Chronic diarrhea: A concern after gallbladder removal?

I had my gallbladder removed six months ago, and I continue to have problems with diarrhea. Is this unusual? Is there anything I can do about it?

- Janet / Canada

Answer

As many as 20 percent of people who have surgery to remove their gallbladders (cholecystectomy) develop diarrhea. The diarrhea may last for many years. But it often improves over time — even without treatment.

The cause of diarrhea after gallbladder removal isn't clear. Many experts believe that it results from an increase in bile, especially bile acids, entering the large intestine — which may act as a laxative.

Treatment of diarrhea after gallbladder removal may include:

• Anti-diarrheal medications, such as loperamide (Imodium)
• Medications that impair absorption of bile acids, such as cholestyramine or aluminum hydroxide
• A high-fiber diet to give your stool more bulk

There's no evidence that dietary changes improve diarrhea associated with gallbladder removal. However, you may want to limit foods that can worsen diarrhea. These include:

• Spicy foods
• Dairy products
• Fatty foods
• Caffeine
• Alcohol

Certain medications — such as antacids with magnesium — also can increase diarrhea. Talk to your doctor before making any changes to your diet or medications.

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