Table of ContentsView AllTable of ContentsLife After RemovalComplicationsDiagnosis & TreatmentWhen to See a ProviderFoods to Avoid
Table of ContentsView All
View All
Table of Contents
Life After Removal
Complications
Diagnosis & Treatment
When to See a Provider
Foods to Avoid
Many people don’t have issues followinggallbladder surgery(cholecystectomy). However, problems after gallbladder removal may occur years later or could occur immediately after the procedure. Symptoms of problems include nausea, abdominal pain after eating, and diarrhea.
This article explains why digestive symptoms happen after gallbladder surgery, how your condition can be treated, and which foods to avoid when you no longer have a gallbladder.
Verywell / Cindy Chung
Life After Gallbladder Removal
It is safe to live without a gallbladder, which is one of the reasons gallbladder removal is typically the recommended treatment forgallbladder problems. Your gallbladder’s main job is to storebile(a substance needed for digesting fats) and to secrete bile into your small intestine in response to ingesting foods containing fat.
Without your gallbladder, your liver continues to produce bile, but instead of it being sent to the gallbladder for storage, the bile passes into yourcommon bile ductand then makes its way into your small intestine.
Signs You May Need Your Gallbladder Removed
Complications of Gallbladder Removal
Most of the time, the body adapts to the loss of the gallbladder. However, there are a few possible digestive complications that people may experience following gallbladder removal.
Postcholecystectomy Diarrhea
Approximately 25% of people who have had their gallbladders removed will experience recurrent problems withdiarrhea, a condition known as postcholecystectomy diarrhea.
This problem results from the fact that without the gallbladder, there is nothing to regulate the amount of bile that passes into the small intestine. The resulting higher amount of bile can create stools that are watery and more frequent. Luckily, for most of these individuals, this problem will resolve itself slowly over time.
Sphincter of Oddi Dysfunction
If you are experiencing ongoing upper abdominal pain following gallbladder removal, you may want to speak with your healthcare provider about a possible problem with your sphincter of Oddi (SO).
The sphincter of Oddi is a valve found within the small intestine that regulates the flow of bile and pancreatic juices. A very small number of people may experiencesphincter of Oddidysfunction (SOD), afunctional gastrointestinal disorder (FGD).
In SOD, the sphincter does not relax as it should, preventing the bile and pancreatic juices from entering the small intestine.
Pain from SOD generally occurs a short time after eating. Some people report nausea and vomiting. The pain symptoms of SOD are thought to be the result of the excess accumulation of the juices in the ducts.
SOD is most often seen in people after gallbladder removal, or in those who have pancreatitis. It’s hard to gauge SOD’s actual prevalence after gallbladder removal, as studies report prevalence rates ranging from just 3% up to 40%.SOD can be treated with medication or a procedure known as endoscopic retrogradecholangiopancreatography(ERCP).
ERCP: Everything You Need to Know
Liver Problems
There appears to be a link between gallbladder removal and liver disorders. A 2021 study of 4,497 people who had gallbladder surgery found that 73.3% had a higher risk of liver cirrhosis and 60% had a higher risk of liver fibrosis.
Liver fibrosis refers to scarring of the liver tissue. Mild to moderate fibrosis usually does not cause symptoms. If it’s found early enough, fibrosis can be reversed. However, if left untreated, liver fibrosis can lead to liver cirrhosis and liver cancer.
Liver cirrhosisis a condition that causes the liver to become not only scarred but also permanently damaged. Symptoms may not be present until the damage is advanced. Over time, the liver starts to fail.
Diagnosis and Treatment After Gallbladder Removal
Having your gallbladder removed may make you more likely to developirritable bowel syndrome (IBS). This is especially true for the form of IBS with diarrhea. This is largely due to excessive bile acids andbile acid malabsorption (BAM), a condition in which there is dysfunction with the way that bile acids are processed within the body.
Bile acid diarrhea (BAD)is a similar complication that can occur after gall bladder removal. It’s estimated that around 5% to 12% of cholecystectomy patients develop BAD. These patients usually have chronic watery diarrhea and more frequent bowel movements than before surgery.
Postcholecystectomy BAM, BAD, and IBS can be difficult to diagnose. Work with your healthcare provider to identify and resolve digestive problems.
An accurate diagnosis is necessary so you can get the right treatment plan. The American College of Gastroenterology (ACG) warns that testing for BAM is limited in the United States, and testing is not completely validated.
These medications include:
The ACG does not currently recommend use of these drugs for diarrhea-predominant irritable bowel syndrome (IBS-D), citing a lack of evidence.Still, the experts at ACG realize that these medications may be helpful in some cases, and may be used at the discretion of your medical provider.
When to See Your Healthcare Provider
If you are experiencing ongoing problems with abdominal pain and/or diarrhea, work with your healthcare provider to get an accurate diagnosis. The range of possibilities for your ongoing problems is fairly varied:
Remember to always mention your surgery when speaking with a new healthcare provider, even if your gallbladder was removed years ago.
If you are experiencing fever, chills, or signs of dehydration, you should contact your healthcare provider immediately.
Foods to Avoid After Gallbladder Removal
Without your gallbladder participating in the process of digestion, you may need to change your eating habits. If your gallbladder was only removed very recently, you may want to eat a bland diet until your diarrhea symptoms start to ease.
The gallbladder’s job is to help you digest fatty food, so having it removed can make these foods problematic for you. Once you’re back on a “regular” diet after surgery, you may want to limit or avoid certain foods:
Gradually reintroducing possible “problem” foods into your diet can help you to learn what bothers you without creating too much discomfort.
What to Avoid After Gallbladder Removal
Although there isn’t necessarily hard science behind these recommendations, you might find the following tips to be helpful:
Remember, although coping with symptoms is no fun, there are a few factors (such as your diet) that are in your control.
Summary
Problems after gallbladder removal can occur years later or show up right away. While many people don’t have any problems after gallbladder removal, others do. Complications can include postcholecystectomy diarrhea, sphincter of Oddi dysfunction, and liver problems.
Talk to a healthcare provider if you’re experiencing problems following cholecystectomy. If you’re having symptoms, whether abdominal pain or diarrhea, even years after gallbladder removal, work with your provider to develop an accurate diagnosis. Treatment will depend on the underlying cause. Modifying your diet may help in some cases.
13 Sources
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Arora D, Kaushik R, Kaur R, Sachdev A.Post-cholecystectomy syndrome: a new look at an old problem.J Minim Access Surg. 2018;14(3):202–207. doi:10.4103/jmas.JMAS_92_17
Del Grande LM, Leme LFP, Marques FP, Ramos AT, Ramos PT, Souza FA.Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy.Arq Bras Cir Dig. 2017;30(1):3–6. doi:10.1590/0102-6720201700010002
Afghani E, Lo SK, Covington PS, Cash BD, Pandol SJ.Sphincter of Oddi function and risk factors for dysfunction.Front Nutr. 2017;4:1. doi:10.3389/fnut.2017.00001
International Foundation for Gastrointestinal Disorders, Inc.Sphincter of Oddi dysfunction.
Latenstein CSS, Wennmacker SZ, de Jong JJ, van Laarhoven CJHM, Drenth JPH, de Reuver PR.Etiologies of long-term postcholecystectomy symptoms: a systematic review.Gastroenterol Res Pract. 2019;2019:4278373. doi:10.1155/2019/4278373
Xie ZQ, Li HX, Tan WL, et al.Association of cholecystectomy with liver fibrosis and cirrhosis among adults in the USA: a population-based propensity score-matched study.Front Med (Lausanne). 2021;8:787777. doi:10.3389/fmed.2021.787777
American Liver Foundation.Fibrosis (scarring).
National Institute of Diabetes and Digestive and Kidney Diseases.Definition & facts for cirrhosis.
Zhao J, Tian L, Xia B, et al.Cholecystectomy is associated with a higher risk of irritable bowel syndrome in the UK Biobank: a prospective cohort study.Front Pharmacol. 2023;14:1244563. doi:10.3389/fphar.2023.1244563
Huang RL, Huang WK, Xiao XY, Ma LF, Gu HZR, Yang GP.Diagnosis and treatment of post-cholecystectomy diarrhoea.World J Gastrointest Surg. 2023;15(11):2398-2405. doi:10.4240/wjgs.v15.i11.2398
Lacy BE, Pimentel M, Brenner DM, et al.ACG Clinical Guideline: management of irritable bowel syndrome.AM J Gastroenterol. 2021:116:17-14. doi:10.14309/AJG0000000000001036
Shin Y, Choi D, Lee KG, Choi HS, Park Y.Association between dietary intake and postlaparoscopic cholecystectomic symptoms in patients with gallbladder disease.Korean J Intern Med.2018;33(4):829-836. doi:10.3904/kjim.2016.223
Farrugia A, Attard JA, Hanmer S, et al.Rates of bile acid diarrhoea after cholecystectomy: a multicentre audit.World J Surg. 2021;45(8):2447-2453. doi:10.1007/s00268-021-06147-8National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.Wilcox CM.Sphincter of Oddi dysfunction type III: New studies suggest new approaches are needed.World J Gastroenterol. 2015;21(19):5755-5761. doi:10.3748/wjg.v21.i19.5755
Farrugia A, Attard JA, Hanmer S, et al.Rates of bile acid diarrhoea after cholecystectomy: a multicentre audit.World J Surg. 2021;45(8):2447-2453. doi:10.1007/s00268-021-06147-8
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.
Wilcox CM.Sphincter of Oddi dysfunction type III: New studies suggest new approaches are needed.World J Gastroenterol. 2015;21(19):5755-5761. doi:10.3748/wjg.v21.i19.5755
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