Life after gall bladder removal

November 25, 2022 2:31 AM

I had my gall bladder removed three weeks ago and am finding conflicting information about what my diet should be for the rest of my life and what I can expect my digestive system to be doing now in the short term and also in the mid+longer term... I see two schools of thought on diet. The NHS seems to say I can go back to my previous diet*, whereas many other online resources say: keep fat to a minimum and also eat more smaller meals rather than three square ones.

My gut does seem to be struggling so far. Initially things were quite good (first few days) but now I get a lot of bloating (resulting in a lot of belching) after meals, and a lot of sort of rumbling and bubbling and mild discomfort from my tummy.

* They describe the procedure as not really resulting in a net effect on the stomach at all, they say that bile now continually drips from the liver instead of accumulating first in the gall bladder.

So yeah, just looking for thoughts from the hive mind on life post gall bladder surgery

posted by dance to Health & Fitness (12 answers total)

The consensus is...there's no consensus.

It really varies from person to person. My mother had her gallbladder removed, she had no problems eating whatever she wanted for the rest of her life. Me? I was fine at first but after a few years developed postcholecystectomy syndrome. It's mostly managed by medication (colestyramine) and avoiding ingesting large amounts of fat at one time. If the fat is buffered by something else (like fatty meat that's also eaten with some plain rice) I can usually come out fine. Some types of fats bother me more than others (coconut oil is a flat out no-go). I also have a touchy GI system in general though so not everything is attributable to the lack of gallbladder.

My advice is yeah, small plain meals right now until you can get your GI tract to calm down and then add things back in slowly and see your doctor about medication options if it's interfering with your life significantly.
posted by mochi_cat at 2:54 AM on November 25, 2022 [4 favorites]

I was on omeprazole before and after for something else, so I don't know how much that helped. Post-surgery I avoided greasy food and stuck to small portions. Butter and cheese were a bit too rich at the start. Now it's fine as long as I stick to small portions. I would start with the recommended diet and then test small portions of other food.
posted by dorothyisunderwood at 4:05 AM on November 25, 2022

I had my gall bladder out three years ago and have honestly felt no side effects to the surgery at all. My current eating plan is low fat/high fiber meals* 5 times a day, which I'm very comfortable with. It's all good, especially compared to the grinding pain of the gallstone attacks that preceded the procedure.

*The definition of "meal" varies a lot. I have pretty normal breakfast and lunch, lunch being my main meal of the day. Mid-morning, mid-afternoon "snacks" and dinner are smaller, since I'm also trying to lose weight. You might experience some weight loss as a side-effect, which is great in my case but may vary for you.
posted by SPrintF at 4:09 AM on November 25, 2022 [1 favorite]

i had mine removed a few years ago and have not changed my meals at all. So, the fat level (which could be argued to be a bit high) and fiber level (which could be argued to be a bit low) is exactly the same. I haven’t noticed anything different.
posted by alchemist at 5:05 AM on November 25, 2022

I had my gallbladder out in January 2022. I have experienced changes in my bowel movements- whereas before I suffered from constipation, I no longer have that issue. In the first few months after my surgery there was a learning curve of what I could eat vs. not eat- the main issues were high fat foods and strong coffee, and both sent me running to the bathroom with little lead time. There is one particular bakery where I know I can not get baked goods from anymore as they are just too high in fat, but beyond that one place, I have very few issues as long as I avoid very high fat meals-like fish and chips for example. And honestly, that hasn't been so hard for me, if I want to eat fish and chips, I share with someone else, and just don't eat a full serving. Initially, in the first months, I really second guessed having the surgery due to the bathroom issues, but almost a year in, everything has resolved/I know what to avoid, and it isn't a great sacrifice to avoid the things I need to. And not having gallbladder attacks is well worth it! I had two un-medicated births, and my gallbladder attacks hurt more than those did.
posted by momochan at 8:36 AM on November 25, 2022

Anesthesia, pain meds, and surgery itself can really mess your gut up for a while. And you’re adjusting to a change of a digestive organ. I would suggest a gentle diet for a few weeks, with easy to digest, low acid, lower fat foods as you heal. And plenty of water and liquids.

Then I would slowly resume a more typical diet and see what, if anything, affects you.

I have incredibly terrible stomach issues and I’ve had my gallbladder out. No gallbladder specific issues post sugery other than not doing well with a ton of fat, but I’ve never been able to do that anyway. Some people have issues. But you won’t know for a while and you HAVE to let your body recover.

If you find you do have issues, check with your doctor and/or a dietician.
posted by Crystalinne at 9:38 AM on November 25, 2022

My experience is that eating too much fat now just causes diarrhea, which IMO is a huge improvement over the terrifying attacks of stabbing chest pains and vomiting plus chronic debilitating upper back pain that I had before surgery.

So it depends on your body and what you want to achieve. If you want perfect poops then you may still need to watch what you eat. If you don't mind loose stools being your new normal, eat what you want.
posted by Jacqueline at 10:09 AM on November 25, 2022

I had my gall bladder out in 1991. The reason I had gallstones was extreme weightloss using Herbalife, then using antihistamines to help manage reactive airway disease, and accompanying dehydration. Other than making myself drink enough water, and avoiding high cholesterol fats day to day, and still sometimes eating red meat, but no butter in my house just olive oil, I had no changes. I don't use over the counter meds, or meds, especially antihistamines. Once the gallstones were gone, and not periodically blocking my commom bile duct, it was over. I had an abdominal ultra sound a couple of years ago, there was no subsequent blockage of my common bile duct. So, it should just be a non issue. You can always take a course of probiotics to make sure your gut bacteria is varied enough. I know I am not you, but the surgery should leave you clear of any pain that drove you to surgery.
posted by Oyéah at 11:48 AM on November 25, 2022

Seconding Crystalinne and Jacqueline - IANYRD, but I'm a dietitian and I got my gallbladder removed in 2015... One *big* gallstone. And I got them to take pictures of the procedure so I could bring them into my medical nutrition therapy class at the time, haha!

Here's the mechanism for what's happening:
- Bile acids/salts will continuously circulate in your GI system (enterohepatic system) versus being stored in the gallbladder.
- Because of this, your body can now handle/metabolize a "small"/steady stream of fats dependant on bile salts for digestion* versus a big portion at once.
- Large amounts (and the normal caveat of bodies are complicated, YMMV, what's large for you is different than for anyone else) will result in some degree of upset stomach and steatorrhea (fat in stool, will be SMELLY, yellowish-tan, and/or streaked with mucus-looking fat; you may also notice brown or black flecks of bile salts in your stool for a while).
- It'll take a little bit of time for your GI system to adjust to this new normal!
- Typically, for the first few weeks after surgery people are recommended to eat no more than 50gms of fat per day (I give a 10% leeway, because again, bodies are complicated), so it may be helpful to keep a food log for a few days so you can check where you are. I like Nutritionix, a lot of people use MyFitnessPal, pen and paper also a good idea.

*Fun fact, short and medium-chain triglycerides like those found in coconut oil do not require bile for digestion! So, not all fats are alike, but remember that all types of fats are found in some proportion in each fat-containing food.
--------
My "fun" post-chole experience:

It took about a year or two for my body to fully adjust, and I still get a "warning twinge" from my body if I eat too much fat at once for too long. Normal! I rarely have that happen now 7 years out. I took this as a reason to assess my overall diet and make tweaks.

A year after my surgery, it was "peanut day" on the college campus I worked at as a dietetic intern/on my way to be their R&D chef. I love peanuts and peanut butter... And had never tried boiled peanuts before that I'd liked... So when I actually liked them this time, I went hard and ate a large cup of them along with all of these other amazing peanut and peanut butter foods that day. The next day... Let's just say between the nausea, steatorrhea, and pain I thought I had the flu or food poisoning!! Learned my lesson, and I've generally been much more conscious of my overall fat intake since then.

I still totally enjoy all of the same foods as before, I just watch my portions of high-fat foods and know that if I don't it'll hurt! No problems with pizza, for example.

In very very rare cases, some people have reoccurrence of gallstones in the biliary ducts, but that can be managed in-hospital.

So, yes, generally you might not need a drastic dietary change, but you'll learn your new normal over time.
posted by OhHaieThere at 1:03 PM on November 25, 2022 [4 favorites]

My mom has hers out, without any dietary changes. I was okay for a few months, but then had more issues with small amounts of sauces and fats. My doctor prescribed cholestyramine and that was a miracle worker. So if you do find you need it, don't be afraid to ask.

Like others said, though, the first few weeks are going to be an adjustment period. Things that matter now, might be fine later.
posted by bizzyb at 3:38 PM on November 25, 2022

To add to the chorus, I had mine out a decade ago and have been fortunate enough to not require any changes to the way I eat. I am ultraprocessed food guy, so who knows if that will change. So far so good.
posted by maxwelton at 11:21 PM on November 25, 2022

My surgeon said no changes were needed but it was probably a good idea to eat low fat for a few weeks after the procedure. I ate super low fat for one month out of an abundance of caution.

After 6 months I could eat most things, but you will need to see how fat treats your body afterward. Quite frankly, the times I feel sick (either through bloating/bowel movements/overfullness) is when I eat in a super bad American style way. I’ve found I can have some fat but if I have tons of fat all day long in all my meals it might be bad news. It seems to be changing as my body heals — a few month afterwards a hot dog and fries sent me running for a bathroom while I was grocery shopping but I can eat that now without immediate toilet repercussions as long as I also didn’t have pizza/ice cream/baked goods that day.
posted by Bunglegirl at 6:43 PM on November 26, 2022 [1 favorite]