Question and Answer: Diarrhea After Gallbladder Surgery

Treating Chronic Diarrhea After Gallbladder Surgery

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Question: I had surgery to remove my gallbladder two months ago and have had diarrhea ever since. Help!

 

Answer: Chronic diarrhea, defined as three or more watery stools per day that last for a month or longer, is something up to 20 percent of all gallbladder surgery patients have to deal with.

The good news is that for most patients, it slowly gets better. The bad news is that it is usually a slow and very annoying process that can make it difficult to resume your normal activities after surgery.

Why Am I Having Chronic Diarrhea?

It is believed that the chronic diarrhea is caused by too much bile in the intestinal tract. The gallbladder stores bile, so when it is removed, there is less regulation on how much bile is produced.

Chronic Diarrhea-Annoyance or Serious Problem?

For most patients chronic diarrhea is an annoyance, rather than a serious medical problem. For a rare few, it can be a problem if it causes dehydration or an electrolyte imbalance, which you might notice first as constant thirst or leg cramps.

Your surgeon should be aware that you are having this problem, as your surgery may not be the cause. Your physician may also be able to suggest medications that may improve your symptoms.

What to Eat To Improve Chronic Diarrhea

To help combat the diarrhea, many doctors recommend the “BRATY” diet, which stands for Bananas, Rice, Applesauce, Tea/Toast, Yogurt. Supplementing your diet with these items, in addition to high fiber foods, may help improve your symptoms.

Fiber is important because it adds bulk to your stool and may help firm it up.  

If you find fiber to be helpful in slowing your episodes of diarrhea, you may consider supplementing your diet with psyllium husks, the active ingredient in Metamucil.  For some, this added fiber is able to absorb more water and decrease the severity of diarrhea.

 Just be careful not to overdo it, and be sure to drink plenty of water, to avoid the opposite problem: constipation.

Stopping The Pain of Chronic Diarrhea

While you are waiting for your diarrhea to improve your poor defenseless bum may be sore, even burning, from the constant diarrhea. Diarrhea contains both bile and stomach acid, both of which are very irritating to the skin.

While you are waiting things out, consider the following care:

  • Avoid spicy foods, anything that burns your mouth can burn on the way out as well. 
  • Don’t wipe after a bowel movement, pat gently. This will clean without being abrasive. Baby wipes are a great way to gently clean without causing more irritation. You can always put them in the refrigerator for extra soothing.
  • Consider using “cooling wipes” such as medicated pads with witch hazel to cool the fire.
  • If your rectal area is very sore from the constant diarrhea, consider a soothing soak in the tub. There are many products that are meant to sooth irritated skin as a bath additive.
  • Consider applying healing a thick protective ointment to the sore area. It will provide a barrier between your sensitive skin and the bile/gastric acids that are causing the irritation.  You can also use ointments that are designed for diaper rash, as they tend to be thick and long lasting.
  • Consider starting a food diary, writing down what you eat and when. You may find that certain foods help the diarrhea, while others make it worse. 
  • Consider medication to speed the process along, cholestyramine--a bile acid sequestrant-- is often prescribed for diarrhea after gallbladder surgery.

If your rectum remains raw and irritated, or the diarrhea doesn't improve, be sure to tell your doctor.  There are prescription medications that can help reduce diarrhea and improve your quality of life after gallbladder surgery.

Medication for Diarrhea After Gallbladder Surgery

One of the more commonly used medications is cholestyramine, also known as Questran.

 This medication is a bile acid sequestrant, a type of medication typically used for high cholesterol that works by binding bile acid in the gut.  For people with diarrhea caused by removal of the gallbladder, this medication can also dramatically reduce the severity and frequency of diarrhea.  

This medication is available in a "light" version for diabetics that utilizes artificial sweetener.  The medication comes in a packet and is taken as a drink after being added to water.

If cholestyramine, plus diet and lifestyle modifications are not effective, there are additional prescription medications that can be used to reduce diarrhea and bowel movement urgency and frequency.  These medications will typically be prescribed by gastroenterology, the medical specialty that typically deals with chronic diarrhea and other gut problems. 

A Word From VeryWell

Diarrhea after gallbladder surgery is both common and troublesome.  If you or a loved one is experiencing this complication after surgery, start by reducing the amount of fat in the diet by eliminating fatty and fried foods.  Focus on fresh foods and avoid fast food, and if the problem persists notify your surgeon or primary care provider.  For most patients, the problem can be fixed with lifestyle changes and, for some, medication.

 

More Surgery Information: Answers To Common Questions After Surgery

Sources:

Diarrhea. Digestive Diseases Information Clearinghouse. March 2007. http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/index.htm.

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