3 Weeks Post-Op - will this ever end?

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Hi, i had my gallbladder removed exactly 3 weeks ago and am still having the dreaded diareah.  I just wanted to ask whether anyone else had it this long - or longer - and then it went away.  Really, i just want to know whether there is any hope of it stopping.  I've also still got constant discomfort / pain in the area of the gallbladder and wondered whether this is normal 3 weeks on. 

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  • Posted

    I had my GB removed in April 2015 and was told just before my op that I would have to most probably take something like immodium all the time and this turned out to be true - I take one or two immodium a day and it keeps everything in check.  This doesn't seem to happen to everyone so give yourself time and things may balance out.   If it does seem like its going to be a long term thing maybe something like immodium would help.  

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    • Posted

      Thanks for your reply.  I'm really surprised at what was said to you before the op as i was told before mine that this only happened to about 1 in 200 people!!

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  • Posted

    Hi

    I had no diarrhoea following my op but think that was down to the cocodamol - however for the last 10-14 days I've taken much less painkillers and had a fair few days of diarrhoea - I'm now 4 wks post op and just today things have eased up. Hope that helps

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    • Posted

      Thanks dona, that does at least give me a bit of hope.  I did have one day when i thought things were easing up but then the next day it started again.  Here's hoping that the problem is sorting itself out for you.  This whole thing just seems to be a never ending nightmare! Best wishes.

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    • Posted

      No problem - I've it's read Gertrude's reply and feel I've clearly supposedly done things all wrong since my surgery.

      I've eaten completely normally and whilst on holiday had a fair few three course meals which were very heavy all with no ill effects so a complete contradiction to Gertrude's findings. It's maybe all down to the individual - I had a poor diet before and stil do :-)

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    • Posted

      Hello Dona,

      Before my op, I had read so many horror stories about chronic diarrhoea and bile acid malabsorption post-op so i was understandably concerned.  I read a lot of journal articles and looked at some books then devised that diet for myself to help minimise the effect of bile acids in my gut.  I may have been ok just eating my normal diet but I didn't want to risk it based on what I had read on the forum.  As you say, maybe it's all down to the individual. What I was told by the surgeon was that some people suffer from BAM afterwards but most are ok. The liver constantly produces bile but now there's no gallbladder to store it in. Since the bile is now much less concentrated, sometimes the body cannot cope with high-fat foods eg. pizza. The body is also not used ot bile just sitting in the gut.  I am not saying my method was right - just my experience.

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  • Posted

    Hello Carol,

    (The text below is an edited version of a reply I sent to someone some weeks ago. I thought you would find it useful)

    I am sorry to hear that you have been having such awful problems since your gb removal.  I also had a cholecystectomy at the beginning of June after suffering several episodes of excruciating biliary colic over the past two years.  Tests revealed mulitple gallstones in an inflamed gb with very deranged liver function tests. 

    Since the op, I only experienced acute pain - mainly around the belly button area - in the first two weeks and now just an occasional ache due to scar tissue in that area.  I never had any diarrhoea or stomach problems at all.

    I have a degree in Nutrition and before the operation, I spent several hours researching about all aspects of the cholecystectomy op, including bile acid malabsorption.  I think I have become an expert on bile acids - primary and secondary - and conjugated bile acids (bile salts). During the course of my research, I came across some journal (gastroenterogy journal) articles about bile acid malabsorption and substances that mop up/absorb bile acids such as fibre, pectin, cellulose etc. There has been quite a lot of research in this area.  I also discovered that if bile acid malabsorption is suspected, your doctor should refer you for a SeHCAT test for a definitive diagnosis and treatment.

    In my case, before I was discharged, I devised a dietary plan to minimise the amount of bile acids just sitting in my intestine.  I would start the morning off with a glass or two of water, then an apple, then porridge with semi-skimmed milk. Then I would eat a banana mid morning.  For the first few days after the op, I had low-fat soups for lunch eg. chicken and vegetables/rice or minestrone with wholemeal bread. For dinner, I would eat maybe poached fish with potatoes and vegetables/salad. I now eat some nuts every day because our bodies are still producing bile all day and every day so that same bile can break down the fat in the nuts.  We need healthy fats! If feeling peckish at any time, I have toast with cottage cheese with cherry tomatoes, celery or olives. A good qualty jam or marmalade will give you pectin too.  I have not tried chocolate, pizza, or any high-fat foods apart from an avocado which was ok. I have tried tuna and sardines and was okay with them.  I also eat probiotic yogurts to ensure that I have the right kinds of bacterial flora to break down the bile acids.

    Before my gallbladder was removed, I was very reluctant to drink water and many people said that this could have contributed to my gallstones. I don't know if there is any truth in that but now I drink plenty of water and herbal tea (some mornings a spoonful of apple cider vinegar in the water) because I am aware that the gallstones can still form even without a gallbladder. 

    In summary, try to eat pectin-rich fruits - apples, oranges, pears, apricots during the day to soak up the bile. Eat high fibre foods as much as possible. Drink water first thing in the morning and last thing at night.  Don't go too long without food so that the bile won't build up in your gut. I eat as many different fruits and veg as I can. I usually have a mug of Ovaltine and a banana and/or orange at night. 

    If you would like to read some of those journal articles or would like the name of a particular book about this topic, do let me kinow and I will send you a private message - not allowed to give book names in this forum. 

    Gertrude

    I do hope you feel better soon.  Best wishes.

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    • Posted

      Hi there!

      Wow your reply was fantastic.. I'm awaiting to have my operation to remove my gall bladder, I'm petrified.. I see so many stories on here of people worse post op.

      I have cut all dairy products from my diet and I don't eat meat any more, no junk food, no chocolate or take aways etc, I live on fresh veg and fruit, and I do eat quorn... I feel so much better already and have lost 2 and a half stone!! I have not even had a twinge from my gall bladder since, but it's packed with little stones and needs to come out. I already had a bout of jaundice when a stone got stuck in the bile duct and I was so violently sick... I'm so scared.... I have never eaten fish since but wondered about tuna,... Should I try it? It brine not oil, and do you think I should continue my eating like this post op? Xx

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    • Posted

      Hi Gertychin, thanks for your message and apologies for my delay in replying! In terms of the food that I'm eating... i have from the start been extremely careful and eating no fat (or less than 4g). I've also been eating the foods recommended on the BRAT diet, ie. bananas, rice, apple and dry toast as well as being aware of FODMAPs. To be honest i don't really think this has made any difference.  I've also been eating small amounts on a regular basis.  I've found that if i leave too long between eating the pain/discomfort gets worse (I noticed this happened before i had the operation too). When I tried eating porridge, made with water, i found it made the pain worse.  When realised that it contained 8.4g fat i put it down to that. I've not been eating more than 4grams. Like you, i also did a lot of research prior to my op, into BAM.  Really though i wanted to know whether other people had had this problem for a long period of time before it went better.  I read somewhere about a woman having the D for 8 weeks before it went better by itself. Anyway, thanks again for taking the trouble to reply and best wishes to you.

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    • Posted

      Hello Ali29525,

      I totally understand about being violently sick. The last time my gb made me sick I ended up being admitted via A&E and I stayed in hospital for 4 days.  My gallbladder was very inflamed and full of stones but luckily there was no pancreatitis as the doctors had originally suspected.  For the first 2 days, I was put on a drip and was nil by mouth.  They wanted to rest my gallbladder and stop it contracting. That was interesting.

      Are you vegetarian?  I note you haven't mentioned chicken but you eat Quorn (and you want to try or re-try tuna).  Why have you cut all dairy products? There are some low or no-fat probiotic yogurts that would provide you with protein, calcium and "good" bacteria and maybe fibre. How about pulses eg. beans, lentils and peas? They are a good source of protein and fibre. I am assuming that you are on low carbs since you didn't mention them.

      Do you know the trigger foods for your gallbladder? Are you at your ideal healthy weight now?

      If I were you, I wouldn't risk tuna before the op even if it is in brine because the tuna itself is still an oily fish.  There is a Gallstones Diet Sheet somewhere on this website (patient info).  I used to look at it regularly once I knew that I had gallstones. 

      After the op, you will eventually reintroduce healthy fats to your diet. You will be given a post-op information sheet.The NHS has lots of useful information about gallstones and gallbladder removal, including diet post-surgery.  The more you know, the less petrified you will feel.

      I have had no gut problems since the op although I have not had very fatty foods like pizza and chocolates since then.  I have had icecream, cheesecake and cream cheese recently with no problem at all. I just ensure I eat plenty of fibre-rich foods.

      Best wishes.

      G.

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    • Posted

      Hello Carol,

      I do hope that things settle down for you soon. Like you, I try not to go for long periods without food because I don't like the thought of bile continually dripping into my intestine. I guess it's a very fine balancing act: too much fat and some people get diarrhoea; or bile acid malabsorption which also results in diarrhoea for many people.

      Since you are only on 4g or less of fat, it can't be the fat causng the problems.  Maybe you can get your GP to send you for more tests to see if it is BAM.  On the other hand, things might just settle down.  Depends how long you want to wait.  I was one of the lucky ones.

      What do you use to "mop up" the bile.  I am trying to look at pages of that book on Amazon and he is talking about bulking agents and soluble fibre.  I dont' have the actual book! 

      Take care.

      G.

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  • Posted

    I also had my gallbladder removed 3 weeks and 4 days ago. I'm having the same issue. I'm afraid to eat anything and not make it to the bathroom. I've been avoiding fatty type foods but, doesn't seem to help. As for the pain I'm with ya there. The only 1 that really bothers me still is where they removed the gallbladder.

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    • Posted

      Hi jackie, the pain and discomfort I'm stil getting is in the area where the gallbladder was and i know that if i eat the wrong thing it will get even worse.  Also i think it gets worse if i leave it too long to eat between meals, ie. it's best to eat small amounts often - I don't leave it longer than a couple of hours without having a small snack such as some grapes or a piece of chicken, piece of dry toast, etc. I'm introducing one new food each day as that way it's easier to work out if a particular food causes you a problem. I've found that the pain/discomfort seems to get worse as the day goes on... my best time being early in the morning.  I hope that your pain has gone a bit easier today.  I'm sorry you're suffering but it's also something of a comfort to find out that others still get the pain a three or four weeks later. Sometimes you read about people who have no pain after a week and can eat anything they like and you feel that there is something seariously wrong with you when you're not ok.  I guess people really do heal at different rates. keep in touch and let me know how you're doing.

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  • Posted

    I'm 6 weeks post op and I've also been seeing a dietitian for the diarrhoea.

    I stay under 4 grams of fat a meal. Also looked at FODMAP foods to avoid. I eat some but less then I did and gas made a huge difference. The foods you avoid are foods that foment and cause gas and bloating and I has helped heaps. Down to one Bm the past few days solid and soft...( sorry for over share)

    Frequent small meals are also key. Maybe try and you can also get a digestive tonic from health food store that tou take an hour before you eat to help with the digestion of food.

    The pain is normal and from what I understand is everything can be extremely out of walk for two months and improve anywhere up to a year.

    I have lived on salad rice veg fish and chicken breast. But ones that aren't on the FODMAP to avoid.

    Hope this helps

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    • Posted

      Hi stef,

      Thanks for your reply.  I had already looked into the FODMAP foods and like you, I've been eating 'no fat' or less than 4g.  I've not really found that it helps though.  If your BM's are jut getting better now, after 6 weeks of D, then maybe there is hope for me yet! I did read somewhere about someone having D for 8 weeks and then it just went better so maybe with some people it just takes quite a while for their system to sort itself out - let's hope that's the case.  Having said that it doesn't stop you worrying that you're going to end up with this problem for ever does it? I'm glad that you said it can be 'normal' to still having pain after several weeks as i was really beginning to think that it would never get any better. You hear about so many people who are pain free after a week!

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    • Posted

      Along the tribulation of post-op gallbladder removal surgery I did some research on dietary fibers that supposedly help to "soak up" excess bile in the intestine.

      I learned two things from trial and error on eating high fiber foods:

      1. There is a difference between soluble and insoluble fibers. Leafy green vegetables are mostly insoluble where as grains tend to be more soluble.

      2. When I eat insoluble fiber foods (leafy green vegetables), I end up with massive diarrhea. When I eat soluble fiber foods (oats, barley, brown rice, wheat, etc.), I have more bowel movements and slightly decreased diarrhea.

      Soluble fiber foods seem to help but very marginally as my diarrhea continues to be a chronic problem despite this being 12th week since my gallbladder removal surgery.

      Insoluble fibers, however, greatly amplifies the symptom/problem in my case. Not only will they make me go more often, they seem to push out more water.

      Perhaps my comment on this might help someone.

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