Gut doctors explain why life without a gallbladder can lead to urgent bathroom trips

Gallbladder removal surgery is a frequent procedure to alleviate pain or recurrent gallstones, yet some patients experience unexpected gastrointestinal changes, particularly frequent loose stools and an urgent need to use the bathroom after meals. Dr Joseph Salhab, a gastroenterologist, explains via an Instagram video why diarrhoea can occur after gallbladder removal and what potential solutions exist.

The gallbladder normally stores bile produced by the liver, which aids in digesting fats. When consumed, bile is released into the intestines to help break down food. Without the gallbladder, bile is released continuously throughout the day, leading to its potent stimulation of the gastrointestinal tract when eating, causing diarrhea.

Dr Salhab suggests dietary adjustments, such as limiting fat intake, incorporating prebiotics, probiotics, and certain supplements or medications to manage symptoms. Dr Adithya V. Naragund, a senior consultant in GI and HPB Surgery, elaborates that the gallbladder's role is to store and concentrate bile, which is then released in controlled amounts when eating fatty foods.

Post-removal, bile flows continuously into the intestines, leading to excess bile acids reaching the colon, stimulating water secretion, and increasing intestinal movement, resulting in diarrhoea. Dietary changes, including reducing high-fat and fried foods, eating smaller meals, increasing soluble fibre, staying hydrated, and limiting caffeine, spicy foods, and dairy, can effectively manage post-cholecystectomy diarrhoea.

Patients should consult their healthcare provider if diarrhoea persists for more than six to eight weeks, occurs frequently, or interferes with daily life, as these could indicate underlying issues such as bile acid malabsorption, which can be treated with bile acid-binding medications.