If you’re dealing with painful gallstone episodes, your healthcare provider has probably brought up gallbladder removal surgery as a potential treatment. It’s the best way to prevent future gallbladder attacks, which is why over a million people in the United States undergo gallbladder removal surgery each year. Still, you want to have all the information before you decide whether surgery is right for you.
Aside from questions about digestion after gallbladder removal, liver function is one of the main concerns some people have before gallbladder surgery. Your gallbladder and liver work together to aid digestion, but your liver can also work just fine on its own. Read on for a breakdown of what gallbladder removal may mean for your liver.
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Your liver has a lot of jobs—more than 500, to be exact. It’s in charge of processing blood after it leaves your stomach, breaking down nutrients, balancing chemical levels, and metabolizing drugs so your body can use them. Your liver also creates a digestive fluid called bile, which helps break down fats in the foods you eat.
Your gallbladder is a small organ that lies right below your liver. Its job is to store bile created by the liver until it’s needed for digestion. When you eat, your body releases a hormone called cholecystokinin (CCK), which tells the gallbladder to start letting bile travel through the bile ducts and into the duodenum (where the small intestine meets the opening of your stomach).
Sometimes, problems with the gallbladder or bile can lead to hard, crystallized deposits called gallstones. Gallstones typically only need treatment if they get lodged in the bile duct. That’s when they can cause abdominal pain, nausea, and vomiting. (This is called a gallbladder attack.) If you experience frequent or severe gallbladder attacks, your provider may recommend gallbladder removal surgery.
After gallbladder removal surgery, your liver will continue to make bile just as it did before. Instead of excreting it into the gallbladder for storage, your liver will release the bile straight into the small intestine. This may cause some digestive issues at first, like bloating, diarrhea, or an upset stomach after eating fatty foods. However, most people can eventually return to their normal diet after gallbladder removal.
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Because the gallbladder and liver work closely together to aid digestion, you may wonder about the long-term effects of gallbladder removal on liver health. More research is needed to fully understand the relationship between gallbladder removal and different liver conditions. So far, large-scale studies have produced conflicting results.
While some studies have found a link between gallbladder removal and liver cirrhosis, metabolic syndrome, or nonalcoholic fatty liver disease (NAFLD), others have found the opposite to be true. So, why the discrepancy?
It’s difficult to separate causation and correlation between gallbladder removal and these liver conditions. That’s because gallstones have many of the same risk factors as liver problems. For example, a high-cholesterol diet can raise your risk of gallstones, metabolic syndrome, and nonalcoholic fatty liver disease. Other shared risk factors include leading a sedentary lifestyle, being overweight or obese, and having type 2 diabetes. And nonalcoholic fatty liver disease can eventually lead to cirrhosis.
The combined risk factors work both ways, too—liver disease can also increase your risk of gallstones.
The two organs are closely linked. So, it can be difficult to figure out whether certain liver conditions were caused by gallbladder removal. They may have been caused by the same factors that contributed to gallstone formation in the first place. If your concerns about your liver health are keeping you from scheduling your gallbladder removal, talk to your healthcare provider. They can help you understand the relative risks of getting the surgery versus the risk of living with gallstones.
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If you have gallstones, whether or not you decide to have surgery, you may want to take steps to care for your liver health and lower your risk of future liver disease. Usually, this can be done through healthy lifestyle changes, including:
- Reaching and maintaining a healthy weight. This can lower your risk of high blood pressure, type 2 diabetes, gallstones, and liver problems. It may also increase “good” cholesterol (HDL) and lower “bad” cholesterol (LDL) and triglycerides. This can help treat or prevent metabolic syndrome.
- Eat a healthy diet. Try to switch out foods with saturated and trans fats for those with heart-healthy monounsaturated and polyunsaturated fats, like nuts, fish, and olive oil. Include plenty of whole grains, fruits, vegetables, and lean protein in your diet, too.
- Exercise regularly. Physical activity can help you grow muscle tissue while losing fat, which can help improve your overall health and lower your risk of many health conditions, including type 2 diabetes, gallstones, and liver disease. If it’s been a while since you exercised, talk with your provider for advice on safely beginning a new exercise routine. Walking is a great place to start!
- Quit smoking. Smoking is a known risk factor for nonalcoholic fatty liver disease, and it can also speed up liver disease progression in those with NAFLD.
- Cut back on alcohol consumption. Excessive alcohol consumption can contribute to fatty liver disease, alcoholic hepatitis, and cirrhosis, all potentially serious liver conditions. The best way to protect your liver from alcohol damage is to drink in moderation—no more than two drinks a night for men or one for women—or not at all.
For help drinking less, check out this list of tips and resources from the CDC.
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If painful gallbladder attacks are affecting your quality of life, it may be time to consider gallbladder removal surgery. Making healthy lifestyle changes before and after your surgery can help protect your liver health for years to come. For more information about gallbladder removal, including how much you should expect to pay, read our blog post: How much does gallbladder removal surgery cost?