Gallbladder Removal: Symptoms, Risks, and Follow-Up Care

Bowel-related issues, cholecystectomy?

Hello Doctor, my symptoms include sudden abdominal pain and diarrhea, with the stool being darker and having a sour smell.
The frequency is irregular; sometimes it occurs for a few days every half month.
I have gastroesophageal reflux disease, and occasionally I experience rectal bleeding.
For the past two years, I have been undergoing regular colonoscopy and gastroscopy, both of which have returned normal results.
The cause of the bleeding is related to the cardia (I forgot the exact term), but in 2014, I was diagnosed with a 0.8 cm gallbladder polyp, which I have been monitoring annually, and it has not increased in size (sometimes it measures 0.9 cm, and the doctor said this could be due to measurement variability).
However, the issue arose when I had blood tests done during my previous visits, which were all normal.
Last week, I consulted my doctor about gallbladder removal (as I suddenly developed pregnancy-like symptoms this year and am concerned it might be related to the gallbladder).
The doctor ordered a tumor marker blood test, and the results showed that I am on the borderline between normal and abnormal (at the edge of normal).

1.
Should I consider gallbladder removal surgery based on this information?
2.
Could my diarrhea and pregnancy-like symptoms be related to the gallbladder polyp?
3.
I have heard that gallbladder removal can increase the risk of colon cancer; is this true?
4.
After gallbladder removal, will I need to have regular follow-up appointments, and what specific items should be monitored?

Jin Yu, 30~39 year old female. Ask Date: 2020/05/18

Dr. Chen Shidian reply Gastroenterology and Hepatology

Small gallbladder polyps typically do not present any symptoms.
It is recommended to regularly monitor the size changes of the polyps, and there is currently no need for immediate concern or anxiety.

Reply Date: 2020/05/18

More Info

Understanding gallbladder removal, also known as cholecystectomy, involves recognizing the symptoms, risks, and necessary follow-up care associated with the procedure. Based on your symptoms and medical history, let’s address your concerns systematically.

1. Should you undergo gallbladder removal surgery?
Given your history of gallbladder polyps and recurrent abdominal pain, along with gastrointestinal symptoms such as diarrhea and the presence of blood in your stool, it is reasonable to consider gallbladder removal. Gallbladder polyps, especially those larger than 1 cm, can pose a risk for gallbladder cancer, although the risk is generally low. Since your polyps have not significantly changed in size, this is a positive sign. However, the presence of symptoms like abdominal pain and changes in bowel habits warrants further evaluation. Discussing your symptoms and the results of the tumor marker blood test with your healthcare provider is crucial. They can provide a more personalized recommendation based on your overall health and the specifics of your condition.

2. Could your diarrhea and pregnancy-like symptoms be related to gallbladder polyps?
While gallbladder polyps themselves typically do not cause symptoms, the gallbladder's function in bile storage and release can influence digestion. If the gallbladder is not functioning properly, it can lead to digestive issues, including diarrhea, especially after fatty meals. The pregnancy-like symptoms you mentioned could be due to various factors, including gastrointestinal disturbances or hormonal changes. It is essential to discuss these symptoms with your doctor, as they may require further investigation to rule out other potential causes.

3. Is there a risk of colon cancer after gallbladder removal?
The concern about gallbladder removal leading to an increased risk of colon cancer is not well-supported by evidence. While some studies have suggested a potential association, the overall risk is considered low. The primary concern after gallbladder removal is the potential for changes in digestion, particularly in fat absorption, which can lead to diarrhea or changes in bowel habits. Regular follow-up with your healthcare provider can help monitor any changes in your health post-surgery.

4. Will you need regular follow-up after gallbladder removal, and what should be monitored?
Yes, after gallbladder removal, it is advisable to have regular follow-up appointments with your healthcare provider. These visits typically focus on monitoring your digestive health and any symptoms you may experience. Your doctor may recommend dietary adjustments to help manage any changes in digestion, particularly regarding fat intake. Additionally, if you have a history of gastrointestinal issues, your doctor may suggest periodic screenings, such as colonoscopies, to monitor your colon health, especially if you have experienced symptoms like blood in your stool.

In conclusion, while gallbladder removal may be a suitable option for you given your symptoms and medical history, it is essential to have a thorough discussion with your healthcare provider. They can provide guidance tailored to your specific situation, ensuring that you make an informed decision about your health. Regular follow-up care is crucial to monitor your recovery and any potential changes in your gastrointestinal health.

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