You may need to change the way you eat after gallbladder surgery (cholecystectomy). For example, you'll need to eat lean protein and low-fat dairy and avoid fatty foods. This is because the bile fluids that are normally stored in the gallbladder now go directly into the small intestine.
This article explains how gallbladder removal may alter the way your digestive system works. It will also offer you ideas about how to modify your diet to avoid foods that may cause trouble while keeping those that are part of a healthy, balanced diet.
Foods to Avoid After Gallbladder Surgery
One of the most common problems after gallbladder removal is the risk of diarrhea. This interferes with how your body absorbs key nutrients. A diet designed for your body's new needs can help bring these symptoms under control.
There is no standard diet that you should follow after your gallbladder surgery. The goal is to limit the amount of fat that you eat, because bile's role is to break it down so that it is more easily absorbed. Changing your diet allows the bile that remains to work more efficiently in your small intestine.
In most cases, you need to avoid anything fatty, greasy, or fried. Processed and sugary foods should be avoided too, because they can lead to diarrhea. You should continue following these guidelines for at least a month after the surgery.
Not everyone who has a gallbladder removed will need to stick to a strict low-fat diet for the rest of their life. However, doing so will almost always improve bowel function as well as overall health.
If you still find yourself struggling with digestion after the first month, you may be experiencing postcholecystectomy syndrome (PCS). It is characterized by:
- Stomach upset
- Diarrhea
- Nausea
- Bloating
- Flatulence (gas)
- Vomiting
Persistent PCS may require the extended or permanent use of a low-fat diet.
Fatty Meats
Avoid cuts of meat that contain a lot of fat. Examples of meat that is high in fat include:
- Rib eye steaks and other heavily marbled cuts
- Pork ribs and bacon
- Lamb
You should also avoid eating deep fried meats and/or meats that have been pan fried in a lot of oil.
High-Fat Dairy
Whole dairy products are very high in fat. Limit or eliminate the following foods:
- Whole milk
- Full fat yogurt and cheese
- Heavy cream and/or half-n-half
- Butter
- Ice cream
- Sauces and dressings made with cream
High-Fiber Foods
High-fiber foods should be avoided immediately after gallbladder surgery, and reintroduced slowly as you recover. Some examples include:
- Whole grain bread
- Cereals
- Oatmeal
- Fruits and vegetables
- Beans and legumes
- Nuts and seeds
Avoid refined carbohydrates such as white bread, white pasta, and white rice.
High-Sugar Foods
Desserts that are high in sugar and trans fat are especially difficult to digest. Ice cream, cakes, cookies, puddings, and chocolate should only be eaten occasionally and in moderation.
There are some good low-fat, non-dairy desserts on grocery store shelves, but keep an eye out for artificial sweeteners like sorbitol that can increase the risk of diarrhea.
Alcohol
Avoid drinking alcohol after gallbladder surgery. Alcohol can cause GI pain along with inflammation of the pancreas. If you are unwilling to cut out alcohol entirely, avoid sweet co*cktails and high-carb beers. Even sweeter wines, like port and sherry, can cause problems.
Between 10% and 40% of people who have gallbladder removal will experience diarrhea and other gastrointestinal (GI) symptoms, usually within the first three years after surgery.
Researchers who looked at 125 cases of gallbladder removal found that the risk of symptoms was greater in men over age 45 who didn't reduce fat in their diets for at least one week after the surgery.
Digestion Problems After Gallbladder Surgery
Foods to Eat After Gallbladder Surgery
For the first few weeks after surgery, you'll need to follow astandardlow-fat dietcontaining 30% calories fromfat or less, with 1 gram of fat equaling 9 calories. This means that:
- A 1,500-calorie diet translates to 50gramsoffat per day.
- A 2,000-calorie diet translates to 67gramsoffat per day.
There isn’t a single post-cholecystectomy diet that works for everyone. Some foods tend to cause more problems than others.
Lean Protein
You don't need a gallbladder to digest protein. This means that high-protein foods aren’t likely to cause you trouble unless they are also high in fat. Choose cuts of meat that aren't heavily marbled, and trim any excess fat from chicken, pork, beef, and other meats.
Don't cut out all fats from your diet. Healthy polyunsaturated and monounsaturated fats, especially omega-3 fatty acids found in fish, can help you to meet your recommended dietary intake (RDI) of dietary fat. This will significantly lower your risk of bile acid diarrhea and irritable bowel syndrome (IBS).
Low Fat Dairy
Low-fat yogurt, dairy-free milk options, and some low-fat cheeses may be easier to tolerate if you eat them in moderation. You can also try dairy-free cheese made from cashews or tofu.
Bile acid diarrhea is a common complication of gallbladder surgery. Sphincter of Oddi dysfunction may also occur. This causes painful spasms of the valve that connects the pancreas to the intestine.
Research suggests people prone to diarrhea before surgery are more likely to have diarrhea after gallbladder surgery than those who weren't. Obesity is also known to contribute to this issue.
How to Manage Diarrhea After Gallbladder Surgery
Other Diet Tips
Your diet will be much more restrictive immediately following surgery. As you recover, you will be able to gradually return to a normal diet, though you will likely benefit from restricting high fat foods in the long term.
Start With Clear Liquids
Immediately following a cholecystectomy, your healthcare provider will likely place you on a clear liquid diet. This will help to prevent nausea, vomiting, and constipation. Some of these liquids include:
- Clear broth
- Gelatin
- Juice
- Popsicles
- Carbonated beverages
Over the next few days, you will advance to a bland BRAT diet. The BRAT diet involves eating bread, white rice, applesauce, and toast or soda crackers to gently bind loose or runny stool. If you are already passing normal stools, though, a BRAT diet may not be needed.
Eat Smaller Meals
Without a gallbladder to assist with digestion, four to six small meals per day may work better than the three large meals you may be used to.
If you are on the go, have plenty of low-fat snacks on hand to keep you on track. This may help to keep you from overeating when you finally are able to sit down for a meal.
After meals, give yourself time to digest your food. Jumping straight into a strenuous activity after eating will certainly increase the risk of indigestion.
Substitute Ingredients
Vegetables bind to bile acid more easily when they have been lightly cooked as opposed to eating them raw. Substitute steamed vegetables for raw vegetables whenever possible. You can also steam fish or poach chicken rather than pan-frying them.
As a general rule, avoid cooking with butter, lard, margarine, and hydrogenated vegetable oils. If you need oil for grilling or roasting, use a spray bottle to lightly coat the food rather than dousing it in oil.
Instead of a prepared oil-based dressing, try flavoring salads with a sprinkling of white balsamic vinegar and fresh herbs. You can also substitute mayonnaise dressings for ones made with plain non-fat yogurt, vinegar, garlic powder, mustard, and fresh herbs.
While spices like cayenne, curry, and cinnamon can be rough on the stomach, others like ginger or turmeric may be soothing. As a rule of thumb, always start with the smallest amount of spice to see how your body reacts. Spicy foods may set you up for indigestion and diarrhea.
Try a Plant-Based Diet
As you recover, the soluble fiber in sweet potato and broccoli can help prevent diarrhea. If you find that citrus fruits like oranges and grapefruit are too acidic, stick with apples, bananas, avocado, and berries. Vegetable soups are nutritious and easy to digest.
As you begin easing back into a regular diet, focus on increasing your fiber intake from whole grains. They include brown rice and barley. Toast and crackers can be useful when recovering from surgery, but you’ll eventually want to replace those made with refined white flour with whole grain products.
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Any change in your diet can cause side effects. Your body is an interrelated system that strives to maintain homeostasis (an overall state of balance). If anything upsets that balance, including changes in diet, your body systems will try to re-establish it.
When starting a low-fat diet, constipation is a common response. You can usually help ease the symptoms by drinking plenty of water and taking a fiber supplement if needed.
Sometimes, you may add too much fiber to your diet by eating extra vegetables and whole grains. They can trigger diarrhea, but you can shift to a BRAT diet or decrease fiber intake until your body adapts.
Fortunately, side effects like these tend to be mild and will ease after several days or weeks. If they don't, speak with a gastroenterologist who specializes in digestive disorders to see if there may be other causes for your symptoms.
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Summary
Some people develop diarrhea and other symptoms after a cholecystectomy, or gallbladder removal. The surgery means the body's digestive system has changed, and this, in turn, calls for changes in your diet too.
Some of these changes, like drinking only clear fluids, last only for a few days. Others, such as reducing the fat in your diet, will be changes you'll need to make across a lifetime. You also may need to integrate them into any dietary needs you already have, as is the case with someone who is vegan or has food allergies.
Fortunately, there are many food choices you can make to help you make this shift. Discuss them with your healthcare provider or consider seeing a dietitian who can offer advice.