Nutrition Hotline
By Reed Mangels, PhD, RD
QUESTION: What does it mean as far as diet/nutrition if the gallbladder is removed?
A.T., MD
ANSWER: The gallbladder is a small organ located below the liver. Its main function is to store bile, a fluid produced by the liver. Bile is used to help digest fats. The gallbladder also concentrates bile, making it less watery. After a meal that contains fat is eaten, the gallbladder sends bile into the small intestine to help with fat digestion. The tube that connects the gallbladder and the liver to the small intestine is called the common bile duct.
Sometimes gallstones, hard particles, develop in the gallbladder. Gallstones form when some of the substances in bile solidify. Often, people don't know that they have gallstones, and the gallstones don't cause problems. It is a problem when gallstones block the common bile duct or other ducts (tubes) connecting the gallbladder to other organs. When this happens, people experience pain, nausea, vomiting, and other symptoms. This is called symptomatic gallbladder disease. Surgery to remove the gallbladder may be needed. As we discuss in this month's Scientific Review, risk of gallbladder disease may be affected by a vegetarian diet. One study suggested that vegetarians were at higher risk for symptomatic gallbladder disease while another found vegetarian women, but not vegetarian men, to have a lower risk of symptomatic gallbladder disease compared to non-vegetarians. Cancer of the gallbladder is another, much less common reason for surgery to remove the gallbladder.
After gallbladder removal surgery, people are still able to digest fat. Bile moves directly from the liver, where it is produced, through ducts, to the small intestine. Bile will not be stored anymore but it will be available to help with digestion of fat in the small intestines. After gallbladder removal, bile entering the intestines is less concentrated.
This, along with a more continuous movement of bile into the small intestines, can have a laxative effect, leading to diarrhea. Diarrhea may also be due to undigested fat in the intestines. Since bile is not being stored, not as much is on hand to help with digestion of a high-fat meal. Undigested fat in the intestines can cause gas and bloating, in addition to diarrhea. In most cases, the diarrhea lasts a few weeks to a few months while the body becomes accustomed to functioning without a gallbladder. In some cases, it lasts longer.
Eating high-fat or very spicy foods may make the diarrhea worse, and so some providers recommend avoiding very greasy or spicy foods for a while. Eating smaller meals, more frequently, may also be helpful. Gradually increasing the amount of dietary fiber can also assist with control of diarrhea. Focus on foods higher in soluble fiber like oats and barley. A food-and-symptoms diary can be useful in determining which foods result in more symptoms. A registered dietitian can provide individualized advice for dietary modifications. If the diarrhea doesn't improve with time, contact your physician.
REFERENCE
Subodh K. Gallbladder removal — discharge instructions. Medline Plus website. 2016. www.medlineplus.gov/ency/patientinstructions/000117.htm
