What foods to stay away from after gallbladder removal

The so-called gallbladder cleanse is often touted on social media as a treatment for gallstones or an alternative to gallbladder removal.

There are many different recipes for this “cleanse,” but most involve drinking large amounts of citrus juices, Epsom salts, and olive oil.

The advertised promises may sound enticing, especially if you’re facing the cost and hassle of gallbladder removal.

But there are no gallbladder flushes or cleanses that have been proven to break up or eliminate gallstones, says Sanjay Jagannath, MD, a gastroenterologist in Raleigh, North Carolina.

“There’s not any good evidence to suggest there’s anything out there to reliably do that,” Dr. Jagannath says.

Jagannath says that people who try out these remedies often have subsequent bowel movements that include small round objects thought to be gallstones.

But, he notes, the observed objects are actually the result of the olive oil mixing with bile, the fluid in the gallbladder that digests fat.

“Bile mixes with olive oil to form a yellowish-colored soap,” Jagannath says. “There are no real stones actually pushed out by the gallbladder in most cases.”

Jagannath adds that these objects usually float in the toilet, while real gallstones are hard — like pebbles — and sink to the bottom.

And you should be especially wary of any product marketed as an herbal gallbladder treatment. “The problem with all herbal treatments is there’s no regulation by the FDA [Food and Drug Administration],” Jagannath warns.

It’s always advisable to check with your doctor before trying any kind of over-the-counter treatment for gallbladder problems, he adds.

You can live just fine without a gallbladder. In fact, most people who have a cholecystectomy (gallbladder removal) don't experience any long-term effects.

You may need to change your diet and eating habits, though. This is because the bile fluids that are normally stored in the gallbladder now go directly into the small intestine.

This article explains how gallbladder removal may alter the way your digestive system works. It will offer you ideas about how to modify your diet to avoid foods that may cause trouble while keeping those that are part of a healthy, balanced diet.

One of the most common problems after gallbladder removal is the risk of diarrhea. This interferes with how your body absorbs key nutrients. A diet designed for your body's new needs can help bring these symptoms under control.

There is no standard diet that you should follow after your gallbladder surgery. The goal is to limit the amount of fat that you eat, because bile's role is to break it down so that it is more easily absorbed. Changing your diet allows the bile that remains to work better in your small intestine.

Benefits

Diarrhea and other gastrointestinal (GI) symptoms won't affect everyone. However, between 10% and 40% of people who have gallbladder removal will experience these symptoms.

Those who do develop these symptoms tend to notice them within the first three years after the surgery. Studies have shown that there are a few ways to predict who will develop symptoms and which factors can increase a person's risk.

For example, researchers who looked at 125 cases of gallbladder removal have found the risk of symptoms was greater in men over age 45 who didn't reduce fat in their diets for at least one week after the surgery.

The complications included bile acid diarrhea. They also include sphincter of Oddi dysfunction, which are painful spasms of the valve that connects the pancreas to the intestine.

Research suggests people prone to diarrhea before surgery are more likely to have diarrhea after gallbladder surgery than those who weren't. Obesity is also known to contribute to this issue.

The aims of the post-cholecystectomy diet are simple:

• By reducing the intake of fat, you limit the laxative effect of free-flowing bile.
• By reducing the acids in the stool, you ease the work of the intestine, which leads to more regular bowel movements and fewer intestinal spasms.
• By reducing certain fats, you can better absorb (rather than block) nutrients.

Recap

Some people develop diarrhea and other symptoms after gallbladder removal. This is because the digestive system has changed. The bile that aids in breaking down food in the small intestine is routed directly into it. By eating a low-fat diet, you can avoid symptoms and improve nutrition.

How It Works

Immediately following a cholecystectomy, your healthcare provider will likely place you on a clear liquid diet. This will help to prevent nausea, vomiting, and constipation. Some of these liquids are:

• Clear broth
• Gelatin
• Juice
• Popsicles
• Carbonated beverages

Over the next few days, you would advance to a bland BRAT diet. The BRAT diet involves the use of bread, white rice, applesauce, and toast or soda crackers to gently bind loose or runny stool. If you are already passing normal stools, though, a BRAT diet may not be needed.

This is when your low-fat diet would begin. You would need to follow it for at least a few weeks.

By definition, a standard low-fat diet contains 30% calories from fat or less, with 1 gram of fat equaling 9 calories. This means that:

• A 1,500-calorie diet translates to 50 grams of fat per day.
• A 2,000-calorie diet translates to 67 grams of fat per day.

In most cases, you need to avoid anything fatty, greasy, or fried. Processed and sugary foods should be avoided too, because they can lead to diarrhea.

People with severe symptoms after gallbladder removal may need to limit their intake of dairy, fatty meats, caffeine, spicy foods, and alcohol. Trial-and-error will help you to know which of these foods you can eat without causing symptoms.

What you shouldn't try to do is cut out all dietary fat. Fat is essential to supporting cell growth, processing nutrients, protecting organs, and producing hormones.

Healthy polyunsaturated and monounsaturated fats, especially omega-3 fatty acids found in fish, can help you to meet your recommended dietary intake (RDI) of dietary fat. This will significantly lower your risk of bile acid diarrhea and irritable bowel syndrome (IBS).

Other changes in your diet may be recommended too. You may need to boost your intake of fiber, which can bind to excess bile between bowel movements and prevent gastritis.

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Duration

As a general rule, a low-fat diet should be used by anyone who has undergone a cholecystectomy. This is true regardless of your age, sex, or health status, for at least a month after the surgery.

Not everyone who has a gallbladder removed will need to stick to a strict low-fat diet for the rest of their lives. Yet doing so will almost always improve bowel function as well as overall health.

After a month or so, you may be able to return your fat and sugar intake to normal. Some people may even be able to return to the same diet they had before surgery.

If you still find yourself struggling with digestion, you may be experiencing postcholecystectomy syndrome (PCS). It is characterized by:

• Stomach upset
• Diarrhea
• Nausea
• Bloating
• Flatulence (gas)
• Vomiting

Persistent PCS may require the extended or permanent use of a low-fat diet.

Recap

Your diet after gallbladder removal will likely follow some common steps. You'll first start on clear liquids and then bland foods like rice and applesauce. As you return to a more "normal" diet, you'll need to limit fats and other foods that can cause symptoms, like dairy, for about a month.

What to Eat

There isn’t one post-cholecystectomy diet that works for everyone. Some foods that tend to cause more problems than others.

Helpful Foods

• Apples, applesauce, and pears

• Avocados

• Bananas

• Beans, legumes, and lentils

• Berries

• Broth and clear soups

• Broccoli

• Brussels sprouts

• Cabbage

• Carrots

• Chickpeas

• Collard and mustard greens

• Dairy-free milks (soy, rice, almond, oat)

• Eggs, egg whites, and egg substitutes

• Fish (salmon, cod, halibut)

• Grapefruit and oranges

• Green bell peppers

• Kale

• Low-fat Greek yogurt

• Nuts and nut butters (almond, cashew, walnut)

• Oats and barley

• Olive oil (extra virgin)

• Plums and prunes

• Rice (white if having symptoms)

• Seeds (chia seeds, flax seeds)

• Sweet potatoes

• Tofu and tempeh

• White meat chicken and turkey without skin

Problem Foods

• Alcohol

• Butter, lard, vegetable oil, and margarine

• Caffeine (coffee, tea, energy drinks, soda)

• Chocolate and candy

• Fatty and fried food

• Frozen meals and desserts

• Full-fat dairy

• Ice cream, whipped cream, custard, and pudding

• Lamb

• Processed and packaged snacks

• Pies, pastries, doughnuts, cake, and cookies

• Pizza and calzones

• Pork, bacon, sausage, and lunchmeat

• Potato chips and buttered popcorn

• Red meat

• Spices (as tolerated)

• White refined flour (including bread and pasta)

Fruits and vegetables: The soluble fiber in sweet potato and broccoli can help prevent diarrhea. If you find that citrus fruits like oranges and grapefruit are too acidic, stick with apples, bananas, avocado, and berries. Vegetable soups are nutritious and easy to digest. It may be better to avoid creamy soups, at least for the short term. 

Dairy: Full-fat dairy products may be too hard for your body to break down, especially while recovering from surgery. Low-fat yogurt, dairy-free milk options, and some low-fat cheese may be easier to tolerate if you eat them in moderation. You can try dairy-free cheese made from cashews or tofu. 

Grains: As you begin easing back into a regular diet, focus on increasing your fiber intake from whole grains. They include brown rice and barley. Toast and crackers can be useful when recovering from surgery, but you’ll eventually want to replace those made with refined white flour with whole grain products.

Pizza, calzones, and other foods made with hard "00" flour are hard to digest. You can make a lighter, dairy-free pizza made with flour tortillas, lactose-free cheese substitutes, and fresh vegetables.

Protein: You don't need a gallbladder to digest protein. This means that high-protein foods aren’t likely to cause you trouble unless they are also high in fat. Avoid cuts of beef that look heavily marbled, and trim any excess fat from chicken, pork, beef, and other meats.

Nuts, seeds, and nut butters are good sources of plant-based protein but they're very high in fat. Beans, legumes, and soy products are healthy choices as long as they don’t cause digestive symptoms. 

Beverages: You may initially need to avoid sodas and alcohol after having your gallbladder removed. It's best to avoid high-sugar drinks, like sweetened juices and concentrates. Over time, you can discover what works best for you.

Milky coffee drinks, such as lattes made with whole milk, may be far too difficult to digest. Instead, look for low-fat or non-dairy options made with soy or almond milk. Herbal teas, especially peppermint, can be very soothing to the digestive tract. 

If you are unwilling to cut out alcohol entirely, avoid sweet cocktails and high-carb beers. Even sweeter wines, like port and sherry, can cause problems.

Desserts: Desserts that are high in sugar and trans fat are especially difficult to digest. Ice cream, cakes, cookies, puddings, and chocolate should only be eaten occasionally and in moderation.

There are some good low-fat, non-dairy desserts on grocery store shelves, but keep an eye out for artificial sweeteners like sorbitol that can increase the risk of diarrhea.

Recap

Within a span of a few weeks of having your gallbladder removed, you should be able to increase the amount and range of foods you are able to eat. Experiment with different food groups to see how your body responds. By keeping a food diary, you can keep tabs on which foods cause you the most problems and which don't.

Recommended Timing

You may need to alter the timing of your meals and snacks. Without a gallbladder to assist with digestion, four to six small meals per day may work better than the three large meals you may be used to.

If you are on the go, have plenty of low-fat snacks on hand to keep you on track. This may help to keep you from overeating when you finally are able to sit down for a meal.

After meals, give yourself time to digest your food. Jumping straight into a strenuous activity after eating will certainly increase the risk of indigestion.

If eating outdoors, avoid sitting under the hot sun for too long. Overheating the body can increase the risk of diarrhea. Find some shade and drink plenty of water to stay hydrated.

Cooking Tips

As much as you may enjoy a big crunchy salad, vegetables bind to bile acid more easily when they have been lightly cooked as opposed to eating them raw. Steaming vegetables is a quick and easy way to make them easier on your system.

You can also steam fish or poach chicken rather than pan-frying them. If you need oil for grilling or roasting, use a spray bottle to lightly coat the food rather than dousing it in oil.

As a general rule, avoid cooking with butter, lard, margarine, and hydrogenated vegetable oils.

Instead of a prepared oil-based dressing, try flavoring salads with a sprinkling of white balsamic vinegar and fresh herbs. You can also substitute mayonnaise dressings for ones made with plain non-fat yogurt, vinegar, garlic powder, mustard, and fresh herbs.

While spices like cayenne, curry, and cinnamon can be rough on the stomach, others like ginger or turmeric may be soothing. As a rule of thumb, always start with the smallest amount of spice to see how your body reacts. Spicy foods may set you up for indigestion and diarrhea.

Modifications

You may have other health conditions that require dietary changes, such as hypertension (high blood pressure) or type 2 diabetes. You may need to modify your diet even more to better manage these diseases.

With that said, the foods to eat after your gallbladder removal are more or less the same as those that will help to manage high blood pressure or diabetes. If anything, those diets would be more strict.

The same applies to diets used to treat lactose intolerance or celiac disease. Those diets may require the total exclusion of dairy and gluten, respectively, rather than even a limited intake.

Recap

Changing the foods you eat after gallbladder removal also means a change in how they are cooked, as you shift away from frying meat in fats or begin to steam your vegetables. It also may mean having smaller meals more often, or making changes due to food allergies, pregnancy, and other medical conditions.

The one area where a post-cholecystectomy diet may pose challenges is during pregnancy. Gastrointestinal problems are rife during the various stages of pregnancy. They include:

• Morning sickness
• Gastric reflux
• Diarrhea
• Constipation

It can be hard (if not impossible) to tell the difference between the symptoms caused by pregnancy and those triggered by PCS.

Many of the dietary recommendations made during pregnancy, such as increasing your intake of protein and calcium, may make PCS symptoms worse. That's because they can both lead to diarrhea in people without a gallbladder when they are eaten in large amounts.

Nutritional needs should always be met during pregnancy. A registered dietitian can help you to find alternative sources of protein and calcium if meat and dairy are causing problems.

Considerations

Keep in mind that other factors can influence how easy or hard it is to make and keep the changes to your diet. Your overall nutritional needs, possible side effects, and situations like dining out are among these factors.

General Nutrition 

Whatever your plan after having your gallbladder removed, it should always meet the daily minimum intake of protein, carbs, fats, and nutrients outlined in the 2020-2025 USDA Dietary Guidelines.

If you are struggling to meet these needs, let your healthcare provider know. A dietitian can offer ways to boost your nutrition, such as using supplements to help you keep a balanced diet.

Flexibility

Dining out can be difficult when managing any medically-indicated diet. That's true for a person after their gallbladder is removed too.

Yet even fast food restaurants often have healthy menu items that fit into your diet plan. If you plan on dining out, check out the menu items and nutritional information online before you go.

You may find the options at a sit-down casual dining restaurant are more friendly to your diet. Since much of the food is cooked to order, you can ask that certain ingredients be left off or replaced with a substitute.

If dining out with friends, call the restaurant in advance to let them know about your dietary needs. Many will have ideas and offer suggestions that fit within your diet plan. Others may even prepare a special order if you call a day or two in advance.

Support and Community

Lifestyle changes of any sort can be stressful. If you’re feeling frustrated or disappointed by the changes in your diet, it may help to talk to others with similar experiences.

Online support groups devoted to gallbladder disease can be found on Facebook, for example. They offer a platform to connect with others, ask questions, share stories and insights, and be encouraged as you adapt to your new lifestyle.

Your healthcare team also can offer advice. They can direct you to dietitians, nutritionists, and counselors experienced in gallbladder disease.

Family and friends are also vital to your long-term care. By helping them to understand your condition and why certain diet changes are needed, you can avoid having your plans sabotaged by their well-meaning efforts.

Recap

As you make changes, keep in mind that it's important to maintain the levels of nutrition you need. You may find that some situations, like dining out, are a little harder to navigate but you can still be successful. Let your friends and family help you, join a support group, and don't hesitate to see a dietitian for advice.

Side Effects

Any change in your diet can cause side effects. Your body is an interrelated system that strives to maintain homeostasis (an overall state of balance). If anything upsets that balance, including changes in diet, your body systems will try to re-establish it.

When starting a low-fat diet, constipation is a common response. You can usually help ease the symptoms by drinking plenty of water and taking a fiber supplement if needed.

Sometimes, you may add too much fiber to your diet by eating extra vegetables and whole grains. They can trigger diarrhea, but you can shift to a BRAT diet or decrease fiber intake until your body adapts.

Fortunately, side effects like these tend to be mild and will ease after several days or weeks. If they don't, speak with a gastroenterologist who specializes in digestive disorders to see if there may be other causes for your symptoms.

Dietary Restrictions

You may have other dietary restrictions before you have your cholecystectomy. You may be a strict vegetarian or vegan with no intention of changing your plant-based diet. Or, you may have a food allergy that limits the types of food you can eat.

Vegetarians and Vegans

If you follow a strict plant-based diet, you likely are already meeting your daily protein and calcium needs without the use of meat, fish, eggs, or dairy. The problems only arise if certain proteins, namely beans and legumes, cause digestive distress.

Certain vegetables, like cabbage and cucumber, may only cause gas in people with a gallbladder. But they may trigger IBS symptoms in those who no longer have one.

Whole wheat, bran, green beans, potatoes, cauliflowers, and nuts can trigger IBS in people recovering from gallbladder removal. In such cases, you may need to avoid these foods until your system is better able to handle them.

If symptoms persist, you may need to see a dietitian. They can help you to identify options that will provide you with needed protein or carbohydrates.

Food Allergies

People with food allergies are usually good at monitoring their diets. That said, you may find it challenging to cut even more foods from your diet if you are already avoiding food allergens.

Some food sensitivities, like lactose and gluten, are easy enough to deal with given that whole-fat dairy and refined white flour are already on the "avoid" list. Other common allergies, such as fish, nut, soy, or egg allergies, can be harder because they are prime sources of protein.

For example, if you need to avoid red meat because of PCS, the inability to readily replace these proteins can impact your well-being and health.

As before, a registered dietitian can help to guide you through your food options and ensure that your daily nutritional needs are met.

Summary

Some people develop diarrhea and other symptoms after a cholecystectomy, or gallbladder removal. The surgery means the body's digestive system has changed, and this, in turn, calls for changes in your diet too.

Some of these changes, like drinking only clear fluids, last only for a few days. Others, such as reducing the fat in your diet, will be changes you'll need to make across a lifetime. You also may need to integrate them into any dietary needs you already have, as is the case with someone who is vegan or has food allergies.

Fortunately, there are many food choices you can make to help you make this shift. Discuss them with your healthcare provider or consider seeing a dietitian who can offer the advice you need.

A Word From Verywell

Adopting a new way of eating after gallbladder removal can be challenging. Try to focus on how the changes will improve health and quality of life. Over time, you will learn to adapt even though you may miss your old favorite foods.

Frequently Asked Questions

• Why is my stomach bigger after gallbladder removal?

  Abdominal swelling is common after gallbladder removal due to the trauma of having an organ removed. It should return to normal in a few days to weeks.

• What foods should you avoid after having your gallbladder removed?

  Avoid high-fat foods, sugar, and refined flour after gallbladder removal. Fatty foods include butter, lard, cooking oil, fried food, full-fat dairy, and fatty cuts of meat. Sugary foods include chocolate, cookies, candy, cake, and pastries. Foods made with refined flour including bread and pasta. 

• Why should you avoid fat after gallbladder removal?

  Fat is difficult to digest. The gallbladder stores and releases bile, a liquid that aids in digestion. Without a gallbladder, you may have trouble breaking down fats, which can result in bloating, cramping, and loose stools.

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