I recently had my gallbladder out and I keep having diarrhea. Is there a gallbladder removal diet I should follow?
Answer From Elizabeth Rajan, M.D.
After having their gallbladder removed (cholecystectomy), some people develop frequent loose, watery stools. In most cases, the diarrhea lasts no more than a few weeks to a few months. There isn't a specific gallbladder removal diet that you should follow if you have this problem, but there are a few things you might consider.
First, it helps to understand why you're having diarrhea. Diarrhea after gallbladder removal seems to be related to the release of bile directly into the intestines. Normally, the gallbladder collects and concentrates bile, releasing it when you eat to aid the digestion of fat. When the gallbladder is removed, bile is less concentrated and drains more continuously into the intestines, where it can have a laxative effect.
The amount of fat you eat at one time also plays a role. Smaller amounts of fat are easier to digest, while larger amounts can remain undigested and cause gas, bloating and diarrhea.
Although there isn't a set gallbladder removal diet, the following tips may help minimize problems with diarrhea after you've had your gallbladder out:
- Go easy on the fat. Avoid 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 a serving. Check labels and follow the serving size listed.
- Increase the fiber in your diet. This can help normalize bowel movements. Add soluble fiber, such as oats and barley, to your diet. But be sure to increase the amount of fiber slowly, such as over several weeks, because too much fiber at first can make gas and cramping worse.
- Eat smaller, more-frequent meals. This may ensure a better mix with available bile. A healthy meal should include small amounts of lean protein, such as poultry, fish or fat-free dairy, along with vegetables, fruits and whole grains.
You may also try limiting foods that tend to worsen diarrhea, including:
- Dairy products
- Very sweet foods
Talk with your doctor if your diarrhea doesn't gradually go away or becomes more severe, or if you lose weight and become weak. Your doctor may recommend medicines, such as loperamide (Imodium A-D), which slows down intestinal movement, or medications that decrease the laxative effect of bile, such as cholestyramine (Prevalite). Your doctor may also suggest that you take a multivitamin to compensate for malabsorption of fat-soluble vitamins.
May 30, 2018
Elizabeth Rajan, M.D.
See more Expert Answers
- Kasper DL, et al., eds. Diseases of the gallbladder and bile ducts. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed April 21, 2018.
- Bonis PA, et al. Approach to the adult with chronic diarrhea in resource-rich settings. https://www.uptodate.com/contents/search. Accessed April 21, 2018.
- Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed April 21, 2018.
- Diarrhea nutrition therapy. Nutrition Care Manual. Academy of Nutrition and Dietetics. https://www.nutritioncaremanual.org. Accessed May 4, 2018.
- Disease process. Nutrition Care Manual. Academy of Nutrition and Dietetics. https://www.nutritioncaremanual.org. Accessed May 4, 2018.
- Barrett KE. Gallbladder function. In: Gastrointestinal Physiology. 2nd ed. New York, N.Y.: McGraw-Hill Education; 2014. http:// accessmedicine.mhmedical.com. Accessed Feb. 10, 2015.
- Mahan LK, et al. Medical nutrition therapy for hepatobiliary and pancreatic disorders.In: Krause's Food & the Nutrition Care Process. 14th ed. St. Louis, Mo.: Saunders Elsevier; 2017.
- Gallbladder nutrition therapy. Nutrition Care Manual. Academy of Nutrition and Dietetics. https://www.nutritioncaremanual.org. Accessed May 7, 2018.
- Del Grande LM, et al. Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy. Brazilian Archives of Digestive Surgery. 2017;30:3.