After removal of the gallbladder, the body loses the functions of storage, concentration, bile secretion and secretion of the gallbladder. The problem of fat digestion is that no concentrated bile enters the small intestine, the concentration of bile acids in the intestine decreases, and the content of bile salts is reduced by half compared to normal people. If the fat content of the ingested food is high, it will cause poor digestion of fat and affect the absorption of fat-soluble vitamins, after a period of time the body will gradually adapt and compensate, this process takes 2 to 3 months. Therefore, during this period of adaptation, the intake of fat should be limited, especially 1 time can not eat food containing too much animal fat. Generally, we use the method of eating less and more meals, and one meal should not be too full. Food content can be low-fat semi-liquid or low-fat soft meals, such as various kinds of porridge, noodles, bread, cookies, tofu, egg whites, fat-free milk, low-fat lean meat, low-fiber vegetables and fruits, etc. Cooking by stewing, steaming or boiling is appropriate. Fat control can be transitioned from 20 grams per day to 40 grams per day, depending on tolerance to food. After a period of adaptation after surgery, the intake of fatty foods will be gradually liberalized.
Main causes of diarrhea after cholecystectomy
Many patients with cholecystitis and cholelithiasis often have unformed, thin stools or even diarrhea for 3-6 months after cholecystectomy. The symptoms are more severe when fatty foods are consumed. This condition is medically called “fatty diarrhea”.
So, why do patients with cholecystitis and cholelithiasis have diarrhea after gallbladder surgery? This is because bile is secreted by the liver, which secretes about 800-1,000 ml of bile every day. At the same time, the gallbladder also has the function of storing and concentrating bile.
However, after the gallbladder is removed in patients with cholecystitis and cholelithiasis, the bile secreted by the liver flows directly into the common bile duct and enters the small intestine. When people eat, their digestive ability, especially the ability to digest fat, is significantly reduced because the intestine lacks a sufficient amount of highly concentrated bile to help digestion and absorption of fat. As a result, some of the poorly emulsified fatty food is excreted in the feces, at which point the patient develops diarrhea.
In addition, after gallbladder removal, a large amount of bile produced by the liver enters the intestine directly without being stored and concentrated by the gallbladder, which is also an irritant to the empty, food-free intestine and can cause diarrhea or unformed stools.
After gallbladder removal, the body gradually undergoes some compensatory changes to adapt to the needs of digestion. During this compensatory and adaptive time, the digestion and absorption of fats will be temporarily affected to some extent. After 3-6 months, according to the body’s reaction to fatty food, gradually increase some fatty food until the normal amount is maintained. If there is discomfort or diarrhea, then reduce some or temporarily do not eat fatty foods for a few days as appropriate.
Some people interpret “less fatty food” as less animal fat and no restriction on vegetable oil. In fact, this will also produce the same symptoms. Because whether it is vegetable fats or animal fats, the digestion and absorption in the intestine must be involved in bile. Therefore, if too much vegetable oil is eaten at one time, the symptoms caused are the same.
Life care after cholecystectomy.
The gallbladder is the place in the human body where bile is stored. It constantly stores and concentrates the bile secreted by the liver, and at the time of eating, the gallbladder discharges the concentrated bile into the duodenum by its own contraction to help digest fat. If the gallbladder has to be removed for various reasons, such as cholecystitis, stones, polyps, gallbladder cancer, etc., people will face a change in their physiological state due to unregulated bile. In this case, the bile will continue to enter the duodenum and not enough bile will be available to aid digestion when people eat, leading to symptoms of indigestion, such as abdominal discomfort, bloating and diarrhea.
Surgical removal of the gallbladder is an effective treatment for gallbladder stones. After surgical removal of the gallbladder, patients can obtain their own regulatory compensation after a period of adjustment and recovery, i.e., through compensatory dilation of the bile ducts, effectively maintaining the normal physiological functions of the body. As the regulation of compensatory function after gallbladder removal needs a certain period of time, the digestive function of human body should be relatively weakened at this time after all, therefore, patients after gallbladder removal surgery should pay attention to the following issues in home care.
1, dietary guidance to choose easily digestible food. In the near future after surgery, try to reduce the intake of fat and cholesterol, do not eat or eat less fatty meat, fried food, animal offal, etc. If it is necessary for taste, you can use some olive oil to cook food appropriately. To increase the protein-rich food to meet the body’s metabolic needs, such as lean meat, aquatic products, soy products, etc. Eat more foods rich in dietary fiber and vitamins, such as fresh fruits and vegetables, etc. Develop the habit of eating regularly and in small quantities to adapt to the physiological changes after cholecystectomy. The symptoms of indigestion will last about six months, and as time goes by, the common bile duct will gradually expand and will partially replace the role of the gallbladder, and the symptoms of indigestion will slowly ease. At this time, the diet can also be gradually over to normal.
2, resume a normal diet, it is advisable to maintain a low-fat, low cholesterol, high protein dietary structure, avoid eating brain, liver, kidney, fish and fried food, and should avoid eating fatty meat, alcohol, so as not to affect the function of the liver, or cause bile duct stones.
3, pay attention to mental health, often maintain emotional stability, optimism and open-mindedness, to avoid anger, anxiety, depression and other adverse emotions, in order to prevent the central nervous and plant nerve regulatory function disorders, affecting the recovery of bile duct compensatory function.
4, appropriate participation in physical exercise and light physical labor, avoid prolonged sitting and lying, too little activity, in order to facilitate the recovery of muscle function. Within two to three months after surgery, you can do activities like walking to promote the recovery of the organism.
5.Regularly review the medication as prescribed by the doctor and regularly visit the hospital for follow-up, and seek medical advice in case of any discomfort. Under the guidance of the doctor, take anti-inflammatory and biliary drugs, such as Western medicine anti-inflammatory and biliary tablets, Chinese medicine Da Chai Hu Tang combined with Jin Zhong Zi San plus reduction, and depending on the situation, supplement vitamin B, C, K, etc., which is important to protect the liver and prevent bleeding.
Specific dietary considerations.
(1) According to the symptoms and the degree of fat tolerance, fat should not be consumed excessively, and cooking with vegetable oil is advocated.
(2) The total caloric energy should not be too high on the basis of meeting the patient’s needs. Obese and overweight patients should lose weight to bring it down to the ideal weight. Calories should be supplied according to the principle of low-calorie diet.
(3) Restrict the intake of cholesterol. Cholesterol intake should be less than 300 mg per day. Limit animal fat and foods containing high cholesterol, such as offal as well as fish roe and egg yolk. Fish, lean meat, egg whites, etc. can be used.
(4) Protein should be normal or low, with a daily supply of 50 grams to 70 grams of protein, but choose protein foods containing low fat, such as skim milk, egg whites, sea fish, etc.
(5) Pay attention to vitamin intake, especially fat-soluble vitamin A, vitamin D, vitamin E and vitamin K. Vitamin K is effective in controlling bleeding caused by certain types of jaundice.
(6) Avoid irritating or gas-producing foods, such as radish, onion, etc., and prohibit smoking and alcohol.
(7) Take small and frequent meals and pay attention to drinking more water.