

Apart from any pain resulting from scar tissue or other surgery-related issues, the symptoms listed below are related to the possible side effects of no longer having a gallbladder.

The symptoms have a root cause, some of which are due to the side-effects of having no gallbladder; some are due to something totally different, such as food allergies or inflammation; and some are a combination of several underlying things going on simultaneously. The links lead to more in-depth information.

  • attacks
  • severe pain
  • nausea
  • vomiting
  • mild discomfort
  • gas and bloating, distension
  • burping, belching
  • feelings of fullness
  • heartburn, new or worse
  • acid and bile reflux
  • Barrett’s esophagus
  • constipation
  • diarrhea
  • dumping syndrome
  • weight gain

Gallbladder Attacks After Removal

How could anyone have gallbladder attacks with no gallbladder? Well, technically, they can’t. But if you had gallstones, the attacks were brought on by gallstones blocking the neck or a bile duct. After surgery, stones can still form in the bile ducts and liver, producing the same symptoms and pain.

So even though the gallbladder, its neck, and the cystic duct have been removed during cholecystectomy, it is still possible to develop a stone inside the bile duct. This condition is called choledocolithiasis.

If you had your gallbladder removed due to a low-functioning gallbladder without stones, you are not likely to experience any severe pain like you did before. However, other gallbladder symptoms may be present and may arise over the following months and years. These are primarily due to insufficient, less concentrated bile, or an imbalance in bile acids creating toxic bile.

Attacks are only one of several problems people may experience after gallbladder removal. While some problems are just annoying, others cause excruciating pain. But all of them have an underlying cause. It may take some sleuthing to find that cause in some cases. Others are rather easily understood and can be resolved with a little effort.

You can use diet to prepare for surgery and to support your recovery afterward, but if you have any symptoms whatsoever, following our Diet After Gallbladder Removal makes sense.

Cholecystectomy

What is a cholecystectomy?

A cholecystectomy is surgery to remove your gallbladder.

The gallbladder is a small organ under your liver. It is on the upper right side of your belly or abdomen. The gallbladder stores a digestive juice called bile which is made in the liver.

There are 2 types of surgery to remove the gallbladder:

  • Open (traditional) method. In this method, 1 cut (incision) about 4 to 6 inches long is made in the upper right-hand side of your belly. The surgeon finds the gallbladder and takes it out through the incision.

  • Laparoscopic method. This method uses 3 to 4 very small incisions. It uses a long, thin tube called a laparoscope. The tube has a tiny video camera and surgical tools. The tube, camera and tools are put in through the incisions. The surgeon does the surgery while looking at a TV monitor. The gallbladder is removed through 1 of the incisions.

A laparoscopic cholecystectomy is less invasive. That means it uses very small incisions in your belly. There is less bleeding. The recovery time is usually shorter than an open surgery.

In some cases the laparoscope may show that your gallbladder is very diseased. Or it may show other problems. Then the surgeon may have to use an open surgery method to remove your gallbladder safely.

Why might I need a cholecystectomy?

A cholecystectomy may be done if your gallbladder:

  • Has lumps of solid material (gallstones)

  • Is red or swollen (inflamed), or infected (cholecystitis)

  • Is cancerous

Gallbladder problems may cause pain which:

  • Is usually on the right side or middle of your upper belly

  • May be constant or may get worse after a heavy meal

  • May sometimes feel more like fullness than pain

  • May be felt in your back and in the tip of your right shoulder blade

Other symptoms may include nausea, vomiting, fever, and chills.

The symptoms of gallbladder problems may look like other health problems. Always see your healthcare provider to be sure.

Your healthcare provider may have other reasons to recommend a cholecystectomy.

What are the risks of a cholecystectomy?

Some possible complications of a cholecystectomy may include:

  • Bleeding

  • Infection

  • Injury to the tube (the bile duct) that carries bile from the gallbladder to the small intestine

  • Liver injury

  • Scars and a numb feeling at the incision site

  • A bulging of organ or tissue (a hernia) at the incision site

During a laparoscopic procedure, surgical tools are put into your belly. This may hurt your intestines or blood vessels.

You may have other risks that are unique to you. Be sure to discuss any concerns with your healthcare provider before the procedure.

How do I get ready for a cholecystectomy?

  • Your healthcare provider will explain the procedure to you. Ask him or her any questions you have.

  • You may be asked to sign a consent form that gives permission for the procedure. Read the form carefully and ask questions if anything is not clear.

  • Your provider will ask questions about your past health. He or she may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests.

  • You must not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight.

  • Tell your provider if you are pregnant or think you may be pregnant.

  • Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general).

  • Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.

  • Tell your provider if you have a history of bleeding disorders. Let your provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.

  • If this is an outpatient procedure, you will need to have someone drive you home afterward. You won’t be able to drive because of the medicine given to relax you before and during the procedure.

  • Follow any other instructions your provider gives you to get ready.

What happens during a cholecystectomy?

You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare provider’s practices.

A cholecystectomy is generally done while you are given medicines to put you into a deep sleep (under general anesthesia).

Generally, a cholecystectomy follows this process:

  1. You will be asked to take off any jewelry or other objects that might interfere during surgery.

  2. You will be asked to remove clothing and be given a gown to wear.

  3. An intravenous (IV) line will be put in your arm or hand.

  4. You will be placed on your back on the operating table. The anesthesia will be started.

  5. A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

  6. If there is a lot of hair at the surgical site, it may be clipped off.

  7. The skin over the surgical site will be cleaned with a sterile (antiseptic) solution.

Open method cholecystectomy

  1. An incision will be made. The incision may slant under your ribs on the right side of your abdomen. Or it may be made in the upper part of your abdomen.

  2. Your gallbladder is removed.

  3. In some cases, 1 or more drains may be put into the incision. This allows drainage of fluids or pus.

Laparoscopic method cholecystectomy

  1. About 3 or 4 small incisions will be made in your abdomen. Carbon dioxide gas will be put into your abdomen so that it swells up. This lets the gallbladder and nearby organs be easily seen.

  2. The laparoscope will be put into an incision. Surgical tools will be put through the other incisions to remove your gallbladder.

  3. When the surgery is done, the laparoscope and tools are removed. The carbon dioxide gas is let out through the incisions. Most of it will be reabsorbed by your body.

Procedure completion, both methods

  1. The gallbladder will be sent to a lab for testing

  2. The incisions will be closed with stitches or surgical staples

  3. A sterile bandage or dressing or adhesive strips will be used to cover the wounds

What happens after a cholecystectomy?

In the hospital

After the procedure, you will be taken to the recovery room to be watched. Your recovery process will depend on the type of surgery and the type of anesthesia you had. Once your blood pressure, pulse, and breathing are stable and you are awake and alert, you will be taken to your hospital room.

A laparoscopic cholecystectomy may be done on an outpatient basis. In this case, you may be discharged home from the recovery room.

You will get pain medicine as needed. A nurse may give it to you. Or you may give it to yourself through a device connected to your IV (intravenous) line.

You may have a thin plastic tube that goes through your nose into your stomach. This is to remove air that you swallow. The tube will be taken out when your bowels are working normally. You won’t be able to eat or drink until the tube is removed.

You may have 1 or more drains in the incision if an open procedure was done. The drains will be removed in a day or so. You might be discharged with the drain still in and covered with a dressing. Follow your provider’s instructions for taking care of it.

You will be asked to get out of bed a few hours after a laparoscopic procedure or by the next day after an open procedure.

Depending on your situation, you may be given liquids to drink a few hours after surgery. You will slowly be able to eat more solid foods as tolerated.

Arrangements will be made for a follow-up visit with your provider. This is usually 2 to 3 weeks after surgery.

At home

Once you are home, it’s important to keep the incision clean and dry. Your provider will give you specific bathing instructions. If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and usually will fall off within a few days.

The incision and your abdominal muscles may ache, especially after long periods of standing. If you had a laparoscopic surgery, you may feel pain from any carbon dioxide gas still in your belly. This pain may last for a few days. It should feel a bit better each day.

Take a pain reliever as recommended by your provider. Aspirin or other pain medicines may raise your risk of bleeding. Be sure to take only medicines your healthcare provider has approved.

Walking and limited movement are generally fine. But you should avoid strenuous activity. Your provider will tell you when you can return to work and go back to normal activities.

Call your provider if you have any of the following:

  • Fever or chills

  • Redness, swelling, bleeding, or other drainage from the incision site

  • More pain around the incision site

  • Yellowing of your skin or the whites of your eyes (jaundice)

  • Belly or abdominal pain, cramping, or swelling

  • No bowel movement or gas for 3 days

  • Pain behind your breastbone

A Case of Persistent Hiccup after Laparoscopic Cholecystectomy

Abstract

A 79-year-old man, with history of recent laparoscopic cholecystectomy, came to our attention for persistent hiccup, dysphonia, and dysphagia. Noninvasive imaging studies showed a nodular lesion in the right hepatic lobe with transdiaphragmatic infiltration and increased tracer uptake on positron emission tomography. Suspecting a malignant lesion and given the difficulty of performing a percutaneous transthoracic biopsy, the patient underwent surgery. Histological analysis of surgical specimen showed biliary gallstones surrounded by exudative inflammation, resulting from gallbladder rupture and gallstones spillage as a complication of the previous surgical intervention. This case highlights the importance of considering such rare complication after laparoscopic cholecystectomy.

1. Introduction

Since its introduction, laparoscopic cholecystectomy has become the gold standard of treatment for symptomatic gallstone disease. Gallbladder perforation by trocars with gallstone spillage is an extremely rare event, which can lead to several complications, such as abdominal wall and intraabdominal abscesses formation .

2. Case Presentation

A 79-year-old man, former smoker, with history of arterial hypertension, atrial fibrillation, and laparoscopic cholecystectomy for gallstone disease 4 months before, came to our attention for the onset of hiccup, dysphonia, and dysphagia for one month. Suspecting a gastroesophageal reflux, the patient had been initially treated with proton pump inhibitors for 2 weeks but without symptoms relief. Physical examination was normal; in particular, no abnormal masses, lymphadenopathies, or signs of mediastinal involvement were present. Blood tests revealed normocytic hypochromic hyposideremic anemia with positivity of faecal occult blood test, increase of neuron specific enolase (NSE), cromogranin A, and beta2-microglobulin. Chest X-ray did not show abnormal findings. Abdominal ultrasound revealed a subcapsular hypoechoic mass of about in the right hepatic lobe. Computed tomography of neck, thorax, and abdomen with intravenous contrast demonstrated a nodular image of about close to the diaphragm, in the right side, with transdiaphragmatic infiltration and invasion of the 7th hepatic segment, contrastographic enhancement of the diaphragm in the same location, and arterial vascularization (Figure 1). Small subcarinal lymph nodes were present. Positron emission tomography showed areas of increased tracer uptake in the right costal-phrenic angle and mediastinal subcarinal region (Figure 2). An abdomen magnetic resonance further characterized the lesion, showing a solid component surrounded by a blood-like fluid labrum, with compression of the underlying liver parenchyma, pulmonary consolidation, and minimal pleural effusion close to the lesion (Figure 3). For positivity of faecal occult blood test esophago-gastro-duodenal and colon endoscopy were also performed; they showed only telangiectasia of the inferior part of esophagus and sigma diverticulosis, respectively. No biopsies were performed due to the difficulty of a percutaneous transthoracic approach. Therefore, suspecting a neoplastic lesion, the patient underwent surgery via a left thoracoabdominal approach. An oval lesion of about 30 mm of diameter infiltrating the diaphragm and closely adherent to the lung was enucleated. The histological analysis of surgical specimen showed biliary gallstones surrounded by exudative inflammation with foreign body giant cells. The patient quickly recovered from surgical intervention with complete symptom relief.


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(c) Figure 1
Axial (a), coronal (b), and sagittal (c) images from a computed tomography of neck, thorax, and abdomen with intravenous contrast demonstrating a nodular image close to the diaphragm, in the right side, with transdiaphragmatic infiltration, hepatic invasion, and arterial vascularization (arrows).

Figure 2
Positron emission tomography scan showing an area of increased tracer uptake in the right costal-phrenic angle (arrow).

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(d) Figure 3
Axial (a and b), coronal (c) and sagittal (d) images from an abdomen magnetic resonance showing a lesion with solid component surrounded by a blood-like fluid labrum, with compression of the underlying liver parenchyma, pulmonary consolidation and minimal pleural effusion (arrows).

3. Discussion

Since its introduction, laparoscopic cholecystectomy has become the gold standard of treatment for symptomatic gallstone disease with morbidity rates ranging from 2% to 11% compared to 4%–6% for elective open cholecystectomy. The benefits of laparoscopic cholecystectomy for gallbladder surgery are significant, minimizing mortality rates in the perioperative period, reducing the length of stay in the hospital, and allowing patients to return to their normal activities sooner when compared to open cholecystectomy. However, it carries some major complications, such as damage to the biliary system, blood vessels, and gastrointestinal tract. Additionally, gallbladder perforation by trocars in laparoscopic cholecystectomy leads to bile and gallstone spillage with a reported incidence of 5.4%–19% . Theoretically, spilled gallstones can be displaced to any part of the abdominal cavity leading to several complications, such as abdominal wall and intraabdominal abscesses. The intraabdominal abscesses are commonly located in the subhepatic space or in its retroperitoneal region. Fistula formations, hernia sacs, and ovary and fallopian tubes containing lost gallstones are among some of the rare complications noted for gallstone abscess. Migration of stones through the diaphragm has been also described in case reports, mainly secondary to subphrenic abscesses. The underlying pathophysiologic process involves inflammatory reaction secondary to the presence of retained stones. They may then erode through the diaphragm and cause a bronchopleural fistula with cholelithopthysis, thoracic empyema, or pulmonary abscess . Abscess formation from dropped stones after laparoscopic cholecystectomy has been reported to have an average duration of 4 months, like in our case, to 10 years . In our case, noninvasive imaging studies initially supported the hypothesis of a neoplastic lesion. Secondary involvement of the diaphragm from other intraabdominal or intrathoracic tumors can occur, commonly by direct extension, from mesothelioma, lung cancer, and hepatic carcinoma. Instead, primary tumors of the diaphragm are rare and more than half are benign. The most common benign lesions are bronchogenic or mesothelial cysts and lipoma, while the most common primary malignant lesion is rhabdomyosarcoma . The inflammatory reaction secondary to the presence of retained gallstones can simulate proliferative lesions, giving false positive results on imaging studies such as positron emission tomography. This case highlights the importance of considering such rare but possible complication accompanying gallbladder surgery in patients with history of laparoscopic cholecystectomy.

Authors’ Contribution

All the authors contributed equally to this work.

Conflict of Interests

The authors declare that they have no conflict of interests.

Hiccups

What are hiccups?

Hiccups are repeated spasms of the diaphragm paired with a ‘hic’ sound from your vocal cords closing. The diaphragm is a muscle under your ribcage, separating the chest and the stomach area. This muscle is an important part of the breathing process. It moves downward when you breathe in and upward when you breathe out.

Two things happen when you hiccup:

  • The diaphragm pulls down between breaths, making you suck in air.
  • The glottis (space between the vocal cords) closes to stop more air coming in.

These actions make the ‘hic’ sound of the hiccup. The process of the hiccup happens very quickly and usually returns to normal within minutes to a few hours without treatment.

Can hiccups happen to anyone?

Yes. Hiccups can happen to adults, children, and infants. They are more common in men.

What causes hiccups?

It is not clear why people get hiccups. There are several reasons hiccups might happen, including low levels of carbon dioxide in the blood and irritated nerves. The phrenic nerve (connects the neck to the diaphragm) and vagus nerve (connects the brain to the stomach) are important parts of the breathing process.

Mild hiccups (those that go away in a short period of time) can happen when you:

  • Eat and drink too quickly
  • Drink carbonated beverages
  • Eat too much
  • Experience stress
  • Over-stretch your neck
  • Take drugs (particularly those for anxiety – benzodiazepines)
  • Drink alcohol
  • Drink a very hot or very cold drink

Long-lasting hiccups can be linked to a more serious condition. In those cases, they will not go away until the problem is corrected.

What does it mean if the hiccups last for more than two days?

If the hiccups do not go away within a few days, they are called persistent. If they last for a few months they are called intractable (long-lasting hiccups). Long-lasting hiccups are rare. They can be stressful and exhausting. Intractable hiccups can be part of a larger medical problem and might not go away until that issue is corrected.

Some of these conditions include:

  • Cancer
  • Stroke
  • Tumor
  • GERD (gastrointestinal and abdominal disorder)

Hiccups can also happen after surgery and during the recovery process from a procedure. See a doctor if your hiccups last for a long period of time.

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Coping with cancer

Hiccups are a common problem that we all have from time to time. For most people, hiccups are usually mild and go away without any medical treatment. But when hiccups are a symptom of cancer, or a side effect of cancer treatment, they can go on for longer. This makes them tiring and difficult to cope with.

Hiccups are uncontrolled spasms of your diaphragm between normal breaths. The diaphragm is the dome shaped muscle under your ribcage. Normally, your diaphragm helps to pull air into your lungs by pulling downwards as you breathe in. And when you breathe out, your diaphragm pushes upwards.

But when you hiccup, 2 things happen:

  • your diaphragm contracts and pulls down between your normal breaths, sucking air in
  • immediately after this, the top of the windpipe (trachea) closes briefly, to stop more air getting in – this makes the ‘hic’ sound.

Causes of hiccups

We don’t know the exact cause of hiccups. It might happen if the nerve that controls the diaphragm (the phrenic nerve) is irritated.

Things that might trigger hiccups include:

  • eating and drinking too quickly, particularly gulping fizzy drinks
  • over eating
  • heartburn
  • stress
  • sudden changes in air temperature
  • over stretching your neck
  • certain drugs, such as medicines to treat anxiety (benzodiazepines)
  • alcohol

But if you have cancer you might also get hiccups if:

  • your stomach stops working and becomes extended and bloated
  • you have an infection affecting your chest or food pipe (oesophagus)
  • you are having chemotherapy, steroids or an opioid painkiller such as morphine
  • the cancer is pressing on your diaphragm
  • you have symptoms because of a brain tumour
  • your kidneys are not working normally and your blood chemistry changes
  • you have high blood calcium levels (hypercalcaemia)

Things to try for mild hiccups

Most people find that their hiccups go away either on their own or by trying one of the following suggestions:

  • gargling or drinking ice water
  • eating a piece of dry bread slowly
  • drinking water from the far side of a glass – you will need to be able to bend over to do this
  • taking a deep breath, holding it for as long as you can and repeating this several times
  • sucking on a lemon
  • drinking peppermint water
  • pulling your knees up to your chest
  • breathing in and out of a paper bag (not a plastic one and don’t do this for any longer than 1 minute)

Treatment for more severe hiccups

Some hiccups can last for more than a couple of days. Doctors call these persistent hiccups. If they last longer than a month, doctors call them intractable. If they last this long they can cause other problems, including:

  • weight loss
  • difficulty in sleeping
  • feeling sick (nausea)
  • embarrassment
  • feeling sad or depressed

People with persistent or intractable hiccups need medical treatment. First, your doctor will try to find out what is causing your hiccups. They may disappear by treating the cause, for example, changing the drugs that may be responsible for the hiccups.

But your doctor may treat the hiccups directly. Drugs they may use include:

  • the anti sickness drug metoclopramide (Maxolon)
  • a sedative, such as haloperidol or chlorpromazine
  • a drug to relax your muscles such as baclofen

All you need to know about belly button discharge

There are a few common causes of belly button discharge, which are explained below:

Bacterial or fungal infections

Share on PinterestWhile infections are the most common cause of belly button discharge, other causes include surgery and diabetes.

Leaving the belly button unclean can allow harmful bacteria to overpower the helpful ones and cause an infection.

According to a paper posted by PLOS One, the average belly button contains 67 different types of bacteria, some harmful and some helpful.

A common risk factor for bacterial infection is a belly button piercing. An open wound such as a piercing is the ideal way for bacteria to get under the skin and cause an infection.

Bacterial infections cause a discharge that has a disturbing smell to it. The discharge may be off-yellow or green in color and will often cause swelling and pain.

A fungal infection or yeast infection may cause symptoms that are slightly different. Candida albicans is a yeast found naturally on the skin that prefers dark, damp environments, including the armpits and groin.

A Candida yeast infection will often cause a rash in and around the affected area. The rash is usually itchy and red, and the discharge coming from the belly button will be thick and have an off-white color to it.

Surgery

Anyone who has recently had abdominal surgery and notices pus or liquid draining from their belly button should call their doctor. This kind of discharge may be a sign of an internal infection that needs immediate treatment.

Cysts

Cysts are hard or soft growths that are filled with liquid and pus.

A urachal cyst may be the cause of belly button discharge. The urachus is the tube connecting the bladder of the fetus to the umbilical cord. While the urachus usually closes up before a baby is born, sometimes it does not close completely.

In cases where the urachus tube has not closed completely, a cyst may then form on it later in life. If the cyst becomes infected, it may cause a cloudy or bloody fluid to leak from the belly button. Other symptoms can accompany a discharge, such as abdominal pain, fever, and pain when a person urinates.

Sebaceous cysts are also a cause of belly button discharge in some cases. The sebaceous glands release oil in the skin. If one of these glands in or near the belly button gets backed up or clogged with dirt and oil, a cyst may form under the skin.

If the cyst is infected and leaking, a thick off-white to yellow discharge will often come from it. The discharge will have a foul smell, and the cyst itself can be swollen, red, and painful.

Diabetes

Conditions such as diabetes may put a person at risk of having a discharge from their belly button at certain times. According to research in the Journal of Pediatric & Adolescent Gynecology, there appears to be a link between high blood sugar and candida yeast infections.

People with diabetes often have a higher blood sugar than normal, and yeast feeds on this sugar. The yeast can then spread more easily in the body and on the skin.

FAQs about Sphincter of Oddi Dysfunction

What is the sphincter of Oddi?

The sphincter of Oddi refers to the smooth muscle that surrounds the end portion of the common bile duct and pancreatic duct. This muscle relaxes during a meal to allow bile and pancreatic juice to flow into the intestine.

What is sphincter of Oddi dysfunction?

Sphincter of Oddi dysfunction refers to the medical condition that results from the inability of the sphincter to contract and relax in a normal fashion. This may cause obstruction of bile flow resulting in biliary pain and obstruction to the flow of pancreatic juice, which can lead to pancreatitis.

What causes sphincter of Oddi dysfunction?

The cause of sphincter of Oddi dysfunction is unknown. Several theories have been proposed including the presence of microlithiasis (microscopic stones in the bile) and duodenal inflammation.

What are the symptoms of sphincter of Oddi dysfunction?

The symptoms of sphincter of Oddi dysfunction include recurrent attacks of upper right quadrant or epigastric abdominal pain. This pain is usually non-colicky and steady. The pain may be aggravated by meals, particularly fatty foods. Opiates may also worsen symptoms. Patients may present with a recurrence or persistence of pain after gallbladder removal.

Who is affected by sphincter of Oddi dysfunction?

Sphincter of Oddi dysfunction is usually seen in female patients who have had their gallbladders removed. Typically, patients range in age from 30 to 50 years.

How is sphincter of Oddi diagnosed?

Noninvasive tests include: (1) a blood test to measure liver and pancreatic enzymes; and (2) radiographic tests: quantitative hepatobiliary scintigraphy in which a radioactive isotope is injected into the bloodstream, and the uptake and clearance of the isotope from the liver and biliary tract are measured.
Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure used in diagnosis. During ERCP, an endoscope is inserted into the mouth and advanced to the duodenum to the opening of the bile and pancreatic ducts. Contrast is injected and measurements of ductal diameter and biliary and/or pancreatic drainage times are made. Sphincter of Oddi manometry is the gold standard to diagnose sphincter of Oddi dysfunction. It may be performed at the time of ERCP, and measures pressures using a triple lumen catheter and water perfusion. High pressures are indicative of sphincter dysfunction.

Can sphincter of Oddi be treated and if so, how?

Medical therapy may be considered in the initial treatment plans. This includes a low-fat diet, antispasmodics, non-addictive analgesics, nifedipine and nitroglycerin. Usually the side effects of these drugs limit their usefulness, and none of the drugs are specific to the sphincter of Oddi.
More invasive treatment modalities include: endoscopic injection of botulinum toxin (Botox) into the sphincter and endoscopic or surgical ablation of the sphincter of Oddi.

What is the cause of recurrent symptoms?

Recurrent symptoms usually occur if there is scarring of the incision made during endoscopic sphincterotomy or surgical sphincteroplasty.

What is the long-term outcome of sphincterotomy or sphincteroplasty?

Long-term relief of pain in patients who have undergone endoscopic or surgical procedures for sphincter of Oddi dysfunction may be demonstrated in up to 70 percent of patients.

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