Itchy skin after gallbladder removal

I had my gallbladder surgery last February. If it’s already 5th week and you still feel pain that’s not normal, you should visit your doctor. You might have infection due to surgery or your appendix might be affected because of the gallbladder surgery. (Check your appendix if the pain is on your lower right belly) This is base on the experience of other patients including me. And regarding the itchiness, doctors will say itchiness is normal due to the medicine you’re taking. Ask your doctor for ointment or some med you can apply on your skin. It is hard but avoid to scratch the itchy part as much as you can because it will just get worst and it might leave you wound/scar. Drink plenty of water 

Hi, Hotwheels and Macgirl!! I had the same after my gallbladder surgery. First my hands started swelling then I started getting itchy on my hands and my belly all over. Itching is so severe it makes me crazy. I just saw the surgeon today for my follow up and she brushed it off told me to go and see my GP. I don't know what to think or do. I used cortizone cream and it's not helping. Please let me know if you guys find out anything.

Hi Mia,

Your post is 9 months old but I figure it's worth a try to find others in similar circumstances to mine . Did you find any resolution to your itching? I had my gallbladder removed on December 5, 2019 and about a month after the surgery I was stuck with intense itching. It resolved after about 12 weeks (around April of 2020) but then returned about 6 weeks ago, around October 1, 2020.

For starters, your surgeon is full of crap, they should take your concern more seriously. Your itch is a type of itching called cholestatic pruritus, which means that it is the result of some type of bile flow impairment. One of the problems that you will run into is that most doctors are still under the mistaken impression that these types of itching can be verified in your blood chemistry, specifically by checking for something called bilirubin. This is an old medical canard, bilirubin has nothing at all to do with this type of itching. In fact, there is no way for pruritus of cholestasis to be confirmed in blood chemistry. However, as I mentioned, many doctors will dismiss your claim about your itching when they fail to see bilirubin in your blood tests. So your first battle will be in convincing them that you are not crazy or making this up.

If you are still active on this forum, please contact me. I am trying to contact as many people as I can find who are in a similar situation. I do have a list of medications which are now recommended by GIs to combat cholestatic pruritus. These are relatively new as it has only been very recently that this type of itching is a little more understood, although it's complete pathogenesis is still largely a mystery. I wish you well.

Regards,

Ray

two weeks ago i had emergency gallbladder removal surgery, less than 24 hours after the hospital removed gallstones. I went home and was back in the hospital within 2 hours, very sick, throwing up, had a fever, blood infection, freezing, trouble breathing etc. mri showed dr. nicked my bile duct and there was fluid outside it. i went from bad to worse and was in the hospital for four days. about a week later the intense itching came and hasn't left. it's everywhere. I was also on around the clock antibiotics, iv and pills, for four days, plus 5 days of pills when i got home, so i have a vaginal yeast infection, and in my stomach and mouth, so i was thinking maybe the all over body itch had something to do with that. anything you can tell me that can help, i'd really appreciate. thank you!

Hi - So this really caught my attention. I've suffered with this intense itching for 8 LONG years now. Can you imagine that guys, and I still have my gallbladder. In the beginning I thought it was scabies and I was the butt of jokes in my family. After seeing countless doctors, derms, internal medicine, the ER, GI's and surgeons I dealt with the same crap, they had no clue why I was itching, refused to run further tests and treated it as if it was trivial -- when I clearly stated that is has really affected my quality of life. I heard the same BS that my bilirubin would have to be elevated for me to be itching -- you are exactly correct, that's what they were taught in medical school. The insensitivity of doctors has been unbelievable -- I think when they will never understand unless they experience it themselves. The itching gets so intense at times it's very debilitating. Early 2020 I had my first gallbladder attack and then obstructive jaundice. I refused surgery/cholecystectomy because I was so scared when they took me to pre-op. I've extensively researched this for 1 year now and came to the same conclusion, cholestatic pruritis -- in fact, I've seen many doctors and told them this condition specifically and they still shrugged their shoulders at me. So I dug deeper I went to a holistic practice run by a cardiothoracic surgeon and she was the only one to confirm it must be my bad gallbladder. I'm confident it is, but now I'm scared that removing it will only lead to more itching (from what I'm reading here). Though, I found 2 people in Facebook support groups who confirmed that their itching completely resolved post-op. This scares the crap out of me because how do I know what my outcome will be, every person will be different. I understand the anatomy and pathogenesis much better now -- itching with a bad gallbladder is caused by low bile flow, biliary obstruction and probably excess pruritgens in the bloodstream. When you have gallstones in the gallbladder it's impeding bile flow which explains why you will be constipated. I think also the bile stored in the gallbladder gets too concentrated when it's not ejecting properly and maybe pushes bile back up towards the liver and irritates it and causes itching. My concern now is that by removing the gallbladder you will have a constant trickle of bile flowing into the biliary system which can maybe cause excess bile irritating the gut and then induce further itching (as evident by what you guys are saying here). To any of you has your itching resolved post-op? I'm about to go through with surgery after trying alternatives for 1 year, and asking many docs to just cut the stones out, but none of them will do it, it goes against their gold standard. I would love to go to China and get a gallbladder-preserving cholelithotomy, but that's unlikely during the pandemic. And they charge $6,500.

Yeah, the bile leak you had would most definitely cause itching. Itching is completely a result of the liver and bile flow, and any obstructions. I'm so sorry to hear this happened to you. Did they correct the leak and has it resolved now?

Hi Ray,

I started taking care of my husbands grandparents probably September 2020 and not too long ago the grandmother had an emergency gallbladder removal. Shortly after her recovery she started mentioning this intense itching all over her body. We've tried lots of creams but nothing really helps. She has an appointment tomorrow with her GP so i will mention this condition. Any advice or suggestions greatly appreciated.

Alexis

Hi so I am wondering how you're doing? did you get it removed? I never itched until i had it removed sounds like you may have had blockage . Diet is key at this point ... to minimize the bile leaking .

I hope you're feeling better the itching can drive you nuts !

HI Ray,

I am 6 weeks post op from Gallbladder removal. At my 2 week follow up, the Dr felt I had an infection in my belly button incision and put me on an antibiotic. Took that, felt ok, was working my way through eating well. A week after I FINISHED the antibiotic, broke out in a horrible rash, on the feet and hands, spread to arms and up legs. Primary directed me to Urgent Care because he was booked. Urgent care diagnosed as "delayed allergic reaction" and prescribed 7 days of Prednisone. Finished Prednisone. Exactly 7 days later, it's back. Primary again said Urgent Care, but we will refer to Dermatologist. I insisted on blood work, because NO ONE has checked anything since Gallbladder removal. He agreed. Today I had blood work and went to Urgent Care. Urgent Care says - no way this is allergic reaction. I think you have Gallbladder Vasculitis. Requires more blood work and you need to see your Primary AND a Dermatologist. Now, I'm reading this post and I'm shocked to see how many others have these issues! What medications were used to treat you?

Jenn

Hi - I did not remove my gallbladder yet and I'm miserable with my itching. I'm going to see more doctors to get answers but I think I'm delaying the inevitable and just worsening my quality of life because of my fear and anxiety. I've weaved a long web of indecisiveness and I'm getting ready to call the surgeon. Diet-wise, I've ate healthy for 13 years as a vegetarian/vegan, I'm not in pain or having attacks, just the pruritus which I can't tolerate any longer. I've postulated that my low-fat diet may be the cause of my gallstones, causing my gallbladder to not empty properly. I had 1 ERCP don't think I have any blockages (unless intrahepatic; in fact, I was confused how the ERCP did not resolve my itching because I had obstructive jaundice - unless some stones were missed. What's your story?

Has your itching resolved?

Ray - Has your itching resolved at this point? How far post-op are you?

I found a GI doc/professor running a clinical trial that offered to do a bile acid test and cholestasis genetic panel - they actually can test for cholestasis. He was hard to find, but has been the most knowledgeable.

I also had a hepatologist tell me the same bull about bilirubin, unbelievable. Apparently the American healthcare system needs to be reformed so people don't suffer for years - they can update those old canards that are not producing good patient outcomes. I'm gonna write a book about this.

You can do another CT scan with contrast or MRCP to find more possible stones/blockages - intra or extrahepatic. The doc said CT's show calcifications better (stones) vs. MRI's.

rmroz,

If you could get into contact with me, or simply respond to this post with the list of medications you're talking about, I'd be really grateful.

Had my gallbladder taken out about 3 months ago, and have had very upsetting chronic itches all over my body. Doctors are attempting to send me to a dermatologist, even though this itching started exactly after my gallbladder removal. It's very annoying.

There doesn't appear to be a private messaging system on this site, so I'll try keep tabs on here for a response, not sure how much you frequent here.

Thank you,

-Mark

How did your testing go?

Hi Mark, sorry to hear about your itch. It is terrible. And sorry to others who have replied to my post, I have been busy dealing with things and was not getting email notifications about these questions on this forum so I was never aware of them. Sorry. I will login in a day or two and properly reply to everyone.

Mark, this link to an excellent medical journal article titled Itch and Liver: Management in Primary Care published in The British Journal of General Practice in 2015 contains a high level summary of some of the most recent information available regarding cholestatic pruritus, it's causes, treatment and so on. Specifically there is section titled Diagnosis and Treatment which mentions a few medications along with supporting study data. The first line of drug therapy is cholestramine powder (brand name Questran here in Canada). I have used it with some decent results thus far with very minor side effects (constipation). Please don't be thrown by the title of the article or by the primary focus of the subject matter (Liver disease). The underlying mechanism around your pruritus and those found with liver disease produce essentially the same net effect.

I will add more later, but I hope that this gets you started. And keep in mind that these therapies are meant to be a stop gap to manage your itch until you and your doc can find a cause. Of course this assumes that you have a doctor who is willing to take you seriously and admit that something might be wrong. And believe me, questioning medical orthodoxy is not going to make you popular. In any event, good luck and I'll be back here soon.

Regards,

Ray

Hi Alexis,

Sorry to hear about your grand mum-in-law and her itch. It can be incredibly stressful, especially for a senior should think.

Please have a look at my answer to mark1993 below. I would recommend that you print out the article which I referenced, it's quite short. I would also recommend that you direct your GP to the first paragraph of the "Presentation" section, pointing out that the salient point you are referring to is the complete lack of correlation between (blood) chemistry, namely bilirubin, and the presence of an itch (he/she will try and deflect and straw man you by saying that this article is about liver disease - remind them that your point is about the lack of connection between bilirubin and itch). Emphasize that there has been no rash, no skin conditions which are responsible for the itch and that it is NOT a secondary itch (docs will always try to find some other cause here for the itch, be it a rash, an allergy, an irritant - it seems that doctors are big fans of coincidence. I am not). As I said, your first battle will be to shake him/her lose from the mistaken belief that cholestatic pruritus can be seen in the blood chemistry.

Once you win your doctor over to your side you can at least begin to address the actual issue and maybe get your grand mum some help. A HIDA scan might be a good next step (yes people without a gallbladder can get them - in fact it makes them cheaper and quicker to do). Or maybe an ERCP. The crucial part is getting your doctor onside first, so that's your first big step. Good luck!

Regards,

Ray

wow, 8 years of intense itching!?! How you have not wound up in a lunatic asylum is beyond me, because another year of this and I would be eating a very BIG barbiturate sandwich.

Please let us know how it goes for you. I suspect that your itching will have resolved with your cholecystectomy, just playing the numbers should produce that result. In any event, I certainly hope so. And I completely understand your hesitancy with regard to GB removal. As i understand it, however, those who have developed stones/sludge once are much more likely to redevelop them again and this is why physicians opt for the full cholecystectomy. Although, and this leads in well with my next point, recent medical studies are showing an interesting relationship coffee and gallbladder disease. Regular coffee drinkers are less likely to develop gallbladder disease, with heavy coffee drinkers virtually never developing stones or sludge. So perhaps stone removal followed by a heavy coffee habit? I would make that bargain.

I hope things have gotten better. And if you did opt for the cholecystectomy and are having other bile acid related symptoms, have a look at cholestramine as well. It works wonders for things like bile acid related symptoms/side-effects, post GB removal.

Regards,

Hello again,

My cholecystectomy was on 5 December, 2019 (incidentally this is my birthday... no kidding). It did resolve again, about 8 weeks after the second flare up last fall, but it has returned again for a third time last week on thursday which is what reminded me to check back here - I was surprised at all of the answers.. As I mentioned elsewhere, I tried the cholestramine, 2x4g pouches per day, 1 first thing and one in the evening. It really seemed to mitigate my symptoms when used last fall. I began it again 2 days ago and it seems to be helping again. I'll update.

I would be interested in whatever info you have on that clinical trial though, assuming they are still looking for participants. Where is it situated? I'm in Canada btw.

And thanks for the advice. I am waiting on CT with IV contrast now actually. And I am having a FibroScan of my liver next month just to cover my bases.

Finally, I just want to point out that my gallbladder came back from pathology as completely healthy. I never had stones or sludge (I knew that going in actually but they convinced me that my GB was malfunctioning and causing me pain). I did have two attacks which felt exactly like how biliary colic is described and dull pain (which I still have). I also eat quite well - NOT a vegetarian but actually close to one. I am lean body type (6'1", 185 lbs), so not typical for GB stones. And a heavy coffee drinker (see earlier post) Anyway, my point is that I have to live with the fact that this all happened for nothing as my GB was perfectly healthy...

sighs

Regards

Ray

Dana, this s**t is bananas. Let me start be saying that your lucky to have pulled through this far. You have had a rough go there with some terrible complications. Bile leaks are, as I understand them to be, nasty business. And then to pile on septicaemia along with everything else.... just wow.

I see this was all 6 months ago. I sure hope that things have settled back to boring for you and that your docs have you all sorted out.

With regard to your itch, for sure, any bile leak could conceivably cause intense itching. And much worse. I sure hope that they have you all fixed up by now. Please let us know. And also keep an eye for possible complications such as Fitz Hugh Curtis Syndrome or the like, especially given the extent of infection within the peritoneum. Good luck!

Ray

Well it appears as if the chemistry has been cracked at least. Here is an article which details the very recent research of this problem.

Journal article

I suspect that the race will be on now by big pharma to produce a field of products to manage this problem. Unfortunately I fear that the initial prices will be exorbitantly expensive for many Americans, at least until the patents expire on the drugs.

regards,

Ray