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Is removal of gall bladder necessary? Have scalp psoriasis and nail pits

Hello Dr. is the removal of gall bladder necessary to cure the patient from gall stones and how the fatty lever disease is related with gallstone . I have been diagnosed with gallstones and fatty lever. I also have scalp psoriasis and nail pits.My IT Software job involves shift working including night shifts. thankyou a lot!! MShakeel
Asked On : Sun, 6 Jan 2013
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Gastroenterologist 's  Response
Hello, MShakee,
If you have been diagnosed to have gallstones, especially ,mutiple,
then removal of gallbladder is the definitive treatment as a cure.
You can live without a gallbladder which is essentially a storage
organ. Bile is produced in the liver and carried to the gallbladder.
It releases the bile periodically after meals to help with digestion.
Even after the gallbladder is removed, bile now comes into the
intestine directly and helps with digestion. In some people,
there could be diarrhea from bile irritation on the lining of the
intestine, but his is temporary and gets better with time.
As for recuperation, it is faster since the surgery is done through
a laparoscope and it is same day in and out surgery.
As for as fatty liver is concerned, it depends on the grades.
Grade 0-1 or even Grade-2 , is completely reversible with proper
diet, weight control, sugar control and lipid control. You should
consider taking Super B-Complex Vitamin daily, along with 1000 mg.
of Vit-C and 800 i.u. of Vit-E daily. These will help. If you have not
had complete liver tests, get it to see how the enzyme levels are.
If they are normal, you don't have to worry.
I wish you well.
Answered: Sun, 6 Jan 2013
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General & Family Physician Dr. Ravi Kant's  Response
Gall stones can be symptomatic or silent(asymptomatic), silent stone can be left as such if it is not causing any problem because gall bladder removal(cholecystectomy) itself can cause many complications intraoperatively and postoperatively Symptomatic stone need surgery which can be open(laprotomy) or laproscopic.
Gall stones are mainly of two types cholesterol and pigment stone, cholesterol stone can be sometime removed by medical treatment but it is attempted only when stone size is less than 8mm confirmed through abdominal USG.Ursodeoxycholic acid is taken orally for 2 year can dissolve cholesterol stone in few cases. ERCP can be done to remove the stone causing obstruction of common bile duct, extracorporeal shock wave lithotripsy can be done to break the gall stone into smaller pieces which can then be passed out through stool.
Fatty liver is a reversible condition in which triglyceride(fat) gets accumulated within liver cells, it can cause enlargement of liver, mild jaundice, increased liver enzymes in serum and even fibrosis and cirrhosis in late cases. But this fatty liver can be reversed back by loosing weight slowly, reducing fat intake and quieting alcohol completely.
Fatty liver directly does not causes gall stone so commonly but metabolic dearrangement due to obesity can cause both cholesterol gall stone and fatty liver.So try to avoid overeating and alcohol and take adequate rest.
As far your scalp psoriasis is concerned first of all treatment with systemic or topical steroid, retinoid, methotrexate or cyclosporine can be used for removal of the lesion and the relapse can be prevented by using tar products like gel,cream,ointment or medicated shampoo daily or twice weekly as required.
Don't worry and take care.

Answered: Mon, 7 Jan 2013
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