Food rich in fat should be avoided by patients with gallbladder stone disease as it can

lead to precipitation or worsening of the symptoms. The most common indication

for removal of gallbladder is gall bladder stone disease.

CHOLECYSTECTOMY — GALLBLADDER REMOVAL SURGERY

While harbouring stones in gall bladder is the most common reason for a surgical
removal of gall bladder ( cholecystectomy) there are other less common
indications for the removal of the gallbladder as well including gallbladder cancer,
polyp in gall bladder, infection in gall bladder.
Although not very common one of the important problem of gallbladder removal
surgery is diarrhea, which occurs due to ineffective regulation of the flow of bile from
the liver to the intestine. It is important that people modify their diet after gallbladder
removal, in order to prevent complications of gallbladder removal — especially
diarrhea.

CHOLECYSTECTOMY: WHAT HAPPENS DURING GALLBLADDER REMOVAL

SURGERY ?
Cholecystectomy is a surgical procedure during which the gallbladder is removed. It
is usually done by simple and comfortable laparoscopic method. Some times painful
and rather difficult open incision surgery is required. The laparoscopic method is now
the most commonly employed method to remove the gallbladder. Gall bladder
removal surgery is the commonest abdominal surgery being done world wide.

EFFECTS OF GALL BLADDER REMOVAL :

In a normal individual, bile is secreted by the liver. When the individual is not taking
food, the bile flows into the gallbladder where it is stored and concentrated. When
the individual eats, especially a fatty meal, the gallbladder contracts and there by
pumps the stored bile and the bile thus flows through the bile duct into the small
intestine. In the small intestine, it helps in the digestion and absorption of fat. After
the fat is digested and absorbed, remaining bile salts are absorbed back in to the
blood from the last portion of the small intestine and flows back to liver
(enterohepatic circulation). In individuals in whom the gallbladder has been removed,
the bile is not stored and it flows directly into the small intestine and therefore lot of
bile reaches the small intestines.

The excess bile salts are too much for the terminal small intestine to absorb, and
some of the bile salts escape to the large intestine. The bile salts that reaches the
large intestines ( colon ) can cause some irritation of the colon and this results in
diarrhea.

GALL BLADDER REMOVAL: RECOVERY

People who have undergone a laparoscopic removal of gall bladder are usually able
to go home at around 24 hours after surgery, while those who underwent a more
traditional open cholecystectomy will need to stay in the hospital for three to five
days.
You can expect to return to your normal daily activities within a week of receiving
a laparoscopic cholecystectomy, while recovery from an open cholecystectomy can
take up to four to six weeks.

DIETARY CHANGES AFTER GALLBLADDER REMOVAL

People with gallbladder disease are usually instructed to avoid foods that are rich in
fat. This is because fatty food either precipitates the symptoms of gallbladder
disease or worsens the symptoms. Once a diseased gallbladder is removed, the
symptoms which are precipitated by a fatty meal usually do not occur. So most of the
time, the surgeon who operates on the individual does not give advice regarding any
specific cholecystectomy diet after gallbladder removal.

  
Bile salts are required for the digestion and absorption of fat. If an individual who has
undergone surgery for gallbladder removal eats a meal rich in fat, the fat may not get
digested well as the secretion of bile does not occur in the usual way. Since fat is not
digested well and absorbed, a fatty meal may result in fatty diarrhea.  Studies have
shown that fat content of the stool is higher in individuals who have had their
gallbladder removed.

So in an individual who has had the gallbladder removed, diarrhea will be the most
common complication, and it occurs due to excess bile salts reaching the colon and
the excess fat that is not digested well. This diarrhea is more of a nuisance than a
serious medical problem in many people. To prevent and to treat this complication,
dietary changes are required after gallbladder removal.

WHAT IS AN APPROPRIATE DIET AFTER GALLBLADDER REMOVAL?

The first step in the diet plan after gallbladder removal is to eat smaller meals more
frequently, and to avoid a diet rich in fat. The number of total calories provided by fat
should be limited to less than 30% of the total caloric intake of these patients. Intake
of saturated fat should be limited. Fried food should be avoided. Similarly, processed
food, which tends to be rich in fats, should also be avoided.

Improvement may be seen if the BRAT diet is taken. The BRAT diet is advised by
doctors for relief the of symptoms from any type of diarrhea, even with cancer
treatment regimes. "BRAT" stands for "banana, rice, apple and toast". High fiber
intake in addition to the BRAT diet will provide relief from diarrhea and help pass
well-formed stools.
THE DIET AFTER GALLBLADDER REMOVAL SHOULD INCLUDE THE
FOLLOWING :

 Fruits and vegetables – These should include apples, grapes, cucumber, and
beet root. These are rich in fiber. They help to control diarrhea and help pass
well-formed stools. At least one serving of fruits and vegetables should be
consumed during each meal.
 Yogurt
 Lean meat –  Chicken
 Fish
 Cottage cheese
 Whole grains
 Eggs
 Insoluble fibres
insoluble fiber doesn't dissolve in water. It absorbs fluid and sticks to other materials. This forms
softer, bulkier, and more regular stools. Insoluble fiber helps your body process waste better.
Good sources of insoluble fiber include:

 Wheat bran
 Wheat germ
 Oat bran
 Beans
 Lentils
 Legumes
 Berries such as blackberries, blueberries, strawberries
 Green peas
 Spinach
 Cauliflower
 Green beans
 Carrots
 Potatoes
 Nuts
 Whole wheat flour

CERTAIN FOOD ITEMS CAN WORSEN DIARRHEA AND THESE SHOULD BE

AVOIDED IF YOU ARE ALREADY VULNERABLE TO LOOSE STOOLS. THIS
INCLUDES FOOD ITEMS LIKE:
  Red meat – This contains animal fat and protein that are difficult to digest.
 Milk and milk products
 Caffeine
 Fatty meals
 Refined carbohydrates
 Refined flour
 Fried and processed food
 Hydrogenated fat
 High-fat foods. Because high-fat foods are harder to digest, you should avoid them if
you're having gas, bloating, or diarrhea after your surgery. In general, fat should make up
no more than 30% of your daily calories. Saturated fat should make up no more than 10%
of your daily calories. 
 Try to stick with foods that contain less than 3 grams of fat per serving. Foods that are
high in fat include:

 Butter
 Lard
 Beef
 Pork
 Lamb
 Hot dogs
 Cream
 Whole milk
 Ice cream
 Full-fat cheese
 Tropical oils such as palm and coconut
 Processed baked goods such as cookies, pastries, and cakes

Spicy foods. Foods that contain capsaicin, the active ingredient in hot peppers, can irritate your
stomach lining. This can cause stomach pain, nausea, vomiting, and diarrhea. 

Foods that generally make diarrhea worse. You may get some relief by avoiding caffeine,
dairy products, and very sweet foods.  

WEIGHT LOSS AFTER GALLBLADDER SURGERY

If you are overweight or obese after your gallbladder removal surgery, you may want
to take active steps to lose weight. The healthiest approach to diet after gallbladder
removal is the same approach that is best for the general population: eat a balanced
diet that includes all major food groups, but restrict your caloric and unhealthy
fat intake. Do not forget to add some healthy fats into your diet, as your body still
needs those. In addition to eating a balanced diet, a healthy approach to weight loss
requires regular exercise,  and should be a gradual, sustained effort. Do not turn to
fad diets to lose weight rapidly!