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Had chronic cholecystitis and mirena coil was removed after the scan. Increased the dosage of spironolactone. Will it affect digestive health?

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Practicing since : 2005
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i was booked to have my gallbladder removed as it had chronic cholecystitis. I had the mirena coil removed a few days after the scan. Two months later, prior to the op, I had a scan and my gallbladder is now three times the size as it was before and completely healthy with regular walls. The only thing I changed was that I removed the mirena. My bloodwork shows cholesterol at 163, I am very slim and sporty. I did not have stones. the only other thing I have done is increase my spironolactone dose from 100g mg per day to 200mg. My question is, as both the mirena and the spironolactone work on playing with potassium, progesterone levels and magnesium, which one of these is likely to have had such a big impact on my gallbladder and digestive health? I do still have gallbladder pain, but I am not sure if it is psychosomatic!
Posted Tue, 19 Nov 2013 in Liver and Gall Bladder
Answered by Dr. Rhea Chanda 51 minutes later
Brief Answer:
Mirena is not the cause

Detailed Answer:
The removal of the MIRENA is not the cause for any of your gall bladder problems. Its a hormone medicated device and is unrelated to any changes that might occur with your liver and GB. You need to still have that surgery, because any enlargement of the GB is pathologic. If its size has increased, then its because, of infection, or stones or blockage. Now, spironolactone is a potassium sparing drug, that means that it doesnt increase absorption of potassium. That means that your potassium levels may be higher than usual.Progestrone levels are unaffected by this, but sometimes, magnesium levels can be. But only is severe cases. If you have GB pain, you should get it removed. Only a histopathology of the specimen can give you a diagnosis. Your potassium levels do need to be monitored because in the long run it can affect the heart. Less potassium in the gut can cause bowel problems.
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Follow-up: Had chronic cholecystitis and mirena coil was removed after the scan. Increased the dosage of spironolactone. Will it affect digestive health? 12 minutes later

Thank you for your email. Please can you explain to me what the term pathologic means medically?

Thank you for your kind reply!

Answered by Dr. Rhea Chanda 6 minutes later
Brief Answer:
Pathology means abnormal

Detailed Answer:
Pathology means anything abnormal in the biochemical or microbiological structure of the organ. In this case, it means that the there must be a reason for the enlargement of the gall bladder like infection, stones or tumors, scarring of the ducts, kinking of the ducts, blockage of the ducts etc. This inflammation of the GB causes digestive problems. Hence, the need for surgery. It can end up in jaundice, if not treated.
Above answer was peer-reviewed by
Follow-up: Had chronic cholecystitis and mirena coil was removed after the scan. Increased the dosage of spironolactone. Will it affect digestive health? 6 hours later

Thank you for all your detailed replies. I just have one more question. what are the symptoms of an infected GB? I have stomach ache and chills and nausea, but I thought this was actually flu. I do not feel terrible, just not operating on full cylinders! I have an appointment with my surgeon on Thursday and the operation is still booked for the following Tuesday, but any information that you can give me is enormously useful as I am just so confused. When I did the most recent scan on monday, the gastro- intestinal doctor thought the GB looked healthy and could not believe how much it had grown. I do know that you already answered this question earlier, but my question this time is are there any further diagnostic tests, blood tests or other things to check before surgery if the GB is infected or if it has repaired itself. It would be a tragedy to remove a healthy organ. I would like to know which other tests I could ask for prior to the operation to help clarify this matter.
Answered by Dr. Rhea Chanda 2 hours later
Brief Answer:
All tests may have been done

Detailed Answer:

The symptoms of cholecystitis are pain is in the right upper quadrant radiating to the back , nausea , vomiting , appetite problems , and sometimes digestive problems . The best method of diagnosis is examination , ultrasound , ct scan and liver function tests . I believe all have been done?. If the organ is enlarged then it cannot be totally healthy .

A normal GB is not palpable on examination . If there is inflammation and recent changes its possible that it may still 'appear ' healthy . Chronically inflamed .GB may have thick walls with sludge .

I suggest you see your surgeon again and let him re examine you .

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