Q: I am a 66 year-old female in good health, exercise regularly and have kept a food diary for four years so I know I am right on track with food consumption, etc. I am really in the dark with this slow and constant weight gain since the removal of my gallbladder in July 2012. I never ate greasy, fatty foods, nor do I now. It is really sad to read the hundreds of blogs online of the very same thing happening to so many people who are in the dark, as well.
Do you know if there is anything to help this problem? I have tried digestive enzymes but if they make it worse, I don’t know; but I do know they didn’t make it better. Any help would be so appreciated, as I feel like giving up and eating whatever I want. Thank you for all the help you provide to all of us.
A: While not well documented, moderate weight gain following cholecystectomy can occur. The gallbladder is a rather small pouch located just under the liver. Following meals, it is flat and empty, whereas prior to a meal it may be full of bile and about the size of a small pear. Its purpose is to store bile produced by the liver. Interestingly, bile helps digest fats; however, the gallbladder isn’t essential. Following gallbladder removal, for example, bile will still flow from the liver into the small intestine; however, some side effects, particularly following ingesting a meal high in fat, may result.
Testing to diagnose abnormalities of the gallbladder include an abdominal X-ray or ultrasound, MRI, HIDA scan, and endoscopic retrograde cholangiopancreatography. While the X-ray cannot provide a diagnosis of gallbladder disease, it may detect gallstones that cause inflammation, nausea and pain. The MRI and ultrasound are far better tests for the detection of stones and allow a view of the gallbladder wall. A cholescintigraphy (HIDA scan) injects radioactive dye intravenously to help provide the diagnosis of cholecystitis (inflammation of the gallbladder). The endoscopic retrograde cholangiopancreatography (ERCP for short) utilizes a flexible tube inserted through the mouth, through the stomach and into the small intestine. Dye injected into bile system ducts will allow a physician to treat some conditions such as removal of stones from the ducts leaving the gallbladder.
Treatment may include antibiotics if infection is present; surgery to remove the gallbladder — either through laparoscopy or the more traditional procedure of laparotomy; shock wave lithotripsy to break up the gallstones; bile salts or insertion of chemicals to dissolve gallstones; and, in the case of cancer, chemotherapy and radiation.
Therefore, a reduction in dietary fat post removal may be necessary. I have heard of horror stories following cholecystectomy, including severe stomach cramping, nausea, fever, chest twinges, pain between the shoulder blades, excessive weight gain, an immediate and uncontrollable urge to have a bowel movement following eating, and more. Some individuals have had their daily lives severely compromised and state, in retrospect, they wish they never had the procedure done. So, instead of a normal three-meal-a-day regimen, consider small, more frequent fat-free meals throughout the day. Probiotic supplements taken daily may help some readers since the good bacteria they contain can help break food down and allow for a more efficient pattern of digestion. Try gradually increasing your daily intake of fiber. A fat-free diet and food items with whole grains, fruits, vegetables and beans will help speed the food through your system that will, in turn, help reduce bloating. When all else fails and you don’t get answers from your surgeon, consider your idea of consuming what you want and throwing caution to the wind. Good luck.
