Fall 2012
Ask the Expert

My friend recently had her gallbladder removed. What does a gallbladder do? Do we actually need one?

Surgeon Elizabeth Honigsberg, MD, responds:

Gallbladder removal (cholecystectomy) is a relatively common surgical procedure with approximately 750,000 performed in the United States each year. Your doctor may recommend gallbladder removal surgery if you have gallstones that are causing pain, infection (cholecystitis), or other symptoms or if your gallbladder is not functioning properly.

The good news is, the gallbladder is an organ that is not essential to our health and there are few, if any, lifestyle changes one has to make after it is removed.

Located directly under the liver, the gallbladder stores some of the bile that the liver produces to help digest fats. When we eat, the gallbladder squeezes some of that bile into the small intestine through the common bile duct to help break down the food.

Even without a gallbladder, the liver continues to produce bile, which flows from the liver directly through the common bile duct and into the small intestine. Most people do not notice any difference in their digestion, but some people who have had their gallbladder removed experience mild diarrhea after a fatty food or meal. Reducing fatty foods is a good first step. Medication is also available.

 

What are kidney stones?

Urologist Jeremy Kaufman, MD, responds:

Kidney stones develop in all shapes and sizes in the urine. Most are small enough to pass through the urinary tract without requiring surgical intervention, although they can still be extremely painful as they travel.

Some patients need medical treatment and/or procedures for their kidney stones. These are patients who experience severe pain that is not relieved with medication, those who have a blockage from a kidney stone that is associated with an infection and those with a stone that has grown too large to pass on its own.

The most effective diagnostic test available today to evaluate for kidney stones is a CT scan. This allows your physician to understand the size and location of a kidney stone, whether it is causing a blockage and how likely it is to respond to treatment.

There are many advanced treatment options available. Some stones can be broken up using shock waves delivered directly through the skin without requiring any invasive measures. Other stones require more aggressive treatment that involves removing the stone through the lower part of the urinary tract or directly through the back.

 

I heard a report on NPR that there is a kidney stone epidemic. What can I do to avoid developing a kidney stone?

Chief of Nephrology Irwin Feintzeig, MD, responds:

There are several different kinds of kidney stones and different predisposing causes for some versus others. Diluting the urine can limit all types of stones from developing. Drinking water throughout the day is a basic and simple way to start.

Calcium-based stones are the most common type of kidney stone. For many years we have known that certain foods are associated with a higher risk of calcium stones. Specifically, animal-based protein (meat) and higher-sodium (salt) diets can increase calcium stone formation and growth. One thing you can do is limit these in your diet. (Plus, limiting these can also have added benefits for people who also have high blood pressure and/or cholesterol.) As with heart disease, a healthy diet rich in fruits and vegetables is the way to go for kidney stones too. Finally, although it may seem counter-intuitive, consuming less calcium than usual does not help and may actually increase the development of calcium-based kidney stones. The bottom line is, drink water, boost the number of fruits and vegetables you eat on a daily basis, maintain normal levels of calcium and limit animal-based proteins and high-sodium foods.

When choosing a specialist, be sure to select an expert physician affiliated with Bridgeport Hospital.
Nephrologists
Aaron Dommu, MD
Irwin Feintzeig, MD
Mitchell Fogel, MD
James Gavin, MD
William Hunt, MD
Robert Kim, MD
Paul Nussbaum, MD

Urologists
Milton Armm, MD
Jeremy Kaufman, MD
Edward Paraiso, MD
Arthur Pinto, MD
Jeffrey Small, MD
Nicholas Viner, MD
Robert Weinstein, MD
Howard Zuckerman, MD
Gastroenterologists
Pietro Andres, MD
Andrew Bedford, MD
Bryan Burns, MD
David Grayer, MD
Tarun Gupta, MD
Chunwang Lam, MD
Alan Landau, MD
Gordon Latzman, MD
Richard Link, MD
Caroline Loeser, MD
Darlene Negbenebor, MD
Alan Nelson, MD
Gregory Soloway, MD
Daniel Stupak, MD
Howard Taubin, MD
Scott Weiss, MD
General surgeons with special expertise in gallbladder removal:
Nabil Atweh, MD
Walter Cholewczynski, MD
Richard Garvey, MD
Elizabeth Honigsberg, MD
Andrew Kenler, MD
Felix Mpuku, MD
Alisa Savetamal, MD
John Schulz, MD
Subhash Shah, MD
Denis Tereb, MD
If you would like more information about, or a referral to, any of these physicians, please visit www.bridgeporthospital.org/FindPhysician or call 1-800-794-5013, toll free, 24/7.