I keep receiving emails from anxious patients with gall bladder related or other problems, and I try to reply to each one as informatively as I can. Since many of the questions I get asked are not covered by my "FAQs" on this web site, I thought it might be a good idea to put up the questions and answers as an alternative FAQ. The names and email addresses of course, have been deleted. The questions are marked Q.and my replies are marked A.

Q. After having the gall bladder removed - what type of diet should a person be on?

A. A normal diet. Special dieting is not required after the gall bladder is removed, unless a diet is necessary for other unrelated problems such as diabetes.
Q. How long does the procedure take?

A.Between 45 minutes and 2 hours usually.

Q.Do you know if high blood pressure would keep a person from having that kind of surgery?

A. No. But High BP would normally be controlled by medication before surgery

Q. I just had a baby 11 weeks ago, would that prevent me from having that kind of surgery?

A. No.

A. You probably had a HIDA scan done. Gall bladders sometimes get swollen and inflamed even without stones and HIDA scans are good for confirming that the outlet of the gall bladder is blocked.

Why am I having surgery, you ask. I presume that you have had a lot of pain and symptoms related to the gall bladder, and possibly your doctor, having found no stones on an ultrasound scan decided to check you further with a HIDA scan. An inflamed gall bladder can cause further trouble, and should be treated. Currently, the best possible permanent solution for an inflamed gall bladder is surgery.

Q. ... My 42 y/o girlfriend weighs a bit over #350. How is this obviously going to affect her surgery and convalesence?
A. I presume that you have not made a typo when you state that your girlfriend weighs a bit over 350 pounds.

Any overweight person is at increased risk from surgery. The general problems that overweight people tend to suffer from include diabetes, high blood pressure and heart trouble. Diabetes needs to be suitably controlled, and the heart and blood pressure need to be carefully monitored and controlled during and after surgery as the drugs used can affect them.

Operating on the abdomen (stomach area) of an overweight person leads to an increased risk of of chest infections after operation, although the risk is much smaller after laparoscopic surgery, since only punctures are made and pain is minimal. But in those occasional instances when a laparoscopic operation is not possible, a large open incision has to be made and there is a definite risk of chest infection. This will need to be countered by chest and breathing exercises before surgery, to be continued after surgery.

The operation itself tends to be a little bit more difficult for a surgeon, though the difficulty may not be so noticeable in a laparoscopic operation.

Finally, overweight people have an increased risk of developing clots in the veins of their legs, which could migrate to the heart. Suitable precautions against this would include special stockings or compression of the legs during surgery, anti-clotting drugs to suppress clotting in the legs, and ensuring early mobilization of the patient after surgery.

Q. 1. What effects will the absence of a gall bladder have on her? (such as digestive processes, susceptibility to viruses, etc..)

A. None. She won't miss her gall bladder. Yes, the gall bladder has the function of storing and concentrating bile - but that's gone once stones have formed. Removing the gall bladder will relieve her of her symptoms.

Q. 2. Will she be able to eat "fatty foods" without pain after the removal of her gall bladder?

A .Yes

Q. 3. How will the bile be transferred to her stomach without the gall bladder?

A. There is a main bile tube that carries bile from the liver to the intestine. The gall bladder is a branch from this tube, and removing it does not stop the flow of bile - just like removing a parking area by the side of a road will not affect the flow of traffic on the road.
Q. Almost a year ago I had an upper GI to find out why I was having pain in the middle of my chest. A few things were ruled out, however, it stated on the report that I had gall stones. I asked the doctor what could be done and he told me not to worry at this time. He did say there was no medication to get rid of them. I have constant pain and I try to watch out for things I eat or drink not really knowing what triggers the pain. Is there a time when someone has a few or small gall stones that you don't have to bother.

A. If you are suffering from abdominal, chest, back or shoulder pain and you have gallstones, and no other explanation can be found for the pain, then one has to reach the conclusion that it may well be your gallstones that are causing your pain. Personally, I would seriously consider your gallstones as a possible cause of your symptoms. A pain in the middle of the chest is not impossible with gallstones.

People can have gallstones with absolutely no symptoms at all - but you obviously do not fall into this category, because you do have some symptoms, and it is a question of making a judgement decision as to whether your symptoms are related to your gallstones or not.

Large or small, if gallstones are not causing any symptoms at all, they may be left alone. If symptoms are present, and they can reasonably be attributed to the gallstones, then some form of treatment is essential - and this usually means surgery to remove the gall bladder and gallstones.

Q. I was wondering if there any useful sources on proper diet after Gall Bladder extraction. I had mine removed 4 years ago and have experienced abnormal bowel movements for some time. I have been checked out by a physician and there is nothing else wrong. Most bowel movements I have are extremely watery and tend to explode out of me. After that it feels as though my entire digestive system is bloated and somewhat sore. It is very similar to when a gall stone actually passed through the system when I had the diseased Gall Bladder. Please advise. Thank You.

A. You haven't indicated how long you have had these symptoms for.

On the face of it, these symptoms do not seem to have any connection with your gall bladder at all, although I have a fair number of patients who have similar symptoms and also have had gallstones.

The usual causes of symptoms such as those you complain of include bowel infections (probably unlikely in your case), "malabsorption", and Irritable Bowel Syndrome. (IBS)

I always like to rule out malabsorption and food allergies/intolerance in my patients who have loose stools as well as gallstones, since impaired digestion caused by malabsorption can lead to the formation of gallstones in some people.

A lot of people are intolerant to milk sugar (lactose intolerance) and some to wheat products (sprue). Avoidance of these is helpful in such people.

All in all you appear to have a problem that may require some specialist gastroenterological opinion to help you sort it out - though you may be able to find lots of information about the conditions I have mentioned on the Net.

Q. Hii. I'm a 20 year old female, who recently gave birth in January. Since then I have been experiencing difficulty with my Gall Bladder. It was fine after February, but just this past week started acting up. I went to the ER and appendicitis, pregnancy, and ovarian cysts were ruled out. AN ultrasound was done, and the results were negative. But since my liver enzymes were elevated, the doctor believes I have Gall Bladder disease. My family physician wants me to have a hidascan done to see if the Gall Bladder is performing well. My question to you basically is what is going on? If it is not the gall bladder, what could it be? My hidascan is not until this Monday, and I am concerned. I am not one who tolerates pain very well, and the thought of surgery terrifies me. I was just wondering if there was any insight that you could give me about what my family doctor is looking for with this hidascan, and if that means that my gallbladder will have to be removed. I hope I have not confused you, and that you can help me. I appreciate the time you have taken to read this email.

A. Your hidascan has probably been done now - so you may know by now if it is your gall bladder or not. A hidascan basically indicates blockage or otherwise of the outlet tube from the gall bladder - usually caused by a stone which may or may not be seen on ultrasound.

If it isn't your gall bladder, appendix or an ectopic pregnancy - it is highly unlikely that you will require surgery, although it is difficult to make dogmatic statements without actually examining someone.

Q. I am scheduled for a lapro proceedure for this fri. As luck would have it I am in the middle of my 1st semester in Law School and the work load is crushing, to say the least. My MD has assured me that I should be able to attend classes starting Tuesday morning, assuming that does not invove any great physical activity. (There is an elevator and I can find someone to carry my books, etc.) Also assuming, of course that he doesn't have to convert to an open operation. My question is as follows: Does that timetable seem reasonable to you? I am 30 years old and in otherwise good health. (I run 4-5 miles daily). Also, at what point is it anticipated that I could resume my running? Thanks.

A. What your MD says certainly sounds reasonable and likely.

I normally advise my patients to avoid strenuous physical activity for 4 weeks, though some doctors allow such activity after 2 weeks.

Q. I have a question. I am 37. Last September I had my gall bladder removed. I have not had a normal period since. I have taken hormones, had a D&C and am currently on birth control pills. My GYN and the surgeon who operated on me insist there is no connection between the surgery and my symptoms. I know 2 other women who have had similar experiences after gall bladder surgery. (They are different ages and went to different hospitals) Have you ever heard of such a complication?

A. It is interesting that you say that you know two other women with a similar problem. However, at this point in time, there is no medical evidence to suggest that a woman's periods can be affected in any way by gall bladder surgery, and I would agree with what your surgeon and gynecologist say.

It is in fact quite difficult to even think of any remote connection between the two, so we are really looking at some other cause for the change in your periods.

Q. I am 26 weeks preganant and have found out recently that I have gallstones. I am on a low fat diet but continue to have some pain and discomfort. Is there any way to control attacks? Lowering my fat intake dramatically does not seem to be doing the trick and I'm also not gaining weight like I should be at this time of pregancy. My doctor is no help. It will be a long 3-4 months before delivery. Any advice??

A. There are no easy answers, and it is difficult for me to say if your lack of weight gain is directly related to your dieting, or to your pregnancy hormonal status.

In theory, any eating can aggravate gall bladder pain, and a low-fat diet merely holds back fat, which is among the more potent stimulants of gall bladder related pain.

You are nearly in your 3rd trimester of pregnancy - so perhaps it is best for you to try and pull along with some safe pain-killers (take your doctor's advice regarding this) and your diet until your baby is born, after which you can have your gall bladder sorted out.

Gall bladder operations have been done and can be done in pregnancy - but the 2nd trimester is probably the optimum time to operate on a pregnant woman if such surgery is absolutely mandatory. Personally, I prefer not to interfere with the gall bladder during a pregnancy if that is possible.

Q. ...anyway, back to gall stones. I am more of a alternative person when it comes to health, so surgery is the last thing I relly want to do. I have had two episodes of pain associated with gall stones within 3 months. During the first one I was diagnosed with gall stones. By looking at blood tests showing liver functioning it seems I was passing one at the time of the attack. The ultrasound revealed a 2cm stone in my gall bladder. The pain is pretty intense, you can't even think about sleeping. I ate soups, fruit and vegetables for about 6 weeks and had no problems. Then i slowing started eating more foods and sure enough I got attack #2.

I have read articles about ways to get rid of stones, you can visit one at It suggests a potion that pushes bile out (olive oil) and something to open the ducts so you get no pain (epsom salts). I've heard about olive oil and I think Ayurveda talks about the use of it for liver problems.

I have read that after surgery your colon is subject to more bile and your chances of cancer increase. I have heard some poeple complain about bloating after surgery (8 days after) and they never had bloating before.

Right now my upper-right abdomen is somewhat sensitive to touch and I know the gall bladder is full of something. It's probably stagnating or maybe it's infected? How can you tell? (No fever).

Is there danger in trying to flush out the stones?

A. Many years ago I used to be asked by patients if they could consider Ayurveda or Homoeopathy instead of surgery for gallstones, and my standard reply was that they were welcome to try. Many of them later came back with more problems for surgery and for some years now I have been personally convinced that there is no really good alternative to surgery for gall bladder stones (at this point in time).

Cholesterol, bile pigments and bile salts which are constituents of bile are really terrible substances that hardly dissolve in anything, and nature does a fine job of keeping them dissolved in bile. But once stones have formed, the mechanism for keeping them dissolved is upset and almost nothing will dissolve the stones or get rid of them easily without leading to complications or the possibility of recurring stones.

The possibility of a small increase in the incidence of colon cancer has been reported but I don't think there is unequivocal evidence to prove that people who have their gall bladders removed are at a significantly higher risk than others to develop colon cancer. The problem is that there are many other things that colon cancer has been linked to, including beef eating and constipation. I would say that the theoretical risk of a colon cancer linked to gall bladder removal is far less than the risk to life from infection of the gall bladder or from bile duct blockage by stones. Sticking to the topic of cancer and gallstones - it has been noted that most people with cancer of the gall bladder (which, unlike colon cancer, is practically incurable currently) also have gall stones, but it has not been conclusively proved that gallstones lead to gall bladder cancer. One is at risk from something or the other whichever way you look at it, and one needs to look at priorities and relative risk factors.

Most people remain well, comfortable and symptom free after they have their gall bladders removed. Bloating is a very general symptom that cannot be blamed on removal of the gall bladder alone, and eight days after surgery should be considered as the "early postoperative period" at which time many people can have some symptoms.

Unlike kidney stones. it is difficult or impossible to "flush out" gallstones, because the drainage pipe is narrow and may get blocked and may necessitate urgent surgery. You may have been lucky in having passed a small stone or perhaps sludge.

Chronic infection is an ever-present possibility in symptomatic gallstones, and some authorities have cited infection as the possible cause of the formation of gallstones in the first place. Infection may be present without fever.