EXPERT
Munyaradzi Chimukangara
Surgeon
Dr. Munyaradzi Chimukangara is a general surgeon practicing in MAPLE GROVE, MN. Dr. Chimukangara specializes in abdominal contents including the esophagus, stomach, liver, gallbladder, pancreas and often thyroid glands. General surgeons are able to deal with almost any surgical or critical care emergency, also involving the skin or soft tissue trauma. Dr. Chimukangara provides quality surgical service for gravely ill or injured patients and is able to respond quickly due to knowledge of various surgical procedures.
Munyaradzi Chimukangara
- MAPLE GROVE, MN
- Accepting new patients
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Can you remove gallstones without removing the gallbladder?
*The answer is no.*
The best and standard way to remove gallstones is through gallbladder surgery called cholecystectomy. This surgery is largely performed laparoscopically READ MORE
*The answer is no.*
The best and standard way to remove gallstones is through gallbladder surgery called cholecystectomy. This surgery is largely performed laparoscopically in surgical candidates, meaning keyhole surgery with small incisions.
*Are there procedures to remove gallstones? Yes and No.*
Yes, there are procedures to remove gallstones that have exited the gallbladder, but are stuck in the ducts that drain bile to the gut. A common such procedure is called an ERCP done using a specialized scope through the mouth. Another is surgery.
No, there are no procedures to remove gallstones from the gallbladder itself without removing the gallbladder. The standard of care is cholecystectomy. Nonetheless, if a patient has gallstone issues that manifest outside of the gallbladder (pancreatitis, stones in the common bile duct, etc.), the recommendation is to also address the gallbladder, which is the nidus of the stones as to prevent further sequelae.
*Are there medications to remove gallstones? No.*
There are no medications to remove gallstones that are present in a gallbladder. There are, however, medications that may be used to prevent the formation of gallstones in certain circumstances by physicians. An example is Ursodiol.
*Are there diets to remove gallstones? No.*
While diet is important to prevent gallstone disease, once a person has gallstones, there is no diet to make the existing gallstones go away. Please note, once someone has gallstones that are causing issues, pain, etc., the stones are too big and are clogging the pipes that bile (the digestive juice that comes from the liver and gallbladder) travels through to go to the gut. This can lead to illness ranging from issues like intermittent nausea/pain to frank infection leading to severe illness and death. Therefore, it is paramount to consult with a physician for the appropriate indicated care. It is easier to fix/manage little problems, than to wait till they become complex issues.
The best and standard way to remove gallstones is through gallbladder surgery called cholecystectomy. This surgery is largely performed laparoscopically in surgical candidates, meaning keyhole surgery with small incisions.
*Are there procedures to remove gallstones? Yes and No.*
Yes, there are procedures to remove gallstones that have exited the gallbladder, but are stuck in the ducts that drain bile to the gut. A common such procedure is called an ERCP done using a specialized scope through the mouth. Another is surgery.
No, there are no procedures to remove gallstones from the gallbladder itself without removing the gallbladder. The standard of care is cholecystectomy. Nonetheless, if a patient has gallstone issues that manifest outside of the gallbladder (pancreatitis, stones in the common bile duct, etc.), the recommendation is to also address the gallbladder, which is the nidus of the stones as to prevent further sequelae.
*Are there medications to remove gallstones? No.*
There are no medications to remove gallstones that are present in a gallbladder. There are, however, medications that may be used to prevent the formation of gallstones in certain circumstances by physicians. An example is Ursodiol.
*Are there diets to remove gallstones? No.*
While diet is important to prevent gallstone disease, once a person has gallstones, there is no diet to make the existing gallstones go away. Please note, once someone has gallstones that are causing issues, pain, etc., the stones are too big and are clogging the pipes that bile (the digestive juice that comes from the liver and gallbladder) travels through to go to the gut. This can lead to illness ranging from issues like intermittent nausea/pain to frank infection leading to severe illness and death. Therefore, it is paramount to consult with a physician for the appropriate indicated care. It is easier to fix/manage little problems, than to wait till they become complex issues.
Anal pain?
Suspect that this could be a condition called symptomatic hemorrhoids versus and abscess. There are other conditions beyond the above it could be too. The best way to figure this READ MORE
Suspect that this could be a condition called symptomatic hemorrhoids versus and abscess. There are other conditions beyond the above it could be too. The best way to figure this out is to seek medical care from a physician
Does 5-HT3 receptor antagonists and D2 receptor antagonist prevent the same type of nausea?
Nausea is a complex physiologic response, involving more than one pathway. However, in the end, the body largely responds to nerve stimuli from the brain to create the response READ MORE
Nausea is a complex physiologic response, involving more than one pathway. However, in the end, the body largely responds to nerve stimuli from the brain to create the response we call nausea. The medications you have noted classically involve two neurotransmitters.
(a) 5-HT3 receptor antagonists, for example ondansetron, work by way of the SEROTONIN pathway
(b) D2 antagonists, for example metoclopramide, work by way of the DOPAMINE pathway. Therefore, some of these medications like metoclopramide have an effect of increasing motility in the GI tract.
Clinically speaking, 5-HT3 receptor antagonists (especially ondansetron) have become the workhorse for nausea treatment for many etiologies of nausea, not just CINV. This is because of numerous factors related to this drug class, that include, but are not limited to good patient tolerance, low side effect profile, multiple drug formulations, and cost. So, it is very common for practitioners to prescribe this medication class in most cases of nausea (not just CINV) as a starting point, assess response, and most patients respond well to the therapy.
Because of the above, D2 antagonists tend to be prescribed in special cases generally speaking. These include, but are not limited to scenarios where patients fail to respond to the 5-HT3 receptor antagonists, or are added as an adjunct to 5-HT3 receptor antagonists, or practitioners deem the D2 antagonists to be more aligned with the etiology they are trying to manage.
The other thing to realize is medications tend to have more than one action. This is something we also consider when making clinical decisions.
(a) 5-HT3 receptor antagonists, for example ondansetron, work by way of the SEROTONIN pathway
(b) D2 antagonists, for example metoclopramide, work by way of the DOPAMINE pathway. Therefore, some of these medications like metoclopramide have an effect of increasing motility in the GI tract.
Clinically speaking, 5-HT3 receptor antagonists (especially ondansetron) have become the workhorse for nausea treatment for many etiologies of nausea, not just CINV. This is because of numerous factors related to this drug class, that include, but are not limited to good patient tolerance, low side effect profile, multiple drug formulations, and cost. So, it is very common for practitioners to prescribe this medication class in most cases of nausea (not just CINV) as a starting point, assess response, and most patients respond well to the therapy.
Because of the above, D2 antagonists tend to be prescribed in special cases generally speaking. These include, but are not limited to scenarios where patients fail to respond to the 5-HT3 receptor antagonists, or are added as an adjunct to 5-HT3 receptor antagonists, or practitioners deem the D2 antagonists to be more aligned with the etiology they are trying to manage.
The other thing to realize is medications tend to have more than one action. This is something we also consider when making clinical decisions.
