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

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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.
I have undergone regular colonoscopies and upper endoscopies for the past two years, all of which have returned normal results.
The cause of the bleeding was attributed to a condition at the gastroesophageal junction (I forgot the exact term).
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, but the doctor said this could be due to measurement variability).
However, the issue arose when I had blood tests done during previous check-ups, all of which were normal.
Last week, during a follow-up visit, I inquired about gallbladder removal (as I suddenly developed pregnancy-like symptoms this year, and I am concerned it might be related to the gallbladder).
The doctor ordered a tumor marker blood test, and the results showed I am on the borderline between normal and abnormal (normal range).

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 aspects 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 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 that may warrant the procedure, the associated risks, and the necessary follow-up care. 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, it is reasonable to consider gallbladder removal, especially if your symptoms are affecting your quality of life. The presence of gallbladder polyps, particularly those larger than 1 cm, can increase the risk of gallbladder cancer, although your polyps have remained stable. However, the sudden onset of symptoms resembling pregnancy could indicate gallbladder dysfunction or other gastrointestinal issues. It is essential to have a thorough discussion with your healthcare provider about the potential benefits and risks of surgery, considering your current symptoms and the results of your recent tumor marker tests.

2. Could your diarrhea and pregnancy-like symptoms be related to gallbladder polyps?
While gallbladder polyps themselves typically do not cause diarrhea, gallbladder dysfunction can lead to digestive issues, including diarrhea, especially after eating fatty meals. The symptoms you describe, such as abdominal pain and changes in bowel habits, could be related to gallbladder issues, but they could also stem from other gastrointestinal conditions, such as gastritis or irritable bowel syndrome (IBS). It’s crucial to evaluate all potential causes with your physician.

3. Is there a link between gallbladder removal and colon cancer?
The concern about gallbladder removal leading to an increased risk of colon cancer is not well-supported by scientific evidence. While some studies have suggested a potential association, the overall risk is considered low. Maintaining a healthy diet and lifestyle post-surgery can mitigate any potential risks. It’s essential to focus on regular screenings and a balanced diet rich in fiber to support colon health.

4. What follow-up care is necessary after gallbladder removal?
After a cholecystectomy, regular follow-up appointments are essential to monitor your recovery and address any ongoing symptoms. Your healthcare provider may recommend:
- Dietary adjustments: Initially, you may need to avoid high-fat foods as your body adjusts to the absence of the gallbladder. Gradually reintroducing these foods can help identify any triggers for discomfort.

- Monitoring for complications: While complications are rare, it’s important to be aware of symptoms such as persistent abdominal pain, jaundice, or changes in bowel habits, which should prompt immediate medical attention.

- Regular screenings: Depending on your medical history and risk factors, your doctor may recommend ongoing surveillance for gallbladder polyps or other gastrointestinal issues.

In conclusion, your symptoms warrant a comprehensive evaluation, and discussing the option of gallbladder removal with your healthcare provider is a prudent step. They can provide personalized recommendations based on your specific situation, ensuring that you receive the best possible care moving forward. Remember, open communication with your healthcare team is key to managing your health effectively.

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