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Your doctor might tell you that you should have your gallbladder removed at the speed of light after being diagnosed with gallbladder disease. Could they have forgotten to tell you some important details about gallbladder removal surgery, though?

Your doctor might have told you that you should have your gallbladder removed at the speed of light after being diagnosed with gallbladder disease. Could they have forgotten to inform you about important details regarding your gallbladder removal surgery, though? And what happens after your gallbladder is removed?

Definition Of The Gallbladder And Its Functions

The gallbladder is a small, muscular and pear-shaped structure on the underside of the liver and on the right side of the abdomen. The gallbladder's function is the storage of bile. Bile tastes bitter, hence the word bitterness. The gallbladder holds about a quarter of a cup of a yellowish-green, pasty material called bile. Your liver produces the bile and secretes it into the intestines. This process helps your body to digest fats. [1]

The gallbladder, when healthy, keeps the bile moving in several ways. Mucosa, the inner lining, secretes hydrogen ions into the gallbladder contents. Mucosa maintains an acidic environment, which keeps calcium from precipitating and consequently forming gallbladder stones. As your body digests food, bile is washed away by water and electrolytes. [1]

Formation Of A Gallbladder Stone

First of all, bile is composed of three components: 

  • Cholesterol 
  • Bile salts 
  • Bilirubin.[2

We already described the functioning of the gallbladder above (definition of the gallbladder and its functions), and if the gallbladder is not working properly, the components of bile become unstable. Unstable bile causes the formation of solid crystals, also known as gallstones — they form when a speck of calcium becomes coated with either cholesterol or the pigment bilirubin. However, more than 80% of gallbladder stones are composed of cholesterol. [3] Gallstones are different in size, and they can also be single or multiple.

Interestingly, about half of all people with gallbladder stones don't even know that they have them, and they can float freely in the gallbladder. Of course, these are painless stones, but they are painless only until they grow large enough to pass through and lodge in either the cystic duct or in the common bile duct.

Symptoms Of Gallbladder Disease

Symptoms and their severity depend upon where the stone lodges. 

First of all, a significant number of patients with gallstones do not even show symptoms, so they do not even know they have gallstones. Usually, these stones are found 'incidentally' during medical tests. 

However, a classic gallbladder attack consists of abdominal pain in the right upper quadrant, just under the rib cage on the right side, and is usually followed by nausea and vomiting. [4]

Pain may be severe and can last up to several hours, and is often accompanied by soreness of the abdominal area for at least a few days

Fatty meals usually cause gallbladder attacks, and in some cases, patients even have fever and chills. In more severe cases, gallbladder stone symptoms may indicate jaundice. [5]

Who Is Most Likely To Develop Gallbladder Stones?

Unfortunately, medical experts cannot predict who'll develop gallbladder stones. However, statistics indicate that women are twice as likely to have gallbladder problems compared to men, and the main reason is the hormone estrogen, which is known to increase the rate of lipid synthesis. [6

Women who use birth control pills should pay special attention, because combined contraceptive pills contain estrogen, which increases the cholesterol content of bile. Research proves that women under 30 who have taken birth control pills for less than five years are at an increased risk of gallbladder disease. [7] Concerns have been raised about the risk of gallbladder disease associated with the use of drospirenone, a fourth-generation progestin used in oral contraceptives, however, research indicated that there was no statistically significant increase in the risk of gallstones associated with the other formulations of oral contraceptives. [8]

The next risk factor for the development of gallbladder stones is pregnancy. Pregnancy raises the risk by altering the chemical composition of bile to favor gallstone formation. However, results of a randomly selected population sample prove that pregnancy is not a risk factor for gallstone disease. [9

Some studies also show that gallstones are more common in some countries than others: the western world is disproportionately affected. For example, in Sweden the overall prevalence of gallbladder disease is 15% [10], while in Africa and Asia gallbladder stones are rare. The fact is that gallbladder stones develop more often in patients who live in cultures with high-fat and low-fiber diets, such as the USA or Europe.  

The most significant risk of developing gallbladder disease is obesity. Even people who are moderately overweight are at an increased risk, while the New England Journal of Medicine warns that very obese individuals face a six-fold higher risk of developing gallbladder disease. [11]

Gallbladder Disease Treatment, Risks And Diet

One option for gallbladder disease treatment are drugs: they are prescribed for small stones or if a person cannot tolerate surgery.
Another option is gallbladder removal surgery, which is most often the solution for gallbladder problems. The treatment involves removing the gallbladder, and in most cases, this is done by using laparoscopic surgery. [12]

However, even after surgery certain risks are still present. Since with the removal of the gallbladder, the liver may be "overloaded", a patient must reduce all kinds of chemical overload on the liver, which includes:

  • Pre-packaged food 
  • Minimizing the use of perfumes
  • Cosmetics and even some personal care products

To avoid any complications, patients must strictly adhere to an albeit unofficial "cholecystectomy diet", which means that one must eat [13]:

  • Low-fat foods 
  • Foods high in fiber and preferably organic food, but gradually increase your intake
  • Fresh fruit and vegetables
  • Wholegrain rice, wholewheat pasta and bread, seeds, nuts and oats
  • Probiotic products such as yogurts, although it is often recommended to avoid the (over)consumption of dairy products

The following products should be avoided, on the other hand:

  • Drinks containing caffeine (coffee and tea, coke etc.)
  • Foods that make the problems worse – such as spicy or fatty foods
  • Refined carbohydrates
  • Hydrogenated oils

Why Is Diet And The Elimination Of All Those Products So Important After Gallbladder Removal?

Once the gallbladder is removed, bile cannot be collected and fat cannot be modulated as it was before, when the gallbladder was still present. Bile's function was to break down the fat, but without the bile, the small intestine becomes flooded with water, which happens because the fat draws water from surrounding regions of the body. 

This problem is then combined with activities of intestinal bacteria, which can cause [4,5]: 

  • Bloating 
  • Negative restroom experiences
  • Stomachaches

Factors mentioned above are the main reason a proper diet is essential during a patient's recuperation. In the long run, the body adapts to the gallbladder's absence, and a few months after the surgery a patient should be able to resume more or less regular eating habits.

Gallbladder Removal Recovery

So, your gallbladder was removed and right after your cholecystectomy, it is crucial that you follow your surgeon's instructions to speed up your recovery. You should be prepared to take it easy for around [12]:

  • Two weeks if you had a laparoscopic cholecystectomy
  • Up to six weeks if you had an open cholecystectomy. 

Take painkillers as prescribed, and gradually reintroduce varied foods to your diet. 

A full gallbladder removal recovery depends on more than what your lifestyle is like during the immediate post-surgery period. You need to commit to a healthy lifestyle that minimizes your discomfort for the long haul. It is essential that you educate yourself on getting better and eating healthier. If you follow the suggestions above, your digestive system will operate to its fullest and will help you soothe many of the side effects a gallbladder removal may cause.