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Should You Have Your Gallbladder Removed?

Patients with irritable bowel syndrome (IBS) and other digestive problems such as constipation, diarrhea or abdominal pain often wonder if they have a problem with their gallbladder. Problems with the gallbladder can indeed cause these symptoms. However, many people find that having their gallbladder removed did little or nothing to help their IBS, or even made it worse.

When is it questionable to remove the gallbladder?

It is often tempting for physicians to blame the gallbladder for abdominal pain and digestive problems even when there is little or no evidence that the gallbladder is the culprit. It’s a relatively simple procedure, and most people don’t miss it too much. If stones are present, then the decision is easy to make.

However, in some cases physicians recommended that the gallbladder be removed even when stones are not apparent on any exams. The recommendation is based primarily on symptoms and a lack of any other visible problem.

Gallbladder function tests also may indicate that the gallbladder is not functioning at 100%. However, that does not mean that it is the cause of the problem. If the gallbladder is functioning at a below normal level, removing it will only guarantee that it will not function at all.

Studies have shown that patients with IBS symptoms and/or abdominal pain are more likely than others to have gall bladder removal surgery (cholecycstectomy) when they do not have gall stones. This exposes the patient to the increased (though small) risks of surgery and to further digestive problems caused by the abscence of a gall bladder.

Testing for food allergies and other causes of IBS symptoms, and treating those conditions can enable patients to avoid unnecessary surgery and achieve good digestive health.

Medical Research on Gall Bladder Issues

Corazziari et. al. (2008). CONCLUSION: Irritable bowel syndrome subjects have an increased risk of cholecystectomy that is not due to an increased risk of gallstones, but rather to abdominal pain, awareness of having gallstones, and inappropriate surgical indications.”

Cole et. al. (2005). “The incidence of gallbladder surgery was threefold higher in IBS patients than the general population. Patients with IBS have an increased risk for abdominopelvic and gallbladder surgery and, thus, an associated risk for experiencing morbidity and mortality associated with these surgical procedures.”

Kennedy TM, and Jones RH (2000). CONCLUSION: Symptoms of IBS may cause diagnostic confusion and unproductive surgery. Cholecystectomy may cause IBS-like symptoms, a single underlying disorder may produce symptoms in both gastrointestinal and biliary tracts, or the associations might be due to a combination of these factors.”

Thijs C, Knipschild P (1998). 
”Gallstones were associated with mid upper abdominal pain in the screening study, and with mid upper abdominal pain, biliary pain, and colic (each independently) in the clinical study. When these symptoms were absent (and only dyspeptic symptoms or food intolerance was present), gallstones were not more common than expected from the general population prevalence (estimated from the screening study).”