Most people who undergo gallbladder removal, or cholecystectomy, experience no long-lasting symptoms after the procedure. But some people continue to have digestive symptoms after surgery, sometimes even years later.

Doctors usually refer to the digestive symptoms people experience after gallbladder removal as postcholecystectomy syndrome (PCS). PCS includes symptoms like nausea, vomiting, bloating, gas, diarrhea, and stomach pain.

Some research suggests that the risk of developing irritable bowel syndrome (IBS) after cholecystectomy may be higher than in people without the surgery. However, the symptoms of IBS are often similar to other conditions. What may be thought to be IBS, could really be PCS or another condition called bile acid malabsorption (BAM).

Currently, there isn’t any strong evidence to show that gallbladder removal causes IBS.

A 2008 retrospective study found that people who had their gallbladder removed were twice as likely to develop IBS — IBS with diarrhea (IBS-D), in particular — when compared with people without the surgery.

But the authors of the study acknowledged that diarrhea is common after gallbladder removal. While persistent diarrhea could lead to an IBS-D diagnosis, it’s possible these symptoms may be related to other gallbladder removal complications, such as bile acid malabsorption. In addition, the results of the study weren’t statistically significant.

A 2021 prospective study of 166 people who underwent cholecystectomy couldn’t find a relationship between cholecystectomy and developing IBS.

More research is needed to prove or disprove a potential link between IBS and gallbladder removal surgery. What researchers do know is that gallbladder removal can cause long-term digestive complications, and symptoms can be similar to the symptoms of IBS.

These symptoms, which include nausea, vomiting, bloating, gas, diarrhea, or stomach pain, are collectively referred to as PCS. For most people, PCS is temporary, but symptoms sometimes linger for many years after surgery.

PCS refers to digestive symptoms that arise after gallbladder removal. These symptoms often start right after the surgery, but they can also appear months or even years later.

Bile acid malabsorption (BAM)

After gallbladder removal, the bile produced by the liver flows directly into the small intestine. BAM, also called bile acid diarrhea, happens when your intestines can’t absorb the bile acids. The extra bile acids can cause watery diarrhea. BAM is treated with medications called bile acid sequestrants, such as cholestyramine.

Postcholecystectomy diarrhea

Diarrhea after gallbladder removal is common and usually temporary. It can be related to BAM or other causes.

Sphincter of Oddi dysfunction

The sphincter of Oddi is a valve that opens and closes to let digestive liquids move from the liver and pancreas to the small intestine. Gallbladder removal can cause this valve not to function properly, though the exact cause of this isn’t fully understood. The most common symptom is abdominal pain. The condition can also cause:

  • fever
  • diarrhea
  • nausea
  • vomiting

Retained gallstones

Most people undergo gallbladder removal due to the presence of gallstones. After surgery to remove the gallbladder, a stone can remain in the bile duct and block the flow of bile into your small intestine. This can lead to the following symptoms soon after surgery:

You may need another surgery to remove retained gallstones.

Like other surgeries, gallbladder removal can have risks. Aside from digestive problems, other complications may include:

Mild diarrhea is usually not a cause of concern, but contact a doctor if:

  • you’re losing weight without trying
  • you have bloody diarrhea
  • diarrhea wakes you up at night
  • you have severe abdominal pain
  • diarrhea persists longer than a few days
  • your skin or eyes appear yellow
  • you don’t have a bowel movement or pass gas for 3 days after surgery

Gallbladder removal can sometimes cause digestive issues. Here are some answers to common questions about the connection between gallbladder removal and digestive issues.

Does your digestive system change after gallbladder removal?

After the gallbladder is removed, bile moves directly from your liver to your intestines to aid in fat digestion. Your digestive system may need some time to adjust to its new method of digesting fat.

You’ll still be able to digest most foods, but fatty, greasy, or high fiber foods might upset your stomach. Eating too much can result in bloating, stomach pain, and diarrhea.

Can having your gallbladder removed cause bowel problems?

Gallbladder removal can cause bowel problems like diarrhea, abdominal pain, gas, nausea, vomiting, and jaundice. These symptoms are usually mild and temporary, but in some cases, they can persist for months or years and require treatment.

Can gallbladder removal lead to dumping syndrome?

Gallbladder removal can increase your risk of dumping syndrome if you’ve also had a weight loss procedure called bariatric surgery. In dumping syndrome, food moves too quickly from the stomach to the small intestine. Symptoms include intolerance to high fat foods, diarrhea, nausea, vomiting, bloating, dizziness, sweating, and cramps.

Digestive issues commonly arise after gallbladder surgery, including bloating, diarrhea, and stomach pain. These symptoms can be very similar to the symptoms of IBS, but there isn’t enough research to determine a causal link between IBS and gallbladder removal. Of the studies that have been done, the results are contradictory.

Speak with your doctor if diarrhea or other stomach symptoms persist for several days after gallbladder removal. Your doctor might recommend medications or diet changes, like limiting fatty foods, to help your symptoms.