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How Can Severe Itching Developed Two Weeks Post Gall Bladder Removal Be Treated ?

Posted on Fri, 20 Apr 2012

Question: Good evening,

My wife's gallbladder was removed two weeks ago and since four days she has a very strong iching (sometimes burning) in her hand palms and sometimes in other parts of the body. No other symptoms. However, after revisiting the hospital and taking another blood test, the doctors did not find any critical numbers (liver, bilirubin was fine) and they prescribed her Benadryl. This is not working and the itching drives her crazy. Is this something she just needs to be patient with or can it be something serious like cirrhosis? Thank you and best, XXXXXXX

Answered by Dr. Dr. Rakhi Tayal (31 minutes later)

Hello.
Thanks for writing to us.

The most common reason of itching after gall bladder removal is raised levels of bile salts in the body which gets deposited beneath the skin.

This possibility has already been ruled out by the blood test.

Another possibility is an allergy to any air borne allergen. For this, she has been given benadryl.

If the itching is persistent, then i will suggest you to go for checking the bile duct blockage. A blood test can rule out the bile ducts as the problem, as well as an ultrasound or ERCP.

You can ask your doctor to check liver enzymes as well.

Avoid foods that have high fat or fried foods as well as whole grain breads and cereals, nuts, seeds or gas producing vegetables (baked beans) from the cabbage family (broccoli, brussel sprouts, cabbage or cauliflower). Spicy food seasoned with red or black pepper may cause some discomfort for persons with gall bladder diseases.

For symptomatic relief, you can apply calamine lotion on the skin or coconut oil will help in soothing it.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Wishing you good health.
Regards.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Dr. Rakhi Tayal (2 hours later)

Thanks for the answer yesterday the hepatic values were everything fine, however do you think is better to ask about the bile duct blockage? Thanks

Answered by Dr. Dr. Rakhi Tayal (1 hour later)

Hello.
Thanks for writing again.

Bile duct blockage is the most likely possibility and to investigate for it will be most appropriate.

Also follow the diet advice too.

Hope my answer is helpful.
Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Dr. Rakhi Tayal (7 hours later)

Thanks for the answer. But the doctor told us that could not be bile duct blockage because she hast to have more complications. The hepatic values were the following:
total protein 7.6
albumin 4.4
alk phos 53
alt sgot 23
alt sgpt 28
dir billurubin 0.0
total billirubin 0.3

Everything is normal, what do you think?

Thanks

Answered by Dr. Dr. Rakhi Tayal (1 hour later)

Hi,

Thanks for the follow up.

Yes, your hepatic function tests are normal. It seems that bile duct blockage is not a case here.

Then most likely it is allergic only. Do not worry about cirrhosis as it is much more serious.
Allergic causes need to be excluded.

Hope this is helpful.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr. Rakhi Tayal (25 hours later)

Thanks for the answer. One question you can see if is probably to have a bile conduct blockage just with the blood test or sometimes you can't see any anormal value? or is better a ultrasound to see that? you can trust 100% in the blood test?. for hepatic problems do you need just a blood test examen or oder examens? Thanks

Answered by Dr. Dr. Rakhi Tayal (7 hours later)

Hello.

Thanks for writing again,

If there is blockage of duct, liver functions are definitely affected which are evaluated by blood tests only.

Ultrasound shows only external appearance of liver and not its functional capacity. It will show only late changes on a prolonged illness.

Other investigation preferred for diagnosing a blocked duct is ERCP. your can ask your doctor to get an ERCP done.

Regards.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Manju M