Brief Answer:
Post cholecystectomy Syndrome

Detailed Answer:
Dear
Thanks for contacting with your health concern and following is/are step wise approach to your consideration(s)

1. PCS [post cholecystectomy syndrome] comprising of recurrence of pain and dyspepsia involves both biliary and extra biliary disorders BUT since the symptoms occurred nearly 5 years post laproscopic thus possible explanation could be:
. inflammatory scarring
. recurrent calculi and/or
. biliary dyskinesia

PS. This will require ultrasonography with CT scan followed by direct cholangiography.

2. Since MRCP is a non invasive and reliable alternative to above investigations for the evaluation of biliary tract thus is recommend by your doctor.

3. Since gall bladder has been removed, till further reports of MRCP comes, you can incorporate following:

a. Take: Cucumbers, Green beans, Sweet potatoes, Avocados, Vinegars [all types], Garlic, ripe tomatoes, lemon juice in the morning with hot water, apples, berries, papaya, pear.
. Vegetable juices - Beet and cucumber are especially helpful to gallbladder, avoid cabbage.
. Avoid all fruit juices except organic grape juice and organic apple: fresh, self-juiced is best [dilute with water before drinking]
. High fibre [fresh fruits and vegetables] and low fat diet [skimmed milk], hing, old brown rice, barley, horse gram, moong dal, ginger, green leafy vegetables, oil massage, boiled water,

b. Avoid: Eggs, Onions, Beans and legumes, Coffee, Oranges, grapefruit , Nuts, Fried Foods, Spicy foods, Chocolate, Ice cream, Carbonated water, Tap water, artificial sweeteners, sugar, preservatives, refined and bleached foods .
. Fried foods, urad dal, tomato, turnip, milk and milk products, constipating/heavy food, soda, alcohol, tea, potato, beet root, dry raisins, sour food, cashew nuts.


PS
. Take vitamin-C-rich foods in your daily diet: like amla, orange, grapefruit, kiwi, cantaloupe, XXXXXXX strawberries, broccoli, red pepper, or tomato juice. [Since vitamin C is needed to properly synthesize bile; and deficient intake causes bile to become cholesterol-rich and increasing the likelihood of stone formation].

4. although hormone imbalance [what is the current value of prolactin]? is one potential cause of ED [erectile dysfunction], you have to rule out other causes like high blood sugar, high cholesterol, liver-kidney disease, abnormal thyroid profile.

5. MANAGEMENT of ED

. start with perineal exercises: while urinating, stop the flow of urine, start again, stop & start again 4-5 times.
PS. perineal exercise [pelvic floor programme] is a noninvasive alternative for the treatment of patients with ED by clearing venous occlusion. [will help to achieve full erection afterwards] It also helps to strengthen the muscles and sphincters involved in erection and ejaculation.


. take: milk and milk products, ghee, makhan, cheese, curd, apple, black grapes, pears, raisins, dates, almonds, walnut,pomegranate, carrot, banana, apricots, musk melon, amla, coconut, pistachio, turnip, potato, onion, lady finger, radish, old brown rice, peas,garlic, bottle gourd.

avoid: sour and cold substances, tobacco [in any form], brinjal, tandori roti, red chilies, heavy and food which require long hours to digest, jaggery and its items, deep fried food.

PS. Before prescribing medication for ED, patient should be evaluated for any cardio vascular diseases, thus have an appointment with a Cardiologist for any potential risk of a cardio vascular event, so that Ayurveda medicines/herbs can be incorporated in your daily routine.

6. one of the alternate to 'pituitarium post' is "pituitary 6C" which balances the endocrine system and glandular function.


Dr. Munish Sood
Consultant & Physician
Naimittika

[you can reach me directly on: bit.ly/drmunishsood] for further necessary
Management

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