What to do if your gallbladder has been removed: post-operative care for digestive health

Life after gallbladder removal.

If you have had your gallbladder removed, there is one very important piece of post operative advice that you should have been given, but likely were not. 

So here it is: when you eat a fatty meal, you should take ox bile along with it. 

Now, I have no idea why it’s not standard medical care to give this simple piece of advice after your cholecystectomy. Most likely because the Western medical system simply isn’t built for prevention. For example, you were likely not provided with the preventative treatment options to avoid the gallbladder removal in the first place.

If your gallbladder hasn't been removed yet, check out my article on gallbladder health.

Having your gallbladder removed isn’t the end of the world though, and life can be easier if you adopt the simple practice of taking ox bile with meals. 

To understand why this is important, let’s talk about what the gallbladder does. Bile is an alkaline digestive fluid that breaks down fat, allowing us to digest and absorb fat. Bile is made in the liver, and stored in the gallbladder.

When you eat a fatty meal, your body senses the incoming fat, and your gallbladder contracts and squirts a healthy dose of bile into the duodenum (the upper part of the small intestine) to start breaking down the fat from your meal. The bile emulsifies the fat, breaking it down into smaller particles so it can be absorbed. 

When you don’t have a gallbladder, your liver continues to make bile. Only now your body has nowhere to store it, so the bile just slowly drips into the duodenum at a slow and steady pace. This would be fine if that’s also how you consumed fat. But we tend to eat several meals throughout the day, rather than little nibbles of fat all day, hence the evolution of the gallbladder to store bile. 

In your post op instructions, you were likely given advice to significantly reduce your fat intake.

The problem with that is that fat is a very important aspect of a nutritionally complete diet, and your body will crave fat since it needs it. So after gallbladder removal, most people will limit their fat intake for a while, but eventually just go back to eating normal amounts of fat.

This usually results in one of two things: diarrhea or constipation.

When the fat isn’t broken down by bile, it often will just run through you - the diarrhea side of things. On the other hand, it’s also not uncommon for this undigested fat to gum things up and slow down bowel motility - resulting in chronic constipation. 

Among all the post op complications one can have from surgeries, this is one of the easiest to fix. Ox bile, also called bile salts, are a supplement made from dried bovine bile, which is functionally near identical to human bile.

So you don’t have a bile storage device to time your bile release anymore. But you can simply take ox bile with fatty meals, and this will simulate the effect of your own gallbladder releasing bile at the proper time. 

There are a few important things to know about taking ox bile. 

1. You want to take a capsule, and then eat some food right afterwards to make sure the capsule makes its way down your esophagus. Bile is a very alkaline substance, and you don’t want the capsule getting stuck and opening in your esophagus. It will cause an uncomfortable burning sensation. Easily avoided by taking it in the middle of your meal, and eating more afterwards. 

2. For most people a smaller dosage is better. 125 mg pills are just about right for most people. 500 mg is probably more than you need, and may lead to a gnawing hunger sensation in your duodenum as the alkalinity overwhelms the stomach acid balance. If you are crushing an entire cheese pizza, maybe 500 mg is a good match. You can find the dose that works best for you with trial and error. In either case, it's easier to titrate the dosage with a smaller capsule to begin with.

3. You want to take ox bile when eating fatty meals. You probably don’t want to take it if you’re just eating an apple or a salad. 

You can also benefit from clinical herbal medicine treatment. 

If you’ve had your gallbladder removed, there’s a good chance you may have additional digestive symptoms or other complex health problems that won’t be resolved as simply as taking ox bile. You can benefit from Chinese herbal medicine treatment at any stage of life, whether for prevention, treatment of mild annoyances, or treatment of moderate to severe health issues. 

Ready to get started with healing your digestion using clinical herbal medicine?

Visit my herbal clinic page to schedule your first consultation, find more information on the treatment process, cost, herb quality, and more. 

Sincerely, Sean Dugan L.Ac.

Sean Dugan L.Ac. is a licensed and board-certified herbalist and acupuncturist. He holds a Master’s degree in Chinese Medicine from the Oregon College of Oriental Medicine as well as a Diplomate in Chinese Medicine from the NCCAOM. He has studied under many Master Herbalists including Dr. Guohui Liu, Dr. Jimmy Wei-Yin Chang, Dr. Fang Zhang, Dr. Greg Livingston, and Dr. Darren Huckle. Sean’s herbal medicine practice draws from both Traditional Chinese Medicine and Classical Chinese Medicine treatment methods, with a focus on clinical efficacy above all. He has been treating patients with Chinese Herbal Medicine since 2013. 

Sean works with clients all over the US through the Folkwise Herbal Clinic. In-person appointments are available at our Boise, Idaho clinic.