Why do I need a low fat diet before my gall bladder is taken out?

Your gallbladder is an organ which stores and concentrates bile made by the liver. Bile is a substance which helps to emulsify (break up) fat molecules so it is easier to digest and absorb. Other functions include providing support for the bacteria in the intestine and excretion of copper, manganese and bilirubin. Some people may experience inflammation of the gallbladder (cholescystitis), gallstones (cholelithiasis), or gallbladder cancer in which the gallbladder may be removed.

The reason for a low fat diet before and after removal is to help alleviate the symptoms of fat malabsorption commonly known as steatorrhea. If over time you suffer long periods of steatorrhea you can be at risk of fat soluble vitamin deficiency, unintentional weight loss and malnutrition. In general, it is recommended that you only follow a low fat diet in the first few weeks after your  gallbladder has been removed. After this period, you may like to reintroduce fat into your diet (keeping in mind choose mostly unsaturated fats such as olive oil, nuts and seeds, avocado, plant-based spreads) and look out for signs of steatorrhea.

An Accredited Practising Dieititian (APD) will be able to work with you on getting your diet right to help recover and manage symptoms such as steatorrhea. To find an APD head to the Dietitians Association of Australia website (www.daa.asn.au)

The liver makes bile which is like a detergent and helps you dissolve and  absorb fat.  Your gallbladder stores and concentrates bile.  Every time you eat or dirnk a fatty substance, there are hormones produced by the first part of the small bowel called the duodenum.  These hormones (CCK) stimulate your gallbladder to contract and help deliver a concentrated injection of bile into the duodenum to help digest the fatty meal.

If you have stones or sludge in your gallbladder and your gallbladder contracts, these stones get pushed and may get stuck at the exit of the gallbladder (cystic duct) and give you pain or biliary colic.  They may also pass through the cystic duct into the common bile duct where they can cause other complications such as cholangitis or acute biliary pancreatitis.

Thus, while you are waiting to get your gallbladder out, it is best to stick to a low fat diet. This way your gallbladder will not get stimulated to contract and you will reduce your chances of getting complications from your gallstones.

Dr. Mittal (Sydney)

The story of gallbladder removal (or cholecystectomy) is just one example of how adaptable bodies can be. The gallbladder, an organ near your liver, acts like a reservoir for bile to be stored and used to digest fats later when you need it. But, even once it’s removed, your body can still produce the bile just like before. In fact, your body can even adjust to store bile in the duct between the liver and small intestine, creating a kind of makeshift gallbladder for itself. Pretty impressive, eh? And, more to your line of questioning, some people may notice changes in digestion and need to alter their diets after a cholecystectomy either temporarily or permanently (no two patients are the same!). However, most people are able to return to business as usual with their diet within a few days or weeks. Even though fats sometimes get a bad rap, they are a key part of your body’s dietary needs, and fortunately, the gallbladder-less can still reap the benefits.

There are no universally recommended diets for those who’ve recently parted with their gallbladder. However, there are some general suggestions that dieticians have thought up to help get your digestive tract running as smoothly as possible after surgery:

• Eat smaller, frequent meals, so that your digestive tract can work with smaller amounts of food at a time without its reservoir of bile.
• Avoid high-fat foods right after surgery, to give your body has time to compensate and adjust to the decreased amount of bile.
• Slowly increase fiber intake, which can help with diarrhoea.
• Avoid caffeinated beverages, spicy foods, and dairy right after surgery, which might upset or irritate your digestive tract until it has a chance to bounce back.

The newly gallbladder-less might also want to consider how other side effects from surgery can impact their lives. About 90 percent of gallbladder removals are done as laparoscopic surgeries, which involve a few small incisions to insert a small camera and instruments and remove it as noninvasively as possible. This is the “gold standard”: the risk of complications, such as infection, are low and pain usually decreases significantly after three days. For patients with abdominal scarring or other conditions, an open surgery might be done instead. This carries a slightly higher risk of complications (infection, bruising at the site, or urine retention), but is also a low-risk procedure. Gallbladder removals are very safe, but it’s probably good to be prepared for some pain and discomfort in the days following either type of surgery.

Gallbladder removal may leave you an organ lighter, but chances are you’ll hardly miss it. Maintaining a balanced diet with lots of fruits, veggies, and whole grains, listening to your body’s signals, and keeping in touch with your health care provider about any concerns can help you carry on just as you did before, fats and all!