the Risks of Colorectal Cancer After Gallbladder Removal

Cholecystectomy

Hello Doctor, due to my father's condition, I donated my liver, specifically the left lobe, and my gallbladder was also removed.
I have been resting at home for almost a month since being discharged from the hospital.
I came across information online suggesting that after gallbladder removal, the risk of developing colorectal cancer may increase due to secondary bile acids.
Therefore, I would like to ask the doctor: 1.
After my gallbladder removal, how often should I undergo colorectal screenings in the following years? 2.
In reality, does the risk of developing colorectal cancer significantly increase due to gallbladder removal? Thank you in advance, Doctor.

Li, 30~39 year old female. Ask Date: 2017/10/31

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Mr.
Lee, you are 30 years old.
If there is no family history of colorectal cancer, you belong to a low-risk group.
Additionally, gallbladder removal does not necessarily increase the risk of colorectal cancer.
It is recommended that you consume more fruits and vegetables, exercise regularly, and limit your intake of processed meats.
You can schedule a health check-up for colorectal screening at the age of 40-45.
If you experience any changes in bowel habits that persist for a period of time, please consult a gastroenterologist or a colorectal specialist.
Thank you for your inquiry, and Changhua Hospital cares about your health.

Reply Date: 2017/10/31

More Info

After gallbladder removal, also known as cholecystectomy, there are concerns regarding the potential increased risk of developing colorectal cancer. This is a valid concern, as some studies suggest that the absence of the gallbladder may alter bile acid metabolism, which could theoretically influence colorectal cancer risk. However, the relationship is complex and not fully understood.

1. Colorectal Cancer Screening Recommendations Post-Cholecystectomy:
For individuals who have undergone gallbladder removal, routine colorectal cancer screening is generally recommended to begin at age 45 for average-risk individuals. However, if there are additional risk factors, such as a family history of colorectal cancer or personal history of polyps, screening may need to start earlier. The American Cancer Society recommends that individuals at average risk should have a colonoscopy every 10 years, or a flexible sigmoidoscopy every 5 years, or a stool-based test annually. Given your situation, it would be prudent to discuss with your healthcare provider about establishing a personalized screening schedule, especially if you have any additional risk factors.

2. Risk of Colorectal Cancer After Gallbladder Removal:
The evidence regarding the increased risk of colorectal cancer following gallbladder removal is mixed. Some studies have indicated a slight increase in risk, while others have not found a significant association. The potential mechanism behind this could involve changes in bile acid composition and flow, which may affect the colonic mucosa. However, it is important to note that the overall risk remains relatively low for individuals without other significant risk factors.
In your case, since you are young (30 years old) and if there is no family history of colorectal cancer, you would generally be considered at low risk. Maintaining a healthy lifestyle, including a diet rich in fruits and vegetables, regular physical activity, and avoiding processed meats, can help mitigate your risk.
In summary, while there may be some theoretical basis for an increased risk of colorectal cancer after gallbladder removal, the actual risk is likely to be low, especially in the absence of other risk factors. Regular screening as recommended by your healthcare provider is essential for early detection and prevention. Always consult with your physician for personalized advice and to address any specific concerns you may have regarding your health and screening protocols.

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