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What should I do for my multiple gastric problems?

Dr Sanjiv Saigal
Consultant Gastroenterologist,
Sir Ganga Ram Hospital,
New Delhi

Q: I have been diagnosed with grade III oesophagitis, antral gastritis and duodenogastro oesophageal reflux (bile reflux) after an endoscopy. The nuclear scan showed severe contractile dysfunction of gall bladder and delayed biliary to bowels transit of tracer, and are compatible with chronic cholecystitis (GBEF is minus 24%). No stones present. Will taking any antibiotics improve my gall bladder inflammation? Is there no alternative to gallbladder surgery? Will bile reflux stop after surgery since bile also flows directly from liver to duodenum?

A:In those suffering from chronic cholecystitis, removal of the gall bladder by surgery is the best option. However, in your case, you also suffer from significant gastroesophageal reflux disease. So your symptoms may not improve fully despite getting the gall bladder surgery done. Antibiotics are effective in acute cholecystitis, and will not improve further the chronic inflammation of the gall bladder.For the GE reflux you will need active treatment with acid suppressants, GI prokinetics, and life style measures. These would include avoiding fatty meals, avoiding aerated beverages, keeping the head end of your bed elevated by a brick, not going to sleep within an hour of taking meals, etc.