Symptoms of Post Cholecystectomy Syndrome

The surgical method used for removal of gallbladder is termed as cholecystectomy. Gallbladder is a small organ but has a vital role in the digestive function of the body. It is located very close to the liver in the upper part of the right abdominal cavity and the bile juice released by the liver is stored inside the gallbladder. Bile is an important digestive juice used during digestion for breaking down fatty food substances.

Cholecystectomy is performed when gallstones are formed inside the gallbladder and prevent proper bile flow from it. Post cholecystectomy syndrome or PCS, in short, refers to the complications that arise after the gallbladder is surgically removed.

As the gallbladder is actively involved in the digestive process, its removal has an adverse impact on the overall digestive system. The symptoms of post cholecystectomy syndrome are quite different in every individual's case. The most commonly observed symptoms and the reasons behind them are explained here:

• After cholecystectomy, excess amount of bile gets released directly into the digestive tract as there is no storage facility for the extra bile released by the liver. This causes pain in the lower part of the digestive tract. The intensity of the pain can vary from a dull lower abdominal pain to a sharp stabbing pain.

• One more effect of extra bile flow into the digestive tract is gastritis, which is characterized by inflammation of the stomach lining. This increased amount of bile often tends to flow back into the esophagus and leads to esophagitis, where inflammation occurs in the lining of the esophagus. As a result, a burning pain is experienced in the upper part of the abdomen and chest. Damage in the tissues of esophagus can cause swallowing difficulty.

• Some patients develop jaundice after cholecystectomy. This condition arises when a bile pigment named bilirubin gets accumulated in the mucus membranes, white portion of the eye and skin. It can be identified by a yellowish discoloration in these parts of the body.

• Some people are prone to common digestion related problems like diarrhea soon after cholecystectomy and get watery bowel movements quite frequently. In most cases, this symptom lasts for just a few months but there are people who suffer from this problem for a longer period of time.

• Irritable bowel syndrome (IBS) is another annoying side effect that refuses to go for a long time. This disorder affects the large intestines and it starts contracting abnormally during bowel movements. This results in recurrent bouts of constipation and diarrhea alternately.

• Many people suffer from gastroesophageal reflux disease (GERD). In this condition, the stomach contents flow backwards, enter the esophagus and cause irritation there due to which symptoms like heartburn are felt that gets aggravated when you lie down or bend forward.

Prior to the treatment of post cholecystectomy syndrome, a thorough diagnosis of the problem is a must. An open discussion between the patient and the doctor is needed and is followed by a series of laboratory tests such as X-rays, blood test, CT scans, etc.

The treatment is then based upon the underlying problem. IBS is often treated with suitable medicines that can calm down the abnormal contraction in the bowel.

IBS related constipation can be relieved with the inclusion of dietary fiber. One can get relief from diarrhea with cholestyramine medicines. GERD symptoms are controlled with proton pump inhibitors that can reduce the level of stomach acid. It is often combined with antacids, which are equally effective for this purpose. 

These patients have to follow a proper diet that includes fresh fruits, vegetables and lean proteins. Patients have to cut down on fatty foods particularly saturated fats. Processed foods, refined carbohydrates and sugary foods are not good for them. In certain cases, the doctor may conduct another surgery to ensure proper drainage of the bile juice.

Finally, I would like to tell you that the above symptoms are not observed in every single person who has undergone the surgery. However, if you have had surgery, then you must be watchful of the symptoms discussed in this article. There is no time frame for the occurrence of these symptoms. They may show up just after the surgery or may take several years to come.