A GALLING CONDITION

UNDER THE KNIFE: Kate Baily needs to have her gallbladder removed

Tuesday July 21,2009

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THE pain of gallstones is so severe that it can be mistaken for symptoms of a heart attack, as sufferer Kate Baily explains

I was woken one night in September last year with an excruciating stabbing pain in my stomach. As I screamed in agony my husband Dave began to call for an ambulance but almost immediately it stopped. Apart from a touch of heartburn I felt fine and went back to sleep. It was only next morning I realised my urine was the colour of dark tea and the whites of my eyes had turned yellow.

My doctor took blood tests to check for elevated levels of liver enzymes as this is a symptom of hepatitis which is inflammation of the liver. These revealed excess levels of the main bile pigment bilirubin in my blood. This indicates liver problems and explained my yellow eyes. The pain in my stomach was believed to be gastritis, the cause of which was uncertain.

SEVERE: The condition can be mistaken for symptoms of a heart attack

I felt exhausted. At night I itched so much I thought we had fleas in the house. I later discovered this is also a symptom of a liver condition.

A week later, when my eyes and urine lost their yellow hue, results came back confirming I had hepatitis A. I was told it can by caught through poor food hygiene or contact with stools. This was understandable as my two-year-old son William is still in nappies. I was told to avoid alcohol and rest.

Two weeks later the specialist at Royal Sussex Hospital in Brighton close to my home in Hove said he suspected I had “passed” a gallstone after a particularly fatty meal. This would explain the severe pain and upset stomach. He believes it had become temporarily lodged in the bile duct which had caused the hepatitis. An ultrasound scan would produce more conclusive results.

I waited six weeks for a scan during which time my skin continued to itch and I had nausea, vomiting and diarrhoea. I lost weight, ached all over and felt depressed. Some days I couldn’t get out of bed and when I did I had a short concentration span and my mind felt fuzzy. Fortunately, by the time I had the scan, my blood and liver tests had returned to normal and I was starting to feel better.

It showed a healthy liver and digestive system apart from three fairly large gallstones, the smallest of which measured 9mm in diameter. I was advised to have my gallbladder removed. Since the bile duct is only 4mm in diameter any one of the stones could get stuck and require emergency surgery.

I was surprised with the diagnosis. I eat a healthy diet and I’ve never been overweight.

The only explanation I can suggest is that in my 20s I restricted all fats and had a vegetarian diet. When I met my husband, I started eating meat. I wonder if my system couldn’t cope with the change?

Surgeon Mohammad Abu Hilal from Spire Southampton Hospital, a specialist in gallstones is not convinced. “Many people with different types of diets including a lot of fat will still not form gallstones,” he says. “It is difficult to be sure whether the cause was due to the viral infection or to a passage of gallstones. You do not have acute problems now but you have gallstones in a diseased gallbladder. It is very likely this did contribute to your symptoms and therefore having it removed is more than sensible.”

Dr Abu Hilal refers to the“four Fs” that characterise high-risk groups for developing stones: fertile, female, fair and 40. This is me. I am taking great care to restrict all saturated fats as these make stones bigger and stimulate the gallbladder which could release another stone. I’ve also booked an appointment to have my gallbladder removed. I’m terrified of the same thing happening again.

To contact Dr Mohammad Abu Hilal visit www.spirehealthcare.com/southampton

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