— Laynie, Michigan Anxiety can increase heart rate and thus lead to heart pounding (also known as heart palpitations). Also, some patients develop symptoms of indigestion following gallbladder surgery due to a condition known as postcholecystectomy syndrome; if the indigestion increases your anxiety, then this may be related to your palpitations. However, I would recommend that you see a cardiologist for evaluation, since palpitations could also be symptoms of an electrical disturbance of the heart. Q2. Can a gall bladder operation cause you to have colitis? I had one last June, and I have not been the same since. It does not matter what I eat, I always have a flare-up every day. It makes it hard to enjoy yourself when there is food involved because you do not want to have an incident while you are out with friends. Thank you. No, gall bladder surgery (cholecystectomy) cannot cause a flare of ulcerative colitis. However, patients can have problems with diarrhea following cholecystectomy that is not related to colitis. In such patients, an excess of bile salts flowing into the colon is the cause of diarrhea. A medication like cholestyramine (Questran), which binds bile salts in the gastrointestinal tract, often helps with the diarrhea. It is worth a try in your case, so talk to your doctor for more information. Q3. Have you ever heard of anyone experienced digestive problems after gallbladder surgery (specifically, chronic diarrhea)? I’ve been told I probably have IBS, which seems like a catchall term, but I wasn’t experiencing the symptoms until after my surgery five years ago. Cholecystectomy (removal of the gallbladder) is an extremely common procedure, and it leads to postoperative symptoms in 10 to 25 percent of patients. While these symptoms may be due to a previously unrecognized digestive disorder (such as irritable bowel syndrome, gastroesophageal reflux disease (GERD), peptic ulcer, or pancreatitis), symptoms that are first noticed following gallbladder surgery may be due to other conditions. These include: strictures or narrowings of the biliary tract, which carries bile from the liver to the small intestine; gallstones that remain behind in the bile ducts; dysfunction of the sphincter of Oddi (a muscular structure at the end of the duct system that transports bile to the small intestine); and a condition called cystic duct stump syndrome, thought to be caused by part of a long cystic duct remaining after removal of the gallbladder. You mention chronic diarrhea — this typically occurs when the gallbladder can no longer store bile salts, which in turn causes what’s referred to as bile salt-induced diarrhea. This can be treated with a number of “resins” or substances that can bind up the bile salts and other factors that lead to diarrhea after cholecystectomy. Patients with new-onset diarrhea after a cholecystectomy should seek specific counsel with a gastroenterologist, as this condition may be very easy to treat. Q4. My sister-in-law and I both had Lap-Band surgery in the summer of 2007. She just discovered she has no gallbladder function. What can I do to make sure I don’t damage my gallbladder? How much food should you consume a day to keep it working properly? I don’t want to go through another surgery! Your sister-in-law’s gallbladder malfunction may be due to gallstones, which are the most common cause of gallbladder problems. Gallstones can get stuck in the passageway that carries bile from the bile duct; they can also cause the gallbladder to contract poorly if they are large or there are many of them. They can form for many reasons, but they are more likely to develop in people who are female, pregnant or able to become pregnant, and obese. Ironically, even though obesity is a risk factor for gallstones, they can also be caused by rapid weight loss — for example, after pregnancy or surgery for obesity. Dietary changes do not improve gallbladder function or even lower the number of gallstone complications. However, greasy, fried foods do lead to the formation of new gallstones, so a low-fat diet is recommended. How much food you eat does not appear to have any effect on how well your gallbladder functions. Q5. I have ulcerative colitis and am having gallbladder surgery in a few weeks. What advice can you give me to help me prepare for — and recover from — the surgery? It is unlikely that your ulcerative colitis or the medications used to treat it will interfere with gallbladder surgery. Should symptoms of diarrhea and bleeding appear after surgery, please contact your doctor right away. You might have a flare-up of your colitis (triggered by the surgery), or you could have another problem, like infection with Clostridium difficile. Before you have surgery, make sure that your doctor knows you have been diagnosed with ulcerative colitis. Learn more in the Everyday Health Gallbladder Center.
