Habba Syndrome....
#315121 - 09/16/07 04:28 PM
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Habba Syndrome, if you have not read up on it here is how Habba breaks down "It is an association between a dysfunctional, intact gallbladder and chronic diarrhea. Patients with the syndrome present with varying degrees of chronic diarrhea (three or more bowel movements per day for at least three months). Diarrhea is classically described as frequent, loose bowel movements and may be watery in nature. They could be explosive at times and may even be associated with great urgency and even incontinence. Diarrhea is mostly after meals (post prandial diarrhea). Because of this urgency, patients usually look for a bathroom wherever they go, also known as "bathroom mapping".
These symptoms are usually very distressing and may cause social embarrassment and interference with daily activities. Some patients are even homebound in fear of social embarrassment. Some lose weight because they are afraid to eat for fear of getting diarrhea.
Diarrhea is rarely nocturnal, unless the patient had a late meal close to bedtime.
It is not associated with blood, unless it comes from irritation of the rectal area as a result of frequent bowel movements.
Dr. Habba found that this type of diarrhea is associated with dysfunctional gallbladder.
Is there pain associated with this syndrome?
The patient would not necessarily have abdominal pain related to the gallbladder disease. They could be completely free of any abdominal pain. The gallbladder function is only determined by an abnormal radio-nuclear test that studies the function of the gallbladder (DISIDA scan with CCK injection). This test is non-invasive and can be performed in all well-equipped hospitals and radiology centers.
If ultrasound of the gallbladder is normal, could I still have the syndrome?
Absolutely. In fact, most of the patients with the syndrome have normal ultrasound of the gallbladder. However, the presence of gallstones on ultrasound does not rule out the diagnosis of the syndrome."
i know thisis a little long but i thought the informaiotn might be helpful to some of oyu out there with an intact gallbladder.
Good Luck 
--------------------
Amanda
IBS-D
Severe Pain
aworkman307@yahoo.com
www.myspace.com/aworkman307
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Hi Amanda,
I am male, 30, and also saw the advertisement about Habba Syndrome on the Discovery channel. I have been struggling with what I thought was diarrhea-prone IBS (IBS-D) for about 18 months now. I've had the same gamut of tests that other folks on the boards have talked about - blood, stool, endoscopy, and colonoscopy - and all tests came back clean. As a 30 year-old, I cannot describe the frustration I felt when four different doctors came back with "We don't know - it must be IBS." I was in despair at the time I happened to catch the episode about Dr. Habba while on a business trip. Since I'm based in NYC, I figured it was worth the drive over to Summit, NJ to see him. I'm very glad I did because I ended up testing positive for his syndrome.
All of the tests I had done prior to seeing Dr. Habba were not wasted effort, as Dr. Habba would have ordered them anyway to rule out other afflictions of the digestive tract. Because I had completed all of these tests already, we were able to proceed directly to the biliary (gall bladder and liver) tests that isolate Habba Syndrome. To test for Habba Syndrome, I had to undergo two tests at Overlook Hospital near his office. The first is a biliary ultrasound, which takes about 30 minutes. The ultrasound examines the gall bladder, liver, spleen, and pancreas for any irregularities, masses, or growths that might be interferring with the production and/or release of bile into the digestive tract. My ultrasound was clear, so don't lose heart if the tech tells you the test doesn't reveal anything unusual.
The second test was the kicker for me. This test is called a DISIDA scan w/ CCK. This test takes about 90 minutes and involves taking x-ray-type pictures of your gall bladder and liver. First, they give you a shot of radioactive tracer fluid, and then they take a sequence of pictures over about 30 minutes that shows the fluid bonding to the bile in your gall bladder. These shots are the "baseline" pictures that show how the gall bladder is storing bile. After a few of those pictures, they then give you another injection of a hormone called Cholecystokinin (CCK) which your body produces naturally. Your body produces this hormone during digestion and it basically signals your gall bladder to regulate how much bile is released into the digestive tract. If your gall bladder is not properly regulating how much bile goes into the system, you may experience diarrhea (bile is a digestive stimulant). The tech injected me with the hormone and took another series of pictures over 60 minutes. When a normal gall bladder is triggered by CCK, it should dump bile into the system. Over the course of the hour, my gall bladder barely moved. They measure how much your gall bladder shrinks in size and if it's below a certain percentage, something is wrong. Normal gall bladder "shrinkage" is anywhere between 35-95%. Mine was 6.3%. Obviously, there's a problem. Think about your gall bladder like a reservoir, or "thermostat" for bile. In my case, my gall bladder was not catching and releasing bile at the right rate, so inappropriate amounts of bile were being dumped into my system by my liver, causing the diarrhea.
Just today Dr. Habba called in the scrip for the cholesterol-lowering medication that has the added effect of bonding with and neutralizing bile acids. Although my gall bladder may continue to function improperly, at least the medication will bond with any excess bile in my digestive tract and make my bowel movements more regular. I have a follow-up appt with him in 3 weeks. Hopefully by then I will no longer fear eating before every social engagement, I can stop fixating on the location of the nearest bathroom at every moment of the day, and I won't have to take Immodium constantly. Of course, I'm not sure if you have Habba Syndrome, but I would highly recommend that you at least call Dr. Habba about your case. He told me that the tests above can be performed at any equipped hospital, so you can have them done locally and send the results to him for his review. It may turn out to be something else entirely, but at least then you'll know the cause. Since he's worked with IBS patients extensively, you definitely won't get the useless and defeatist diagnosis I got from other doctors.
Best of luck to you and anyone else suffering from IBS-D.
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very interesting....i'm happy that you finally got some answers...just a couple of questions
1) did you have any other systems that Dr. Habba noted might suggest a likelyhood for Habba Syndrome.
2) Do you always have to go to the bathroom after eating? Did Heather's diet have any positive effects?
3) Whenever I take Immodium I often end up with green d, and my GI said that had to do with Bile. Just wondering if you ever had green d.
Thanks, and best of luck.
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Kmac,
Sorry for the delay - I haven't checked the forums in awhile. Please feel free to contact me directly at ptingles01@yahoo.com if you have any more questions about Habba syndrome. In the meantime, my answers are below. :-)
1) did you have any other systems that Dr. Habba noted might suggest a likelyhood for Habba Syndrome.
Not that he mentioned to me. Habba appears to be a syndrome of the biliary system. Given that I had a clean colonoscopy, upper GI, and endoscopy, no other system/organ appeared to have problems. This is why it's so critical to perform these other tests because you might have Crohn's, malabsorption of the colon, or a number of other afflications that have symptoms simliar to Habba. The biliary ultrasound and DISIDA scan that I wrote about earlier are the true tests for Habba.
2) Do you always have to go to the bathroom after eating? Did Heather's diet have any positive effects?
I didn't have d every time, but often, yes. Habba is worse after fatty meals because of the bile disruption. Meals high in insoluble fiber (Heather's diet) were more tolerable for me, but I was treating the wrong thing. Heather's diet appears best for folks who have issues with their colon, which isn't my problem. My colon is healthy and working just fine - it's my gall bladder that has the problem.
3) Whenever I take Immodium I often end up with green d, and my GI said that had to do with Bile. Just wondering if you ever had green d.
I have not had green d. Immodium was my fave treatment because it effectively eliminated d. The down side is that if I overdid it on immodium, I might not have a movement for three days. The green color of your d though is consistent with what I've read about bile. It's a digestive stimulant, so if your d is high in bile that might suggest you have too much of it in your system.
Take care and good luck to you.
Peter
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To anyone who might be suffering from Habba, I want to provide an update on my progress. It's been three years since I made this post and I'm still on the medication that Dr. Habba prescribed (Welchol tablets). Recently they came out with a powder form that you can add to water like metamucil, but I haven't tried that yet. In a word, they're wonderful and still effective.
My basic regimen is to take 2-3 pills before I eat a rich or acidic meal, and wait about 20-30 minutes before I consume anything. From a practical perspective, I take the pills at home before I leave for dinner and usually by the time I sit down at the table, it's been long enough for the medication to set my body straight. There are no side effects for me and it doesn't affect my overall feeling at all - it pretty much works silently. I noticed a huge difference right away in terms of my ability to digest my food at a more normal pace, and my trips to the bathroom were greatly reduced. Now, a bad d situation happens on a very rare occasion - which I think happens to people even with normal digestion. Most of the time, I digest normally and don't have to constantly worry if there's a bathroom close by. Because I'm a little paranoid, I still keep a few immodium on me if I'm going to a super important event where I don't want to take any risks. But that's more mental than anything - the Welchol is very reliable and I feel better that I'm not taking immodium constantly. The added bonus is that Welchol is a cholesterol-lowering medication. :-)
I know how awful it was before I started on the medication - the constant worry wore me out emotionally and mentally. I barely think about it anymore. As long as I take my meds before a big meal, everything is normal. I don't even need to take it before every meal - just rich, fatty, or acidic ones.
Best of luck to those still searching for treatment and I hope you find a solution that works for you.
Peter
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