Reply To: Are Gall Bladder Removal and Gout Related?

Stopping Gout Together Forums Help My Gout! The Gout Forum Are Gall Bladder Removal and Gout Related? Reply To: Are Gall Bladder Removal and Gout Related?

#7807
Keith Taylor
Keymaster


I don’t think it’s right that bile is no longer available after gallbladder removal since that organ only stores the stuff.

Of course! Basic high school biology forgotten already. Thanks for that and your experiences.

Looking back, I started this discussion with

Is there a link between gall bladder removal & gout? You need to look at all the circumstances. Is it just surgery that is the problem, or is there a gout link?

and

There are several reports of surgery increasing uric acid level, but this is short term, and not conclusive.

So I had another look at this and found a study showing that uric acid usually decreases after surgery. But it increases for some patients.
Snaith, M. L., and J. T. Scott. “Uric acid excretion and surgery.” Annals of the rheumatic diseases 31, no. 3 (1972): 162.

PLASMA URIC ACID (Table II).
In neither group of patients was any consistent pattern of change discernible. In cases 5, 9, 10, and 11 there was a slight decrease in postoperative levels, in Cases 3 and 8 a slight increase, and in Cases 1, 2, 4, 6, and 7, very little change. In both groups mean levels tended to be lower during the postoperative period; the mean basal plasma uric acid for all patients was 4.5 mg./ml. and the mean level during the six postoperative days was 4-2 mg./ml.

In all patients, uric acid excretion increased after surgery. So the mechanisms are clearly complex. Also, there are insufficient data to determine how the results are affected by:

  • Pre-op meds
  • Anasthetic type
  • Post-op meds
  • Type of surgery

Interestingly, the report suggests that gout flares after surgery might be similar to those experienced by patients taking uric acid meds when old crystals start to dissolve (see Allopurinol Medication: Why It Hurts To Get Rid Of Gout
All in all, the only conclusion seems to be that surgery is likely to affect uric acid. But we don’t know if it will go up or down. Also, to get back on topic, that applies to gallbladder removal as much as it does to any surgery.

So, if you are a gout victim with uncontrolled uric acid, it is wise to get uric acid under control before surgery if possible. If not possible, then it seems wise to discuss preventative or as-required gout pain relief with your doctor.

For other people, it is wise to monitor uric acid after surgery to ensure it does not get too high.