Post-Cholecystectomy Symptoms and Cancer Risks - Gastroenterology and Hepatology

Please explain the effects after gallbladder removal?

Hello, Director Chen.
I had my gallbladder removed at the age of 32 due to a one-centimeter polyp based on my physician's recommendation.
Since then, I occasionally feel a vague discomfort in my right lower rib area, which seems to have become more pronounced recently, and I find myself pressing on it repeatedly.
I'm unsure if this is a postoperative complication or if there is another underlying condition.

Additionally, I came across an article by a physician mentioning that patients who have undergone cholecystectomy are at a higher risk for pancreatic cancer and colorectal cancer.
I would like to know how much the risk of these two cancers increases after gallbladder removal and whether I need to undergo regular follow-ups.

For the past two years, I've noticed that my stool shape is often flattened on one side, resembling something that has been scraped.
Concerned that this might be caused by a tumor, I consulted a colorectal surgeon.
After a rectal examination (the physician mentioned it was 10 centimeters deep), I was diagnosed with hemorrhoids.
Given the increased risk of pancreatic and colorectal cancer after gallbladder removal, I would greatly appreciate your guidance and advice amidst your busy schedule.
Thank you very much.

JAMES, 40~49 year old female. Ask Date: 2017/08/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

Sir, many of your localized abnormal sensations are caused by the surgery and do not pose a health risk.
Additionally, it is recommended to regularly monitor for occult blood in the stool after the age of fifty.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/08/26

More Info

Post-cholecystectomy symptoms and the associated risks of developing certain cancers are important topics to address, especially for individuals who have undergone gallbladder removal surgery.
Firstly, it is not uncommon for patients to experience discomfort or unusual sensations in the right upper abdomen after gallbladder surgery. This discomfort can be attributed to several factors, including changes in digestion and bile flow. The gallbladder plays a role in storing bile, which is released into the small intestine to aid in the digestion of fats. After its removal, bile flows directly from the liver to the intestine, which can lead to changes in digestion and may cause discomfort or a sensation of fullness in the upper abdomen. This is often referred to as "post-cholecystectomy syndrome," and symptoms can include abdominal pain, bloating, and changes in bowel habits. If the discomfort persists or worsens, it is advisable to consult with a healthcare provider to rule out any complications or other underlying conditions.

Regarding the concerns about increased cancer risks post-surgery, the relationship between cholecystectomy and the risk of developing pancreatic and colorectal cancers is still a subject of ongoing research. While some studies suggest that individuals who have had their gallbladders removed may have a slightly increased risk of developing these cancers, the evidence is not definitive. The exact increase in risk is difficult to quantify and may vary based on individual health factors, lifestyle, and genetic predispositions.
For colorectal cancer, it is generally recommended that individuals begin regular screening at age 45, or earlier if they have risk factors such as a family history of colorectal cancer or personal history of polyps. The shape of your stool, such as the flat appearance you described, can be concerning, but it is not solely indicative of cancer. Flat stools can occur for various reasons, including dietary changes or benign conditions like hemorrhoids, which your doctor has already diagnosed. However, if you notice persistent changes in bowel habits or other concerning symptoms, further evaluation may be warranted.

As for pancreatic cancer, the risk factors include age, smoking, obesity, and a family history of the disease. While gallbladder removal may be associated with an increased risk, it is essential to consider these other factors as well. Regular check-ups and discussions with your healthcare provider about your personal risk factors and any symptoms you experience are crucial for early detection and prevention.

In summary, while post-cholecystectomy symptoms can be common and often benign, it is essential to monitor any changes in your health and maintain open communication with your healthcare provider. Regular screenings for colorectal cancer and discussions about your risk for pancreatic cancer, especially if you have other risk factors, are advisable. If you have persistent discomfort or new symptoms, do not hesitate to seek medical advice for further evaluation.

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