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 the gallbladder is gall bladder stone disease.
CHOLECYSTECTOMY — GALLBLADDER REMOVAL SURGERY
While harbouring stones in the gall bladder is the most common reason for 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 the gall bladder, infection in the gall bladder.
Although not very common one of the important problems 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 a simple and comfortable laparoscopic method. Sometimes 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 worldwide.
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 thereby 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 into the blood from the last portion of the small intestine and flow back to the 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 a 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 reach 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 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.
- Lean meat – Chicken
- Cottage cheese
- Whole grains
- Insoluble fibers
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
- Berries such as blackberries, blueberries, strawberries
- Green peas
- Green beans
- 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
- 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 a 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:
- Hot dogs
- 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!