Bile diarrhea or bile acid diarrhea is an unusual, but well-known complication or outcome of a gallbladder surgery. It can affect people of all age groups and is common in both men and women. So, let us try to understand what causes this ailment and how it can be treated.
Bile is a thick yellow fluid secreted by the liver, that helps in fat digestion. During the meals, this fluid is stored in the gallbladder, a small sac underneath the liver which squeezes and releases these stored bile salts into the small intestine that aids in digestion. Once the food is digested, the salts are reabsorbed at the end of the small intestine and recycled to be used again and again. Now, when the gallbladder is surgically removed, the liver has to secrete more of these salts, and more are released between meals, since there is no place to store them. This increased amount of salts can sometimes overwhelm or overpower the small intestines' capacity to reabsorb them. The excess spills over into the large intestine, or colon, where the bile acts somewhat like a laxative, which eventually causes diarrhea and abnormal bile bowel movements.
Although the symptoms may vary, quite often many patients suffer persistent diarrhea after their surgery. The condition is so bad, that the patient experiences an urgency and watery diarrhea instantly after having meals. The condition can be extremely embarrassing especially at work or while dining with friends, as the person may have to stop and head for the closest bathroom before finishing the meal. Hence, making people reluctant to have meals away from their home.
Usually there is no particular test for bile diarrhea, however, the doctor may ask about the patient's medical history and various changes in the bowel habits. The patient may have to undergo some blood and stool tests, to determine the underlying cause. In some cases, the doctor will examine the lining of the colon through colonoscopy, to ensure that colitis and cancer are not present.
Treatment Options
No treatment can eradicate the disorder from its root, but they can lessen the symptoms and the urgency. Cholestyramine resin is the most effective medication that helps controlling the symptoms. The medication comes in a powdered form and is dissolved in 6 oz. of water before consuming. It should never be ingested or inhaled in dry form. Locholest, Locholest Light, Prevalite, Questran, and Questran Light are the different formulations available in the market.
Cholestyramine resin also comes in the tablet form called Colestid, that works by reducing the blood cholesterol by trapping and inactivating bile salts in the intestine, hence, avoiding their re-absorption. The medication should only be taken under a doctor's supervision and its recommended dosage is usually once a day. However, if you are taking other medications as well, ensure that there at least 1 - 4 hours of time interval before or after consuming cholestyramine, as it may reduce the effectiveness of other medicines. It is also known to decrease absorption of other vitamins and minerals in the body, hence, taking a multivitamin supplement every morning will help overcoming any deficiencies. Along with these medications, patients suffering from bile diarrhea should be given low fat diets, to avoid the symptoms and urgency.
Unfortunately, there is no way to prevent this condition from happening, as one can not predict its occurrence before and even after the surgery. Hence, this side effect does not reflect on the ability of the surgeon or how the surgery was conducted. Fortunately very few patients develop this ailment, and studies show that only 5% of patients suffer from it after the surgery due to prior medical history or some unhealthy eating habits.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.