Did you develop IBS after having your gallbladder or ileum removed?
That might not be IBS.
Chronic diarrhea (particularly without abdominal pain) following gallbladder removal is typically caused by malabsorption of bile acids secreted by the liver.
These acids, normally stored in the gallbladder, are now dumped directly into the small intestines, causing chronic irritation and diarrhea.
It's a common side effect of surgery that patients often are not warned about in advance.
But - gallbladder surgery, or any other GI surgery, can also traumatize the enteric nervous system of your gut.
This can lead directly to the development of IBS.
So now you might have two problems.
And a wild card - there's also Idiopathic Bile Acid Malabsorption, a condition that can occur without gallbladder removal.
What to do?
Diarrhea from bile acid malabsorption can be treated with the prescription drug cholestyramine. This binds bile acids in the intestines and prevents them from reaching the colon.
The good news if you have BAM is that you don't have IBS.
The bad news is you might have to take cholestyramine for the rest of your life.
Ask your GI doctor if you may need this medication.
But! It's also possible that the surgery itself did lead to the development of IBS.
For some people IBS follows an insult to the gut.
This can mean dysentery, food poisoning, intestinal flu, abdominal surgery, even pregnancy.
Long after physical recovery from the trauma to the GI tract, the nerves within the gut retain a "memory" of the insult and remain hyper-sensitive and prone to over- or under-reaction.
This leaves people with a permanently malfunctioning enteric nervous system, a brain-gut dysfunction in the form of Irritable Bowel Syndrome.
If that sounds like you, add in a ** plain soluble (not insoluble!) fiber supplement** and gradually increase a twice daily dose.
You will probably work up to around 10 grams per day total, maybe more. That will stop the diarrhea and keep it at bay.
If you are stuck in a cycle of pain and diarrhea you can’t break ▶see here for fast help.
Tip Takeaway:** For both bile malabsorption and IBS, it's helpful to follow the low fat, high soluble fiber guidelines of the ** Eating for IBS diet and add in a plain soluble fiber supplement like Tummy Fiber. Fat stimulates bile production and worsens diarrhea. Soluble fiber helps absorb and bind bile in the GI tract and aids in its removal from the body.
You are not alone.
P.S. If you need help or have questions hit the Green Button below and I’ll try to answer every one of you!
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XOXO
Heather
Heather Van Vorous
40+ years of IBS advocacy
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