Like many people who experience gallbladder problems, Journey guitarist Neal Schon spent years dealing with a pain whose cause he couldn’t quite identify. The Hall of Fame rocker learned that cause the hard way recently when he was hospitalized for surgery to remove his gallbladder.
Schon, 64, tweeted Feb. 9 he “apparently had this for the last 3 1/2 years and didn't know it.” As it too often does, that problem came to the fore in a big way.
He wrote that his gallbladder had become “very inflamed-infected” but added that he was “feeling better than ever” after surgery to remove it, called a cholecystectomy.
His experiences — both of not recognizing his pain as coming from the gallbladder and of feeling better when it’s removed — are common ones, said Eric Rideman, DO, a board-certified surgeon who practices at AdventHealth Altamonte Springs, formerly Florida Hospital Altamonte.
Based on his tweets, Schon probably suffered from acute cholecystitis, a swelling of the gallbladder that is usually caused when the main opening of the organ is plugged by a gallstone, Dr. Rideman says.
Before this happens, patients often spend years in occasional pain that can flare up after a meal. When they’re able to seek medical attention before an emergency arises, patients can get their gallbladder removed in a safer, more convenient surgery.
“It’s always better to operate when there isn’t an active infection, such as acute cholecystitis,” Dr. Rideman says.
He explains what the gallbladder is, how it can go wrong and how surgery can help.
Of Gallbladders and Gallstones
The gallbladder is a small organ — it varies in size between a kiwi and a large orange — tucked under the liver, in the upper right part of your belly. It stores a liquid called bile that helps the small intestine digest food.
It’s not clear why some people develop gallstones, most of which are made of cholesterol, a type of fat. They come in different sizes, up to about a quarter’s-width, and they really do look like small pellets, Dr. Rideman says, colored green to brown to black.
Though they are more common in older adults, gallstones can develop in just about anyone. It’s often said that greasy, fatty food brings on gallstone pain, but Dr. Rideman says there’s no diet that will reliably prevent gallstone problems.
They’re not always painful.
“Plenty of people walk around with gallstones and will never know it,” Dr. Rideman says.
Others experience bouts of pain, as a gallstone gets lodged in a passage for bile.
“Some people tough it out for innumerable episodes and come to find out they have gallstones when they have a bigger episode, a true emergency,” Dr. Rideman says.
Symptoms of gallstones include:
- Pain from the upper right part of your belly after meals, sometimes extending to the back
- Nausea (stomach discomfort and the urge to vomit) and vomiting
- Chest pain
Because these symptoms are vague, not much different from indigestion or heartburn, most people in pain don’t think of gallstones. Many people with gallstones end up learning about it because they go to an emergency department believing they may be having a heart attack.
Diagnosing gallstones is typically done using an ultrasound, a painless procedure that uses sound waves to create an image. If gallstones aren’t causing problems, they can typically be left alone. But if there’s a risk of acute cholecystitis, doctors may recommend the gallbladder to come out.
Getting the Gallbladder Out
Unlike similar stones elsewhere in the body, gallstones can’t be dissolved or disintegrated; their only treatment is surgical removal of the gallbladder. Surgery to remove the organ is the most common general surgery procedure in the United States.
It happens under general anesthesia, meaning the patient is unconscious and unaware of the surgery. It is typically performed through three or four small incisions roughly the width of pencil, which is called laparoscopic surgery.
Instead of removing the gallstones themselves, the gallbladder is removed with the stones inside. The surgeon inserts a bag through one of these holes, wraps the gallbladder and removes the bag. This technique prevents the gallbladder from leaking into the abdomen, potentially causing an infection.
Most patients are in some pain when they wake up, but painkillers generally keep it under control. Patients whose surgery was scheduled usually go home the same day as their surgery, though people who come into the emergency department may stay overnight.
After they leave the hospital, most patients can control their pain with over-the-counter medicine.
Aside from the relief of gallstone pain, life without a gallbladder doesn’t change much. At first, some patients have symptoms like diarrhea, but within a month or so their bodies adapt.
“What we hear the most is ‘Thank you for getting me back to a normal lifestyle,’” Dr. Rideman said.
That was Schon’s experience, too. “I’m feeling better then ever,” he said in a tweet. He said he’s still planning to kick off a four-show “Journey Through Time Tour” on Feb. 22.
As with any surgery, a gallbladder removal includes risks. They include a bile duct injury or leak, both of which are quite rare but require an extra procedure to fix.
Then long-term pain caused by gallstones is more than a nuisance; it’s a burden on both body and mind. Even when patients know they have gallstones and don’t worry about where their pain is coming from, it can still limit their lifestyle and diet.
If you think you may have gallstones, consider talking to your doctor as the first step on a path back to a normal diet and relief. By using the latest laparoscopic techniques, AdventHealth surgeons help their patients recover more quickly and with less pain.