The gall bladder is an organ that stores bile produced by the liver. Bile is a fluid that is important for dietary fat digestion. It acts as an emulsifier and helps large fat droplets break into small and easily absorbable parts.
Sometimes, the fluid hardens in the gallbladder and turns into small pebbles like hard substances. These are known as gallstones. They occur when there is an imbalance in bile composition, but the root cause is not clearly understood. Some risk factors for gallstones include diabetes, obesity, elderly individuals, and rapid weight loss history. Gallstones can cause nausea, vomiting, abdominal cramping, and severe pain in the abdomen. When they show such symptoms, the gall bladder is surgically removed. The procedure is known as cholecystectomy.
Low Fat Diet
Following a low-fat diet seems to be a theoretically correct way to eat after gall bladder removal. As storage of bile is not available, which aids in fat digestion, it is logical to think that controlling fat intake is important after gall bladder removal. For example, eating a fatty pizza or deep-fried pakoras would require bile’s assistance for digestion, and the liver may not secrete a large amount of bile quickly enough. This hypothesis often led to low-fat diet advice from health professionals. However, in experiments done so far, the effectiveness of a low-fat diet in individuals after cholecystectomy is not proven.
Post-surgery symptoms like diarrhoea, nausea, and constipation are common. Blasco and the group followed up with patients after gall bladder removal and assessed their symptoms after the surgery over the span of six months. They wanted to see if there is an inverse association between fat intake and remission, i.e., if groups eating lesser fat show better symptoms post-cholecystectomy; no such effect was reported. However, this experiment has certain limitations too. They have recorded the number of fatty foods consumed by groups and not the overall quantity of fat intake. Plus, different fats may have shown distinct effects (sources of Polyunsaturated Fatty Acids are beneficial for health in general).
Another study on the Korean population reported contradictory observations. Consumption of animal protein (likely fatty cuts), eggs and cholesterol were positively associated, and vegetables were negatively related to post-surgery symptoms. However, if you look at the experiment, the asymptomatic group has good nutrition choices and that may have collectively contributed to remission.
In short, no causal association between a low-fat diet and remission after gall bladder removal is evident. This will require a well-controlled experiment known as a randomised controlled trial.
Suggestions
It is best to take an individualistic approach in such a situation. Basal fat intake, distribution throughout the day, and sources should be recorded before starting with any dietary prescription. Afterwards, one should keep monitoring the gastrointestinal symptoms or discomfort. Based on the feedback, fat intake or its pattern should be revised. If there are no issues after incorporating the new diet, you can safely continue the same.
Things that one can try to modify -
- Overall fat quantity
- Different types of fats
- Frequency
- Timing
References:
- Ribas Blasco, Y. et al. (2020) ‘Low-fat Diet After Cholecystectomy: Should It Be Systematically Recommended?’, Cirugía Española (English Edition), 98(1), pp. 36–42. doi: 10.1016/j.cireng.2019.12.006.
- Shin, Y. et al. (2018) ‘Association between dietary intake and postlaparoscopic cholecystectomic symptoms in patients with gallbladder disease’, The Korean Journal of Internal Medicine, 33(4), pp. 829–836. doi: 10.3904/kjim.2016.223.
