Dr. Ramesh Kumar S
Medical Gastroenterology
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Education:
fellow of american college of gastroentrology
Professional Bio:
Dr.Ramesh Kumar S is a highly skilled and established physician in the field of Medical Gastroenterology. He listens to all the patient queries deliberately and is an expert in devising a proper treatment plan.
This doctor is not available for online consultations on the platform anymore.
Dr. Ramesh Kumar S
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Patient's Query
Hello doctor,
My recent ultrasound of the gallbladder showed a 4 mm polyp, a 1.7 cm stone, and a small amount of sludge. Though I am asymptomatic, I visited my gastroenterologist. His opinion was that though rare, having a stone and polyp increases my risk of malignancy, and suggested removal. I am very hesitant to remove and seek your input regarding the increased malignancy risk. Would Ursodiol be useful? If so, how long would it take to work?
Hello,
Welcome to icliniq.com.
Yes, Ursodeoxycholic acid can be tried for three months. But, it is effective only in about 40 % of the cases. A gallstone even if asymptomatic should be removed through surgery because if somehow it slips into the bile duct, then it will block the pancreatic duct causing the symptoms of pancreatitis. Pancreatitis is a medical emergency that can be fatal. Hence, gallbladder stones should be removed laparoscopically at the earliest.
I hope this helps. Thank you.
Patient's Query
Hello doctor,
Regarding my gastroenterologist's statement that having both a stone and polyp increases my malignancy risk, do you agree with that? I am very reluctant to go for surgery as I read many people complain of lifelong digestive and bowel issues post-surgery. Does being male reduce or increase post-surgery complication risk?
Hello,
Welcome back to icliniq.com.
Yes, a polyp and a stone at the same time can increase the chance of malignancy in the future by about 0.5 % to 1 %. Practically, I have performed almost 2000 cholecystectomies and the only problem patient usually face is that they have to limit their fat intake. However, there are many complications, yet they are very rare. Sex has nothing to do with increased risk. Please attach the printed reports of the ultrasound of your abdomen to know the location of the polyp, stone, and its proximity to the bile duct.
Patient's Query
Hello doctor,
I have attached the file below.
Hello,
Welcome back to icliniq.com.
Have seen all the reports and photos attached (attachment removed to protect the patient's identity). The size of the stone is small. Actually, small stones are more dangerous than large stones, because the chances of them slipping out of the gall bladder into the common bile duct are very high and this can lead to a number of complications, which can be even life-threatening also. Sludge is also present in the gall bladder which will further crystalize into new stones. My suggestion is to get the gall bladder removed and stay away from any tension.
Patient's Query
Hello doctor,
Thank you for reviewing the images and reports. What is the current location of the stone? Is it near the bile duct now or causing an obstruction? I am asking because I may attempt Ursodeoxycholic acid before removal.
Hello,
Welcome back to icliniq.com.
Polyps less than 1 cm are usually nonmalignant so do not worry about malignancy. The location of the stone is in non dependent part which means on the other side of the bile duct however location of the stone varies with movements because stone unlike polyp is not fixed. Urodeoxyxholic acid 300 mg twice daily can be tried for three months if you do not want to go for surgical procedures.
I hope this helped. Thank you.
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Dr. Ramesh Kumar S
Medical Gastroenterology
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