What To Do About IBS After Gallbladder Removal

Patient Consulting Doctor for Stomach Pain
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Some people who have had their gallbladders removed -- a procedure known as a cholecystectomy -- find themselves dealing with ongoing digestive problems. Typically, these symptoms include pain or the urgent need to run to the bathroom after eating. Here you will find out why that might be happening and what you can do about it.

Life With and Without Your Gallbladder

One of the reasons why gallbladder removal is typically the recommended treatment for gallbladder problems is that it is safe to live without a gallbladder.

Your gallbladder's main job is to store bile (a substance needed for digesting fats), and to secrete bile into your small intestine in response to ingesting foods containing fat. Without your gallbladder, your liver continues to produce bile, but instead of it being sent to the gallbladder for storage, the bile is sent into your "common bile duct" and then makes its way into your small intestine.

What's Going Wrong

Among the possible problems that people may experience following the removal of their gallbladder are:

1. Postcholecystectomy Diarrhea

For most people, the body adapts to the loss of the gallbladder. However, approximately 20% of people who have had their gallbladders removed will experience recurrent problems with diarrhea, a condition known as postcholecystectomy diarrhea. This problem has been attributed to the fact that without the gallbladder, there is nothing to regulate the amount of bile that passes into the small intestine.

This higher amount of bile can create stools that are watery and more frequent. Luckily, for most of these individuals, this problem will resolve itself slowly over time. However, a small percentage of people may continue to experience diarrhea on an ongoing basis.

2. Sphincter of Oddi Dysfunction

If you are experiencing ongoing upper abdominal pain following gallbladder removal, you may want to speak with your doctor about a possible problem with your sphincter of Oddi.

The "sphincter of Oddi" (SO) is a valve found within the small intestine that regulates the flow of bile and pancreatic juices. A very small number of people may experience "sphincter of Oddi dysfunction" (SOD), a functional gastrointestinal disorder (FGD). In SOD, the sphincter does not relax as it should, preventing the bile and pancreatic juices from entering the small intestine. The Rome III criteria for SOD describe its symptoms as "episodes of moderate to severe steady pain" in the central and upper right regions of the abdomen that lasts for at least 30 minutes. This type of pain generally occurs a short time after eating. Some people report nausea and vomiting. The pain symptoms of SOD are thought to be the result of the excess accumulation of the juices in the ducts.

SOD is most often seen in postcholecystectomy patients or in those who suffer from pancreatitis. Although up to 20% of postcholecystectomy patients will report ongoing upper abdomen pain, only a small percentage will actually suffer from SOD.

SOD can be treated with medication or a procedure known as endoscopic retrograde cholangiopancreatography (ERCP).

IBS Following Gallbladder Removal

Although anecdotally, I have heard numerous stories from IBS patients who report that their IBS showed up following removal of their gallbladder, there is not a lot of clinical research on the subject. However, researchers have begun looking into a condition called bile acid malabsorption (BAM) and its relationship to chronic diarrhea difficulties. 

BAM is a condition in which there is a dysfunction as to how bile acids are processed within the body. People who have had their gallbladders removed are at risk for BAM. For more information, see this article:

What to Do?

If you are experiencing fever, chills or signs of dehydration, you should contact your physician immediately.

If you are experiencing ongoing problems with abdominal pain and/or diarrhea, you should work with your doctor to get an accurate diagnosis. The range of possibilities for your ongoing problems is fairly varied:

  • Common bile duct stones
  • Chronic pancreatitis
  • Dyspepsia
  • IBS
  • Pancreatic cancer
  • SOD

An accurate diagnosis can lead to the optimal treatment plan. In some cases, ongoing diarrhea following gallbladder removal is helped by a class of medications known as "bile acid binding agents," including:

What to Eat?

Without your gallbladder participating in the process of digestion, you may need to change your eating habits.If your gallbladder was only removed very recently, you may want to eat a bland diet until your diarrhea symptoms start to ease. For ongoing problems, you may find some helpful tips in the following articles:

Although there is hard science behind these recommendations, you might find the following to be helpful:


Barkun, A. "Bile acid malabsorption in chronic diarrhea: Pathophysiology and treatment" Canadian Journal of Gastroenterology 2013 27:653–659.

Behar, J. "Functional Gallbladder and Sphincter of Oddi Disorders" Gastroenterology 2006 130:1498-1509.

"Gallstones" National Digestive Diseases Information Clearinghouse (NDDIC) Accessed June 12, 2016.

Wilcox, C. "Sphincter of Oddi dysfunction Type III: New studies suggest new approaches are needed." World Journal of Gastroenterology 2015 21:5755-5761.

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