In our latest question and answer, the pharmacist discusses whether or not digestive supplements are needed after gallbladder removal.
I just had a gallbladder removal surgery, Is it advisable to regularly eat digestive enzymes? What kind of digestive enzymes will be suitable?
There are no guidelines in regard to diet or supplementation after gallbladder removal surgery (cholecystectomy). Most surgical instructions in regard to diet simply state to avoid very high fat meals for a few days after surgery as they can cause GI distress and diarrhea, but you can gradually return to a normal diet.
Nevertheless, many individuals have reported digestion issues after gallbladder removal. Below, we discuss the function of the gallbladder and supplements that may aid in digestion.
The gallbladder stores bile which it receives from the liver, which is then released into the small intestine when fats are consumed. The gallbladder does minimally process the bile from the liver, by removing water and other compounds. When the gallbladder is removed, bile is still released from the liver, but is less concentrated and is continuously released in small amounts into the small intestine, as there is no place to store it.
Bile assists lipases by breaking down consumed fats into smaller particles and by preventing "hydrophobic aggregations", or accumulations of fats. Smaller particles of broken down fat (from bile) allows for greater surface area for lipase enzymes to work.
Data shows that the majority of people won't experience significant digestive problems after a cholecystectomy. While the gallbladder stores bile, it isn't thought to be absolutely necessary for healthy digestion.
However, for some people, digestion is negatively impacted. While there are a lack of studies regarding fat digestion after gallbladder removed, it has been theorized that this may lead to improper digestion of fats and deceased absorption of fat soluble vitamins like vitamin D and vitamin A.
In addition, when the gallbladder is removed, less concentrated bile is slowly and continuously released into the small intestines. This can often have a laxative-type effect. Large consumption of fats may also produce a laxative-type effect due to the decrease in bile.
For those that have digestion issues after gallbladder removal, there are a variety of supplements available that may help improve your digestion, such as:
Lipase supplements are available over the counter and simply add extra lipase enzymes to your GI tract, which may help in breaking down fat from food, especially after high fat meals. Lipase supplements are most often taken with meals.
Bile, available in many different forms, such as ox bile, is used to increase the amount of bile available to help digest fats. Bile supplements are generally taken with a meal for optimal effects.
Betaine HCl is another digestive supplement, an amino acid, that is taken as a supplemental source of hydrochloric acid, to aid in digestion and the breakdown of food.
None of the above supplements are necessarily vital after gallbladder surgery, but nonetheless may help if you are experiencing digestive issues. Be sure to speak with your doctor before adding on any nutritional supplements to your medication regimen.