Digestive Problems After Gallbladder Surgery? Here's How You Can Start Reducing Symptoms.

If you’re having digestive problems after gallbladder surgery, you’re not alone. Let’s look at the effects of gallbladder removal surgery, and some ways Integrative Nutrition can help! 

Unfortunately, gastrointestinal issues can be a frustrating aftermath of gallbladder removal.

I get it.

I’ve suffered from gallbladder and GI issues too.

Many people hope that removing their gallbladder will also eliminate any GI symptoms they were having. Unfortunately, that is not the case.

Not only will removing your gallbladder NOT resolve GI issues, but it may also be the root cause of additional digestive complaints.

You might experience diarrhea, gas, heartburn, and other uncomfortable changes after surgery[i]. These symptoms, collectively known as post-cholecystectomy syndrome, affect many who undergo the surgery. They can start soon after the operation and sometimes linger long-term.

Understanding why this happens can help you find relief. The gallbladder plays a role in digesting fatty foods by storing bile produced by the liver. Without it, your digestive system must adapt, often resulting in unpleasant symptoms. To manage these changes, certain dietary adjustments and proper care are essential.

As an Integrative Nutritionist, my mission is to empower people like you with the knowledge and tools needed for a healthy life after gallbladder surgery. Keep reading for helpful tips on managing symptoms, dietary modifications, and insights into potential complications like leaky gut and SIBO. 

Key Takeaways

  • Digestive issues often occur after gallbladder removal.
  • Understanding physiological changes can help manage symptoms.
  • Dietary adjustments are crucial.

Understanding Gallbladder Removal

Surgical removal of the gallbladder, or cholecystectomy, has become very common in our society. While this organ is crucial for proper gut health, very few surgeons adequately prepare patients for life without it.What To Do with Digestive Problems After Gallbladder Surgery

This lack of preparation and education can lead to unnecessary health consequences, needless suffering, and lost time out of your life. (Just think of all the ways you could show up for yourself, your family and your community if you weren’t plagued by gallbladder-related issues.)

That’s where I come in! Let’s start by reviewing some of the basics before we look at how removing this organ can create additional problems.

Purpose of the Gallbladder

The gallbladder is a small, pear-shaped organ tucked beneath the liver. It stores bile, a digestive fluid produced by the liver. When you eat fatty foods, the gallbladder releases bile into the small intestine to help break down fats. Without it, your body must find other ways to manage fat digestion.

Tell Me More About Bile

Not only is bile needed to break down fats for digestion and absorption, but it also has several other functions. These include:

  • Detoxification: Bile assists in breaking down toxins, excess hormones, and even cholesterol[ii].
  • Lubricant: Bile eases the movement of waste material through the colon and out of the body. Decreased amounts can lead to constipation. Increased amounts can lead to diarrhea.
  • Bacteriostatic: Helps to eliminate or neutralize invaders not destroyed by your stomach acid[iii].
  • Alkalizer: Increases the pH of the first part of your small intestine (the duodenum) to make it more alkaline[iv].

When the digestive process triggers the release of bile by a healthy gallbladder, the quantity secreted at one time does all the above and more. After the gallbladder is removed, instead of intermittent releases of bile when needed, you now have a constant “drip” of bile. This causes:

  • Decreased ability to break down fats, toxins, hormones, and cholesterol.
  • Decreased antimicrobial activity; and
  • Constant changes to the pH of the small intestine.

Why Remove the Gallbladder?

A cholecystectomy is often recommended when you have gallstones causing pain, infection, or other complications. The surgery can be performed laparoscopically, using small incisions, or through open surgery if necessary. Both methods aim to remove the gallbladder safely, but recovery time and scarring may vary.

Did You Know You Have a Choice?

For many people with gallbladder issues, making some simple lifestyle and dietary changes may help them avoid surgery. Unfortunately, this is rarely discussed with the patient, so they don’t realize they have a choice. Ask questions and know your options!

Digestive Complications After Gallbladder Removal?

A multitude of health issues can occur after this surgery. Immediate concerns include things like infection, reaction to anesthesia, and bile duct injury. Removing the gallbladder also impacts the routine functioning of several systems, most notably, the digestive system.

What To Do with Digestive Problems After Gallbladder SurgeryAfter gallbladder removal, your liver still produces bile, but it now drips continuously into your digestive system instead of being stored. You might experience diarrhea, bloating, or gas, especially after eating fatty foods as a result[v].

Removal of Your Gallbladder May Be the Root Cause of Your Digestive Problems

As an Integrative Nutritionist specializing in all things gallbladder, I encourage patients to uncover all possible root causes of gallbladder disease. Some lifestyle contributors to gallbladder and liver dysfunction include:

  • Poor Diet: Low fiber, low iron, increased sugars and fats, etc.
  • Dehydration: Most people are chronically dehydrated — by the time you feel thirsty you’re already dehydrated.
  • Toxins: Such as metals, excess hormones, endocrine disrupting chemicals, etc.,
  • High Stress: Unmanaged stress causes consistent release of hormones such as adrenaline and cortisol and may lead to unhealthy eating choices and poor sleep.
  • Low Physical Activity: A sedentary lifestyle contributes to weight issues, but also impairs detoxification efforts.

Conversely, we also need to examine how the removal of your gallbladder can be the root cause of your post-surgical digestive complaints. These can range from diarrhea and constipation to bloating and reflux. Understanding these problems helps manage and mitigate them effectively.

Gallbladder Removal Only Fixes Gallbladder Attacks, Not GI Issues!

Gallbladder removal addresses gallbladder attacks and pain by removing the gallbladder[vi]. It doesn’t fix related gastrointestinal problems and may even cause them. 

Without a gallbladder, the liver still makes bile but releases it directly into the gut. This can lead to problems including the improper digestion of fatty foods, causing discomfort and digestive disturbances.

Diarrhea & Constipation

Diarrhea after gallbladder removal is found in approximately 20% of patients[vii]. Bile constantly flows into your intestines, causing “fluid secretion and increased mucosal permeability in the colon[viii].” This can lead to loose and frequent stools.

Constipation can also occur, especially if your diet lacks fiber. Eating high-fiber foods and staying hydrated helps manage both diarrhea and constipation. Working with an Integrative Nutritionist can help find the right balance for your digestive health.

Bloating

Impaired fat digestion can lead to excess gas production. This can be uncomfortable and embarrassing!

Reflux

Reflux or heartburn can be more noticeable after gallbladder removal[ix]. Bile can sometimes back up into the stomach and esophagus, causing irritation[x]. Avoiding certain foods like spicy or greasy foods can help manage reflux.

Can Gallbladder Removal Lead to Leaky Gut?

After gallbladder removal, changes in your gastrointestinal system can contribute to a condition known as “leaky gut.”

What is Leaky Gut?

Leaky gut, or increased intestinal permeability, occurs when the lining of your intestines gets damaged.

This lining acts as a barrier to keep out harmful substances. When it’s damaged, it can let bacteria, toxins, and undigested food particles pass into your bloodstream. Symptoms might include abdominal distention, gas, cramps, and food sensitivities. Some people might also experience fatigue and joint pain.

How Can Gallbladder Removal Lead to Leaky Gut?

When your gallbladder is removed, the liver still produces bile, but is now unable to store it in one place. Instead, bile drips continuously into your intestines, irritates your gut lining, and increases fluid secretion[xi].

This irritation can contribute to increased intestinal permeability. Factors like stress, diet, infections, and inflammation make this worse[xii].

Digesting fatty foods, in particular, can become more challenging. This is due to the lack of bile at the right moment, potentially leading to improper digestion and more bowel issues.

Over time, poor digestion can disturb the natural microbial balance in your gut, contributing to the development of leaky gut. 

Can Gallbladder Removal Lead to SIBO?

Gallbladder removal may also be associated with the development of SIBO (Small Intestinal Bacterial Overgrowth)[xiii]. Understanding SIBO and how it might be linked to gallbladder removal can help you manage your symptoms better.

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. It happens when too many bacteria grow in your small intestine[xiv]. Normally, you have abundant bacteria in yourWhat To Do with Digestive Problems After Gallbladder Surgery large intestine, but they shouldn’t be in high numbers elsewhere. When bacteria overgrow in the small intestine, they can cause problems like gas, diarrhea, and stomach pain.

Symptoms of SIBO can be hard to tell apart from other gastrointestinal issues, and it may be misdiagnosed as Irritable Bowel Syndrome. If you have SIBO, you might feel tired, lose weight without trying, have abdominal pain, or have nutrient deficiencies. Treating SIBO often involves antibiotics or changes in diet to reduce bacteria levels and improve gut health.

How Can Gallbladder Removal Lead to SIBO?

After you remove the gallbladder, the direct flow of bile into the small intestine affects food breakdown and gut health[xv]. This bile is less concentrated than that stored in a healthy gallbladder. SIBO can develop in the following manner:

  •       Diluted bile is less effective at breaking down fats.
  •       This leads to undigested food in your small intestine.
  •       Undigested food promotes bacterial overgrowth. 

As you can see, the removal of your gallbladder has direct consequences on your digestive system and may actually be the root cause of digestive issues. Keep reading to learn about some ways to help your body avoid or recover from this surgery.

How to Ease Digestive Issues After Gallbladder Removal

After gallbladder removal, you need to make changes to help your system adjust. Let’s look at some of the things you can do!

Eating Frequency

Eating smaller meals helps to better mix your food with bile. Since you no longer have stored bile “on-demand,” avoid large meals that can overburden your available bile.

A good system to follow is to have a small, healthy meal followed several hours later by a small, healthy snack. Repeat this for breakfast, lunch, and dinner.

Recommended Diet

Your liver still makes bile, but without a gallbladder, it drips slowly into your gut. This can make digesting fats harder. Eating the right foods can help:

  • Lean Meats like chicken and turkey are easier to digest.
  • Smart Dairy Products such as greek yogurt, kefir, low fat cottage cheese, hard cheese, and goat products work best. 
  • Organic Whole Grains like oats and rice add valuable fiber. Just add fiber slowly to avoid gas.
  • Soluble Fiber can help make bowel movements regular.
  • Organic Vegetables such as carrots, spinach, and green beans.
  • Organic Fruits like apples, pears, and berries are great for digestion.

Foods to Avoid

Certain foods can make food breakdown and assimilation tough without a gallbladder. You should avoid these to prevent issues like diarrhea and cramping:

  • Fatty Foods such as fried chicken, bacon, and sausage.
  • Full-Fat Dairy products including whole milk, ice cream, and sour cream.
  • High-Fat Snacks like chips and pastries.
  • Spicy Foods can cause irritation and should be limited.
  • Caffeinated Drinks including coffee and sodas which can upset your stomach.

Hydration

To help your digestive system, try to drink half of your body weight in ounces per day of pure, filtered water.

  • Formula: Your Body Weight in pounds / 2 = ounces of pure water per day to drink.
  • Drink consistently throughout the day, not all at once.What To Do with Digestive Problems After Gallbladder Surgery
  • Limit drinking at mealtimes so as not to dilute your available bile.
  • If you’re pregnant, nursing, exercising, or on medication, this number may need to be increased.

Mindful Eating

Swamped at work? Taking care of elderly parents? Running the kids all over the place? Your life is hectic and busy, and it’s so tempting to multi-task when eating.

Practice a little self-care and soothe your system by being mindful when you eat. What does this look like?

  • Don’t multi-task while eating.
  • Sit down to eat instead of eating while on the go. Cultivate a peaceful eating environment.
  • Turn off the TV, podcasts, webinars, tablet, and your phone.
  • Take deep breaths before, during and after eating.
  • Fully chew each bite. Savor the flavor and textures.

Supplementation

I’m often asked if supplementation can help reduce GI symptoms after gallbladder removal surgery.

The good news is that high-quality customized supplementation CAN help, but you must take the right things at the right time. (Taking the wrong supplement, or the right supplement at the wrong time, can cause additional health problems!)

Some potential options include supplements like Milk Thistle, Artichoke Extract, Burdock Root, Dandelion Root & Leaf, Schisandra, Curcumin, TUDCA, and Ox Bile or other bile acids. (Always consult with your healthcare provider before starting any new supplements.)  You can find some of my favorite brands through Fullscript- shop here

Conclusion

Removing your gallbladder can be the root cause of gastrointestinal complaints such as:

  • Chronic Diarrhea: Frequent, loose stools as your body adjusts.
  • Gas and Bloating: Your system might produce more gas.
  • Intolerance to Certain Foods: Your body might not digest fats well anymore.
  • Leaky Gut Syndrome: You’re more at-risk for gut permeability due to the post-surgical changes[xvi].
  • SIBO: The reduction in bile and resulting changes in pH make you more susceptible to bacterial overgrowth[xvii].

If you suffered from these or other cholecystectomy side effects, I invite you to join my Gallbladder Surgery Repair Plan program and take back your life!

Frequently Asked Questions about Gallbladder Removal and Digestive Issues

What sort of digestive changes might I experience post-gallbladder surgery?

After gallbladder surgery, you might experience some GI issues. Some common symptoms include diarrhea, gas, and abdominal distention. These happen because your body must adjust to not having a gallbladder to store bile. Over time, these issues can worsen, causing additional health problems.

How can this surgery impact my liver function over time?

Your liver still produces bile post-cholecystectomy, but without a place to store it, bile flows directly into your bowels. This can sometimes lead to GI problems. Most people don’t have major long-term issues, but it’s important to monitor any new or persistent symptoms and report them to your doctor.

What should I eat after I have my gallbladder removed?

It’s important to follow a diet that’s easy on your system. Focus on low-fat foods and avoid greasy meals. Eating smaller, more frequent meals can also help. Incorporating high-fiber foods, like fruits and vegetables, can help. Staying hydrated is crucial as well.

Why could someone experience abdominal enlargement following gallbladder removal?

Abdominal swelling or distention can be a sign of your body adjusting to post-surgical changes. This can happen because of excess gas or other changes. If the swelling persists or is accompanied by severe pain, you should contact your healthcare provider. Keeping a food diary might help identify any foods that trigger symptoms.

Need more support?

If you are struggling with chronic digestive problems, fatty liver or weight resistance after Gallbladder surgery I would love to help!

My Gallbladder Surgery Repair Plan will walk you step by step on what you should be doing to address the cause and begin reversing your digestive problems after surgery.

Get started here today!

Resources

[i] Del Grande, L. D. M., Leme, L. F. P., Marques, F. P., Ramos, A. T., Ramos, P. T., & Souza, F. A. D. (2017). Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 30, 3-6.

[ii] Zafarjon, A., & Khidirov, Z. E. (2023). MAIN CAUSES, DIAGNOSIS, AND EFFECTIVE TREATMENT OF POSTCHOLECYSTECTOMY SYNDROME. World Bulletin of Public Health, 21, 223-228.

[iii] Zafarjon, A., & Khidirov, Z. E. (2023). MAIN CAUSES, DIAGNOSIS, AND EFFECTIVE TREATMENT OF POSTCHOLECYSTECTOMY SYNDROME. World Bulletin of Public Health, 21, 223-228.

[iv] Di Gregorio, M. C., Cautela, J., & Galantini, L. (2021). Physiology and physical chemistry of bile acids. International journal of molecular sciences, 22(4), 1780.

[v] Del Grande, L. D. M., Leme, L. F. P., Marques, F. P., Ramos, A. T., Ramos, P. T., & Souza, F. A. D. (2017). Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 30, 3-6.

[vi] Shabanzadeh, D. M. (2023). The Symptomatic Outcomes of Cholecystectomy for Gallstones. Journal of Clinical Medicine, 12(5), 1897.

[vii] Shabanzadeh, D. M. (2023). The Symptomatic Outcomes of Cholecystectomy for Gallstones. Journal of Clinical Medicine, 12(5), 1897.

[viii] Farrugia A, Arasaradnam R. Bile acid diarrhoea: pathophysiology, diagnosis and management. Frontline Gastroenterol. 2020 Sep 22;12(6):500-507. doi: 10.1136/flgastro-2020-101436. PMID: 34712468; PMCID: PMC851527

[ix] Othman, A. A., Dwedar, A. A., ElSadek, H. M., AbdElAziz, H. R., & Abdelrahman, A. A. (2023). Post-cholecystectomy bile reflux gastritis: Prevalence, risk factors, and clinical characteristics. Chronic Illness, 19(3), 529-538.

[x] Qian, J., Xu, H., Liu, J., & Zheng, Y. (2024). Associations of cholecystectomy with the risk of gastroesophageal reflux disease: a Mendelian randomization study. medRxiv, 2024-03.

[xi] Farrugia A, Arasaradnam R. Bile acid diarrhoea: pathophysiology, diagnosis and management. Frontline Gastroenterol. 2020 Sep 22;12(6):500-507. doi: 10.1136/flgastro-2020-101436. PMID: 34712468; PMCID: PMC851527

[xii] Xu, F., Yu, Z., Liu, Y., Du, T., Yu, L., Tian, F., … & Zhai, Q. (2023). A high-fat, high-cholesterol diet promotes intestinal inflammation by exacerbating gut microbiome dysbiosis and bile acid disorders in cholecystectomy. Nutrients, 15(17), 3829.

[xiii] Madigan, K. E., & Weinberg, R. B. (2020). S1316 Distinctive Clinical Correlates of Small Intestinal Bacterial Overgrowth With Methanogens. Official journal of the American College of Gastroenterology| ACG, 115, S661-S662.

[xiv] Efremova, I., Maslennikov, R., Poluektova, E., Vasilieva, E., Zharikov, Y., Suslov, A., … & Ivashkin, V. (2023). Epidemiology of small intestinal bacterial overgrowth. World Journal of Gastroenterology, 29(22), 3400.

[xv] Rana, S. V., & Kaur, J. (2016). Effect of post-cholecystectomy on small intestinal bacterial overgrowth and orocecal transit time in gallstone patients. Int J Dig Dis, 2(1).

[xvi] Xu, F., Yu, Z., Liu, Y., Du, T., Yu, L., Tian, F., … & Zhai, Q. (2023). A high-fat, high-cholesterol diet promotes intestinal inflammation by exacerbating gut microbiome dysbiosis and bile acid disorders in cholecystectomy. Nutrients, 15(17), 3829.

[xvii] Madigan, K. E., & Weinberg, R. B. (2020). S1316 Distinctive Clinical Correlates of Small Intestinal Bacterial Overgrowth With Methanogens. Official journal of the American College of Gastroenterology| ACG, 115, S661-S662.

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