Ask the experts
I have had my gallbladder removed, and subsequently, I have chronic severe diarrhea, is there any treatment for the diarrhea?
Doctor's response
Diarrhea is troubling in 10% of people who have their gallbladders removed. The diarrhea is believed to be due to the fact that following removal of the gallbladder, the intestines contain more bile acids than under normal conditions in which bile acids are stored for much of the day in the gallbladder. Bile acids cause diarrhea by promoting the secretion of fluid by the intestines and, perhaps by stimulating the intestinal muscles to contract. There are no good studies of treatment of this diarrhea, but two treatments have been proposed and appear to be effective. The first is the use of orally ingested resins that attach to bile acids in the intestine (for example, cholestyramine) and prevent them from interacting with the intestine. The second is orally ingested fatty acids (for example, oleic acid) that may act by slowing down the intestinal muscle and, perhaps, by reducing secretion of fluid, although the exact mechanism of action of oleic acid in these patients has not been studied.
It is also important remember that there are many other causes of chronic severe diarrhea such as celiac sprue, ulcerative colitis, Crohn's disease, microscopic colitis, and many more. Please read the Diarrhea article for more information. It is important to work with you doctor to arrive at a firm diagnosis for best treatment results
References
Medically reviewed by Venkatachala Mohan, MD; Board Certified Internal Medicine with subspecialty in Gastroenterology
REFERENCE:
"Uncomplicated gallstone disease in adults"
UpToDate.com
Chronic diarrhea: A concern after gallbladder removal?
Updated on September 29, 2021
Diarrhea is fairly common after gallbladder removal. Find out what to expect.
Question: I had my gallbladder removed six months ago, and I'm still having diarrhea. Is this normal?
Answer Section
It's not clear how many people develop the frequent loose, watery stools that characterize diarrhea after surgery to remove their gallbladders (cholecystectomy). Studies have found that up to 20% of people undergoing gallbladder surgery develop diarrhea.
In most cases, the diarrhea stops soon after the surgery. Rarely, it may last for years.
The cause of diarrhea after gallbladder removal isn't clear. Some experts believe that it results from an increase in bile, especially bile acids, entering the large intestine — which may act as a laxative.
Treatments you and your doctor may consider for controlling your diarrhea after cholecystectomy include:
- Anti-diarrheal medications, such as loperamide (Imodium A-D)
- Medications that impair absorption of bile acids, such as cholestyramine
Talk to your doctor about your options and whether additional tests are recommended. Generally, mild diarrhea after cholecystectomy is not cause for concern, but speak to you doctor if you are losing weight; have bloody diarrhea, diarrhea that awakens you from sleep, fever or significant abdominal pain; or have diarrhea lasting more than a few weeks.
You may also consider limiting foods that can make diarrhea worse, including:
- Caffeine
- Dairy products
- Greasy foods
- Very sweet foods
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After having their gallbladder removed (cholecystectomy), some people develop frequent loose, watery stools. In most cases, the diarrhea lasts no more than a few weeks to a few months. There isn't a specific gallbladder removal diet that you should follow if you have this problem, but there are a few things you might consider. First, it helps to understand why you're having diarrhea. Diarrhea after gallbladder removal seems to be related to the
release of bile directly into the intestines. Normally, the gallbladder collects and concentrates bile, releasing it when you eat to aid the digestion of fat. When the gallbladder is removed, bile is less concentrated and drains more continuously into the intestines, where it can have a laxative effect. The amount of fat you eat at one time also plays a role. Smaller amounts of fat are easier to digest, while larger amounts can remain undigested and cause gas, bloating and diarrhea. Although
there isn't a set gallbladder removal diet, the following tips may help minimize problems with diarrhea after you've had your gallbladder out: You may also try limiting foods that tend to worsen diarrhea, including: Talk with your doctor if your diarrhea doesn't gradually go away or becomes more severe, or if you lose weight and become weak. Your doctor may recommend medicines, such as loperamide (Imodium A-D), which slows down intestinal movement, or medications that decrease the laxative effect of bile, such as
cholestyramine (Prevalite). Your doctor may also suggest that you take a multivitamin to compensate for malabsorption of fat-soluble vitamins.Answer Section
Last Updated: May 26th, 2021
© 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.
Terms of Use