Chronic Pain

Get the Skinny: How Gallbladder Surgery Affects Weight Management

weight gain after gallbladder removal

Most people know that like the appendix, the gallbladder is something humans can live without, but what is its purpose and how does it affects your health?

How do you know if your gallbladders aren’t working properly and what needs to be done to fix it?

Gallbladder disease takes several forms and can even be a symptom of other disorders.

Its removal is usually the answer to a wide range of painful gastrointestinal issues, yet the procedure is not without risk and it can affect your weight and how you digest certain foods.

If you suspect your gallbladder may be a problem or your doctor has recommended surgery, it’s time to learn more about how this humble organ serves you and what you’ll need to do to live without it successfully.

What is the gallbladder? 

The gallbladder is a small pear-shaped sac located below the liver. Its sole responsibility is to store and concentrate bile, a fluid the liver produces to help you digest fat.

The liver makes bile constantly and each time you eat, the gallbladder releases it in modest amounts into your small intestine where it emulsifies fat.

This makes it easier for digestive enzymes to break it down into molecules your body can use, while also absorbing fat-soluble nutrients.

What is a gallbladder disease? 

Gallbladder disease takes several forms, but in general, the symptoms are similar. Inflammation of the gallbladder, called cholecystitis, can happen suddenly or build over time, impairing its ability to function normally.

Cholecystitis can occur as a result of an infection but is usually caused by gallstones — small, hard masses that form from bile pigments, cholesterol, and calcium salts and irritate the lining of the gallbladder.

Gallstones may be present for years or even a lifetime without causing symptoms, but if they become lodged in the common bile duct — the tube that brings bile to the small intestine — it’s called choledocholithiasis and it’s a painful medical emergency.

How do I know if I have a problem with my gallbladder? 

In the early stages, the symptoms of gallbladder disease are similar to other digestive issues. Heartburn, gas, bloating and constipation are among the first signs that’s something is wrong, but these symptoms are often mild and dismissed as esophageal reflux or food intolerance.

As the disease progresses, symptoms become more severe and can be accompanied by nausea, vomiting, frequent stool and pain that begins in the upper abdomen and may radiate to the right shoulder. Stools may appear light and chalky in color, reflecting an absence of bile.

In the late stages, abdominal pain is often so severe that it’s mistaken for a heart attack. The pain will usually be worse after eating a meal high in fat and may be accompanied by fever, fatigue and a yellow tint to the skin and whites of the eyes.

Skin yellowing, called jaundice, is caused by a back-up of bile into the liver and most commonly occurs when the bile duct is obstructed by gallstones.

Most people with gallbladder disease have early warning signs before progressing to the later stages; however, it is possible for the first attack to be the only one necessary to warrant surgical intervention.

Am I at risk for gallbladder disease? 

Gallbladder disease is not uncommon. According to WebMD, risk factors include:

Genetics also play a role as does age, gender, and ethnicity. Gallbladder disease is far more prevalent in women than in men and appears most often after age 40.

Gallstones are also more likely to occur in people of Western European, Hispanic and Native American descent compared to those of Eastern European, Japanese and African American heritage.

Since bile breaks down fat, can a bad gallbladder cause me to gain or lose weight? 

There is no scientific evidence to suggest that gallbladder disease can cause weight gain. In fact, it’s more likely that uncomfortable symptoms it causes will result in weight loss over a period of time.

There is, however, a correlation between weight gain and getting gallbladder disease. Because gallstones form in part due to elevated cholesterol, the same high-calorie, high-fat diet that causes hypercholesterolemia may also be responsible for corresponding weight gain.

What should I do if I suspect I have gallbladder disease? 

It’s always best to have symptoms evaluated before it gets too serious. Talk to your doctor. A simple,

painless ultrasound can determine how effectively your gallbladder is functioning and if there are any obstructions.

Occasionally, further testing is needed if your doctor suspects gallbladder dysfunction, but the ultrasound shows no gallstones.

Biliary dyskinesia, for example, occurs when the gallbladder has lower than normal function and releases bile too slowly. This causes gallbladder pain, but without stones.

How is gallbladder disease treated? 

For early symptoms, your doctor may recommend pain medicine and lifestyle changes that include losing weight slowly if you are overweight, avoiding fatty foods and abstaining from alcohol.

However, when gallstones are present, surgical removal of the gallbladder, or cholecystectomy, remains the treatment of choice in over 80 percent of patients. This short YouTube video by Lee Health explains more.

Is there an alternative to gallbladder surgery? 

According to the experts at WebMD, there are medicines that can help dissolve gallstones, but they take months to work and the results may be short-lived.

In most cases, even if gallstones disappear, they will return. For symptoms that haven’t responded to conservative treatment, surgery is considered the best option.

If left untreated, gallstones can lead to serious problems including an obstructed bile duct and chronic inflammation of the gallbladder and pancreas.

How is gallbladder surgery done? 

According to the Mayo Clinic, surgeons can remove your gallbladder in one of two ways. Both methods are performed under general anesthesia and will require a short hospital stay.

The most common procedure is the laparoscopic cholecystectomy. During this procedure, four small incisions are made through which surgical instruments and a flexible tube with a light and camera, called a laparoscope, are inserted in the abdomen to remove the diseased gallbladder.

For patients who are very overweight or have a bleeding disorder, an open cholecystectomy may be necessary.

During this procedure, the surgeon removes the gallbladder through a single incision about six inches long on the upper abdomen.

What is recovery like after gallbladder removal? 

Since both procedures are done under general anesthesia, there is a short period of grogginess immediately after the surgery while you wake from its effects.

Occasionally, there is mild nausea and some pain is to be expected, but both can be controlled with medication.

After a laparoscopic procedure, the incisions are covered by small bandages that remain in place for a few days and showering should be deferred until the wounds have started to heal.

In some cases, drains may be left the abdomen for a few days to help prevent the uncomfortable build-up of excess fluid, but they can be cared for at home.

Most patients are in the hospital for less than a day. Frequent movement is encouraged to help body functions return to normal as soon as possible and most daily activities can be resumed almost immediately, but heavy lifting and strenuous exertion may be restricted for up to a few weeks.

After surgery, swelling in the abdomen will be present and minor bruising may be visible, but these usually resolve without complications within a few days and scarring will be minimal.

Eating smaller portions of food during this period and avoiding dietary fat will help decrease bloating.

Open cholecystectomies require at least a few days in the hospital and the total recovery period is longer.

Patients can get out of bed the day after surgery, but food may be limited to liquids for a day or two and pain may require narcotic analgesics.

Since the incision is longer, a larger dressing will be in place and will require care for about a week.

Stitches or staples as well as drains, if they were placed, will be removed at a follow-up visit with the doctor about a week after surgery. Activity restrictions may continue for up to a month.

What are the risks of gallbladder surgery? 

In a Healthline article reviewed by Dr. Stacey Sampson, the risk of complication with any surgical procedure done on the abdomen is low, but real, and includes:

  • Reactions to anesthesia
  • Bleeding
  • Infection
  • Blood clots
  • Constipation
  • Pneumonia

In an article for verywellhealth.com, nurse Jennifer Whitlock explains the measures taken to prevent these.

Risks specifically associated with cholecystectomy include: 

  • The leakage of bile into the abdominal cavity
  • Damage to the bile duct or intestines

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), these complications are very rare.

What is the long-term impact of gallbladder removal? 

After the gallbladder is removed, the liver continues to make bile to aid digestion, but since the gallbladder holds about an eight ounce supply that is ready to break down fat whenever you eat it, its absence can result in slow or incomplete fat digestion.

According to Dr. William Brugge, Associate Professor of Medicine at Harvard Medical School and gastroenterologist at Massachusetts General Hospital, in about ten percent of cases, this results in stomach upset and frequent stools that appear greasy due to undigested fat.

For most, these symptoms decrease after the body adjusts to life without a gallbladder, but according to the Cleveland Clinic, it may take a permanent shift to a low-fat diet, as well as increasing fiber intake and avoiding large meals.

How can I be more comfortable after gallbladder surgery? 

In addition to taking prescribed pain medication and avoiding foods that cause stomach upset, these measures will ensure a smooth recovery:

  • Before surgery, stock the refrigerator and pantry with easily digestible foods.
  • Make a few healthy, low-fat meals to put in the freezer.
  • Catch up on laundry, housekeeping and other tasks before the big day.
  • Plan for pleasurable, but easy activities so you don’t get bored.
  • Enlist help around the house. Off-time is essential for a speedy recovery.
  • A few ounces of prune juice daily helps with post-surgical constipation.

Will I gain weight after gallbladder surgery? 

It’s a possibility. Most people who have gallbladder problems have digestive symptoms that make it uncomfortable to eat high-calorie, high-fat foods for quite a while before it is surgically removed.

When the pain is relieved, it’s only natural to want to enjoy your favorite foods and this can lead to weight gain.

In addition, when the frequent stools associated with gallbladder disease cease, a small weight gain is possible.

How can I manage my weight? 

Weight management principles are the same both before and after surgery, but without a gallbladder, high-fat diet plans should be avoided.

A well-balanced diet that’s low in fat and high in fiber will control your weight and prevent uncomfortable gastrointestinal symptoms.

Foods to avoid are: 

  • Fried foods
  • Butter
  • Full-fat cheeses
  • Ice cream
  • Whole milk
  • Red meat

To offset occasional treats, the CDC recommends adding thirty minutes of calorie-burning exercise like walking every day for at least five days per week.

Can gallbladder disease be prevented? 

Risk factors for gallbladder disease like gender, ethnicity and family history can’t be controlled, but your diet may play a role in developing gallstones.

According to the NIDDK, foods high in fiber and healthy fats may help prevent gallstones, while the refined sugar and white flour in cereals, bakery treats, bread, and pasta are associated with a higher risk of gallbladder disease and should be eaten in moderation.

To talk to your doctor if you are experiencing signs or symptoms of gallbladder disease. The earlier problems are identified and treated, the less likely complications will occur.

With the right treatment, you’ll be back on track in no time and by adopting healthy lifestyle changes, you can improve digestion and manage your weight effectively.

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