More people are having their gallbladders removed than ever before—and at a younger age. How does losing your gallbladder affect your diet for the rest of your life?
Several of you have asked me to devote an episode to diet and nutrition following gallbladder removal. This is one of the most commonly performed surgeries--and it's getting more common. Not only that, but the average age at which the procedure is performed is trending down. As a result, there are more people running around the world without gallbladders, and for longer.
The vast majority of people who undergo gallbladder removal do very well and go on to live normal lives. But the removal of this digestive organ does have some ongoing implications for your diet and nutrition. Before we talk about how you might want to adjust your diet following gallbladder removal, let's talk briefly about why this surgery is getting more common.
What is the gallbladder
The gallbladder is a small sac that stores bile, a digestive fluid produced by your liver. After you eat, the stored bile is pumped from the gallbladder into the small intestine, where it helps to break down fats in food so they can be absorbed.
If a gallstone completely blocks the bile duct, it can cause very serious complications, including inflammation, infection, and even damage to other organs such as the pancreas.
Sometimes, however, gallstones form in the gallbladder. Most gallstones are asymptomatic but about 20 percent of the time, they cause abdominal pain, often after eating. If a gallstone completely blocks the bile duct, it can cause very serious complications, including inflammation, infection, and even damage to other organs such as the pancreas. That's why doctors often recommend removing the gallbladder if people have recurring problems with gallstones.
Who gets gallstones?
Women are more likely to suffer from gallstones than men and the risk increases with age. Gallstones have a genetic component, meaning that they tend to run in families. Certain ethnic groups are also more susceptible. In particular, Native American tribes indigenous to the Southwestern United States and people of Mexican heritage have a much higher incidence than non-Hispanic whites. People of African heritage have a much lower incidence. These links are referred to as non-modifiable risk factors—ones you can't do anything about.
Rapid weight loss can trigger gallstones, so our societal addiction to extreme diets also plays a role.
But the reason that gallbladder disease is getting more common and affecting people earlier in life has to do with risk factors that we do have some control over. Gallstones occur more frequently in people suffering from obesity, Type 2 diabetes, and metabolic syndrome. As the number of people affected by these conditions has increased, so has the incidence of gallstones. Rapid weight loss can also trigger gallstones, so our societal addiction to extreme diets also plays a role.
RELATED: The Case for Super-Slow Weight Loss
How to prevent gallstones
Aside from maintaining a healthy body weight and avoiding rapid weight loss, you can reduce your risk of gallstones by eating a healthy diet that is neither very high nor very low in fat. Avoid overeating fried foods, fatty meats, high-fat dairy products, and added sugars. Eat plenty of vegetables, fruits, and legumes. Enjoy nuts, seeds, fish. You know, the usual drill.
Eat plenty of vegetables, fruits, and legumes. Enjoy nuts, seeds, fish. You know, the usual drill.
But for those who have already had their gallbladders taken out, the question is no longer how to prevent gallstones. No gallbladder means no more gallstones. But it also means that you will need to make some adjustments to your diet, at least for a while.
What to eat after gallbladder removal
Your liver continues to produce bile, but instead of directing it into the gallbladder, where it is concentrated and stored, it is released continuously into the small intestine—whether or not there is food to digest. This can cause diarrhea, especially in the weeks and months immediately following the surgery. Fortunately, your body has a marvelous ability to adapt, and this side effect is usually not permanent.
Eating too much fat at one time may cause digestive symptoms like gas, bloating, or diarrhea.
Because your body still produces bile, you still have the ability to digest fat. But because the bile is less concentrated and the amount present in the intestine to digest a meal may be less, eating too much fat at one time may cause digestive symptoms like gas, bloating, or diarrhea. The amount of fat that can be comfortably tolerated varies from individual to individual and may also change over time.
You're advised to eat a low-fat diet for a week or two immediately following the surgery. Then, you can gradually increase the amount of fat you eat at a meal. However, you'll probably always be more comfortable if you limit foods that are very high in fat. It'll be pretty easy to know when you've overdone it. You may also find that certain foods or ingredients, such as coffee or dairy products, are more likely to trigger diarrhea. If that's the case, you'll obviously want to limit those as well.
Eating more fiber—from fruits, vegetables, legumes, and whole grains—can also help improve digestion. But fiber is also something you want to increase gradually, to allow your body to adjust. It's also important to stay adequately hydrated.
Finally, because there is less bile available at one time, you may also find it helpful to eat smaller meals, even if it means eating a little more frequently. For example, although they have become more popular, an intermittent fasting regimen where you eat all of your calories in a 4 to 6 hour period each day would probably not be ideal for you.
Do you need digestive supplements?
Contrary to what you may read online, people who have had their gallbladders removed do not need to take bile salts or fat-digesting enzymes. Remember that your liver is still producing the same amount of bile and your pancreas is still producing the same amount of fat-digesting enzymes. So, you still have the ability to digest dietary fats and absorb fat-soluble vitamins.
In fact, many animals with similar digestive systems to humans don't even have a gallbladder. And it appears that the human body, given time to adjust, is perfectly capable of thriving without one. So, use common sense: Avoid overloading your system with a lot of fat at once and listen to your body. It'll tell you pretty clearly how much is too much.
If, despite following a healthy diet and using common sense, you're still struggling with digestive symptoms long after your surgery, definitely follow up with your surgeon or a digestive disease specialist for additional support.