What's OK to eat after gallbladder removal?

I just got a phone call from a retired Mayo Clinic doctor asking why we don't have a gallbladder removal diet. He went on to explain that he'd had a very uncomfortable and embarrassing incident after eating a large meal that contained lots of fat. My response was that there isn't a set diet people should follow after gallbladder removal because the guidelines depend on the individual.

It's helpful to know a little background: The gallbladder collects bile, a fluid that is produced by the liver, and releases it when you eat to aid the breakdown and absorption of fat. Between meals, bile collects in the gallbladder and is concentrated. When the gallbladder is removed, bile is less concentrated and it drains continuously into the intestine. This affects digestion of fat and fat-soluble vitamins. How much of a problem it is varies from person to person. With time, the body often adjusts and becomes better at digesting fatty foods.

The amount of fat eaten at one time also factors into the equation. Smaller amounts of fat are easier to digest. On the other hand, large amounts can remain undigested and cause gas, bloating and diarrhea.

Although I don't have a specific gallbladder removal diet to recommend, I can offer general advice for avoiding problems after you've had your gallbladder removed:

Eat smaller, more frequent meals. This may ensure a better mix with available bile. Include small amounts of lean protein, such as poultry, fish and nonfat dairy, at every meal, along with vegetables, fruit and whole grains.Go easy on fat. Avoid high-fat foods, fried and greasy foods, and fatty sauces and gravies. Instead, choose nonfat or low-fat foods. Read labels and look for foods with 3 grams of fat or less a serving.Gradually increase the fiber in your diet. This can help normalize bowel movements by reducing incidents of diarrhea or constipation. However, it can also make gas and cramping worse. The best approach is to slowly increase the amount of fiber in your diet over a period of weeks.Be aware that after gallbladder surgery some people find that the following are difficult to digest: caffeinated beverages and dairy products.

Talk with your doctor if your symptoms are severe, don't diminish, continue over time or if you lose weight and become weak.

I'd like to hear from anyone who has had gallbladder surgery — do you have problems — or are you able to eat almost everything? Any advice you can share?

- Jennifer

blog index References Barrett K. Gastrointestinal Physiology. http://www.accessmedicine.com/content.aspx?aID=2306279&searchStr=gallbladder#2306279. Accessed July 6, 2011.Nutrition Care Manual: Gallbladder disease process and meal plan. American Dietetic Association. http://nutritioncaremanual.org/content.cfm?ncm_content_id=81517 Accessed July 6, 2011.Fisher M, et al. Diarrhoea after laparoscopic cholecystectomy: Incidence and main determinants. ANZ Journal of Surgery. 2008;78: 482.Surawicz CM. Mechanisms of diarrhea. Current Gastroenterology Reports. 2010;12:  236.