IBS After Gallbladder Removal: Is There a Connection? (2024)

Most people who undergo gallbladder removal, or cholecystectomy, experience no long-lasting symptoms after the procedure. But some people continue to have digestive symptoms after surgery, sometimes even years later.

Doctors usually refer to the digestive symptoms people experience after gallbladder removal as postcholecystectomy syndrome (PCS). PCS includes symptoms like nausea, vomiting, bloating, gas, diarrhea, and stomach pain.

Some research suggests that the risk of developing irritable bowel syndrome (IBS) after cholecystectomy may be higher than in people without the surgery. However, the symptoms of IBS are often similar to other conditions. What may be thought to be IBS, could really be PCS or another condition called bile acid malabsorption (BAM).

Currently, there isn’t any strong evidence to show that gallbladder removal causes IBS.

A 2008 retrospective study found that people who had their gallbladder removed were twice as likely to develop IBS — IBS with diarrhea (IBS-D), in particular — when compared with people without the surgery.

But the authors of the study acknowledged that diarrhea is common after gallbladder removal. While persistent diarrhea could lead to an IBS-D diagnosis, it’s possible these symptoms may be related to other gallbladder removal complications, such as bile acid malabsorption. In addition, the results of the study weren’t statistically significant.

A 2021 prospective study of 166 people who underwent cholecystectomy couldn’t find a relationship between cholecystectomy and developing IBS.

More research is needed to prove or disprove a potential link between IBS and gallbladder removal surgery. What researchers do know is that gallbladder removal can cause long-term digestive complications, and symptoms can be similar to the symptoms of IBS.

These symptoms, which include nausea, vomiting, bloating, gas, diarrhea, or stomach pain, are collectively referred to as PCS. For most people, PCS is temporary, but symptoms sometimes linger for many years after surgery.

PCS refers to digestive symptoms that arise after gallbladder removal. These symptoms often start right after the surgery, but they can also appear months or even years later.

Bile acid malabsorption (BAM)

After gallbladder removal, the bile produced by the liver flows directly into the small intestine. BAM, also called bile acid diarrhea, happens when your intestines can’t absorb the bile acids. The extra bile acids can cause watery diarrhea. BAM is treated with medications called bile acid sequestrants, such as cholestyramine.

Postcholecystectomy diarrhea

Diarrhea after gallbladder removal is common and usually temporary. It can be related to BAM or other causes.

Sphincter of Oddi dysfunction

The sphincter of Oddi is a valve that opens and closes to let digestive liquids move from the liver and pancreas to the small intestine. Gallbladder removal can cause this valve not to function properly, though the exact cause of this isn’t fully understood. The most common symptom is abdominal pain. The condition can also cause:

  • fever
  • diarrhea
  • nausea
  • vomiting

Retained gallstones

Most people undergo gallbladder removal due to the presence of gallstones. After surgery to remove the gallbladder, a stone can remain in the bile duct and block the flow of bile into your small intestine. This can lead to the following symptoms soon after surgery:

  • pain
  • fever
  • nausea
  • jaundice
  • vomiting

You may need another surgery to remove retained gallstones.

Like other surgeries, gallbladder removal can have risks. Aside from digestive problems, other complications may include:

  • bleeding
  • infection
  • blood clots
  • reaction to the anesthesia
  • short-term constipation
  • injury to the bile duct or other organs, like the liver

Mild diarrhea is usually not a cause of concern, but contact a doctor if:

  • you’re losing weight without trying
  • you have bloody diarrhea
  • diarrhea wakes you up at night
  • you have severe abdominal pain
  • diarrhea persists longer than a few days
  • your skin or eyes appear yellow
  • you don’t have a bowel movement or pass gas for 3 days after surgery

Gallbladder removal can sometimes cause digestive issues. Here are some answers to common questions about the connection between gallbladder removal and digestive issues.

Does your digestive system change after gallbladder removal?

After the gallbladder is removed, bile moves directly from your liver to your intestines to aid in fat digestion. Your digestive system may need some time to adjust to its new method of digesting fat.

You’ll still be able to digest most foods, but fatty, greasy, or high fiber foods might upset your stomach. Eating too much can result in bloating, stomach pain, and diarrhea.

Can having your gallbladder removed cause bowel problems?

Gallbladder removal can cause bowel problems like diarrhea, abdominal pain, gas, nausea, vomiting, and jaundice. These symptoms are usually mild and temporary, but in some cases, they can persist for months or years and require treatment.

Can gallbladder removal lead to dumping syndrome?

Gallbladder removal can increase your risk of dumping syndrome if you’ve also had a weight loss procedure called bariatric surgery. In dumping syndrome, food moves too quickly from the stomach to the small intestine. Symptoms include intolerance to high fat foods, diarrhea, nausea, vomiting, bloating, dizziness, sweating, and cramps.

Digestive issues commonly arise after gallbladder surgery, including bloating, diarrhea, and stomach pain. These symptoms can be very similar to the symptoms of IBS, but there isn’t enough research to determine a causal link between IBS and gallbladder removal. Of the studies that have been done, the results are contradictory.

Speak with your doctor if diarrhea or other stomach symptoms persist for several days after gallbladder removal. Your doctor might recommend medications or diet changes, like limiting fatty foods, to help your symptoms.

IBS After Gallbladder Removal: Is There a Connection? (2024)

FAQs

IBS After Gallbladder Removal: Is There a Connection? ›

Participants with a history of cholecystectomy had a 46% higher risk of IBS than those without (HR = 1.46, 95% CI: 1.32–1.60), and further subtype analysis showed that the risk of IBS with diarrhoea was significantly higher than the risk of IBS without diarrhoea (HR = 1.71, 95% CI: 1.30–2.25 vs.

Is irritable bowel syndrome common after gallbladder removal? ›

One 2023 study investigated the association between cholecystectomy and IBS risk. The study included 413,472 participants. It concluded that people who had a history of cholecystectomy had a 46% higher risk of IBS than people without.

What digestive disorders can you get after gallbladder removal? ›

While many people don't have any problems after gallbladder removal, others do. Complications can include postcholecystectomy diarrhea, sphincter of Oddi dysfunction, and liver problems. Talk to a healthcare provider if you're experiencing problems following cholecystectomy.

How many people have digestive issues after gallbladder removal? ›

It's not known how many people have diarrhea after surgery to remove their gallbladders, called 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.

Should you take probiotics if you don't have a gallbladder? ›

More efficient digestion can also help reduce bloating. Another useful practice is to take a daily probiotic supplement, such as Culturelle. Research suggests that the friendly bacteria in these supplements can help break down food, increasing the efficiency of digestion.

What problems can occur years after gallbladder removal? ›

The symptoms include fatty food intolerance, nausea, vomiting, heartburn, flatulence, indigestion, diarrhea, jaundice, and intermittent episodes of abdominal pain. Post-cholecystectomy syndrome can present early, typically in the post-operative period, but can also manifest months to years after surgery.

What are the long-term side effects of having your gallbladder removed? ›

However, some people experience persistent issues known as post-cholecystectomy syndrome. Long-term effects of gallbladder removal include diarrhea, fatty food intolerance, gas, heartburn, nausea, vomiting, jaundice, and intermittent episodes of abdominal pain.

What are the disadvantages of not having a gallbladder? ›

Without the normal amount of bile in your stomach that used to be produced by your gall bladder, you will experience more gas, bloating and pain as the food is digested. Start to introduce coffee and tea back into your diet gradually to see how much you can handle.

What foods should you avoid if you have no gallbladder? ›

Don't eat high-fat foods, fried and greasy foods, and fatty sauces and gravies for at least a week after surgery. Instead, choose fat-free or low-fat foods. Low-fat foods are those with no more than 3 grams of fat in a serving. Check labels and follow the serving size listed.

What is Mirizzi syndrome? ›

Mirizzi syndrome is defined as common hepatic duct obstruction caused by extrinsic compression from an impacted stone in the cystic duct or infundibulum of the gallbladder [1-3]. Patients with Mirizzi syndrome can present with jaundice, fever, and right upper quadrant pain.

What don't they tell you about gallbladder surgery? ›

There are risks of surgery of all sorts, things like bleeding infection, heart problems, lung problems, these in theory are all possible. Although these risks are high, more specific to gallbladder surgery, we talk about bile duct injury. We have to operate around the main bile duct, leading from the liver.

Will I ever be normal again after gallbladder removal? ›

You can live perfectly normally without a gallbladder, so there aren't usually any long-term effects from gallbladder removal surgery.

How to treat IBS after gallbladder removal? ›

Diarrhea caused by cholecystectomy can be treated with a high-fiber, low-fat diet, as well as fiber supplements, prescription, or over-the-counter medication. Over time, diarrhea may start to settle, but it can take a long time.

What supplement should people with no gallbladder take? ›

OX BILE SUPPLEMENTS FOR NO GALLBLADDER - When you have lost your gallbladder, a lack of bile can produce indigestion, bloating, fatigue, and other symptoms after meals. An Ox Bile supplement standardized to contain bile salts such as cholic acid may help people who have lost their gallbladder.

How do you treat PCS after gallbladder removal? ›

Postcholecystectomy syndrome treatment depends on the identified violations that led to it. Typically, the patient is recommended a dietary restriction table with fatty foods, enzyme preparations, antispasmodics, and sometimes cholagogue.

How long does it take for your bowels to get back to normal after gallbladder surgery? ›

The diarrhea usually goes away in 2 to 4 weeks, but it may last longer. How quickly you recover depends on whether you had a laparoscopic or open surgery.

What is dumping syndrome after gallbladder removal? ›

Dumping syndrome is a condition in which food, especially food high in sugar, moves from your stomach into your small bowel too quickly after you eat. Sometimes called rapid gastric emptying, dumping syndrome most often occurs as a result of surgery on your stomach or esophagus.

Does gallbladder removal affect gut health? ›

Cholecystectomy alters the bile flow into the intestine and the enterohepatic circulation of the bile acids; this may affect the gut microbiota.

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