Medical Edge Newspaper Column

Will Gallbladder Surgery Aggravate Irritable Bowel?

November 25, 2007
Dear Mayo Clinic:
I am a 50-year-old woman. I have some abdominal pain and irritable bowel syndrome. My doctor found polyps in my gallbladder, and a surgeon said my gallbladder should be removed. Are gallbladder polyps worrisome? Do I have to have surgery? I am concerned that an operation could upset my IBS.

Answer:
Most gallbladder polyps — growths in the lining of your gallbladder — aren't cause for concern. They are more common in men and can sometimes be cancerous, but that's rare. The size and growth pattern of the polyps help determine your risk. Polyps smaller than 1 centimeter usually aren't cancerous and generally don't require treatment. Polyps larger than 1 centimeter, or those that grow rapidly, are more likely to be cancerous, and the standard treatment for them is gallbladder removal (cholecystectomy). Removal of your gallbladder also may be wise if you have a gallbladder polyp of any size along with gallstones, which increases your risk of gallbladder cancer.

If the polyps are smaller than 1 centimeter, and you don't have gallstones, removal of your gallbladder probably isn't necessary. But, you need to have the polyps monitored with follow-up appointments about every six months. At those visits, your doctor will check the size and appearance of the polyps using ultrasound. If they grow or if the way they look changes — possible signs they are cancerous — surgery to remove your gallbladder will likely be necessary.

If you need to have your gallbladder removed, the good news is that it's often done using minimally invasive laparoscopic surgery. With this procedure, the surgeon uses several small incisions to access and then remove the organ. Recovery time is shorter and involves less pain and scarring than if you have open surgery with a large abdominal incision.

You may also find some comfort in the fact that gallbladder surgery isn't likely to make your irritable bowel syndrome (IBS) worse. In fact, there's a chance your gallbladder may be causing some of your abdominal discomfort, and removing it might improve your symptoms. In some cases, gallbladder removal may cause chronic diarrhea. For most people who develop this complication, it goes away on its own over time.

You also may be able to reduce IBS symptoms, like abdominal discomfort, by learning more about what triggers those symptoms. Certain foods, medications and stress may make your symptoms worse. Diet and lifestyle changes, along with medication, may offer relief. Learn more by researching IBS and exploring what makes a difference for you. Organizations like the American College of Gastroenterology offer patient-friendly information that can get you started.

— Amy Foxx-Orenstein, D.O., Gastroenterology, Mayo Clinic, Rochester, Minn.