The gallbladder is a small, pear-shaped organ situated beneath the liver in the upper right abdomen. Its primary function is to store and concentrate bile, a fluid produced by the liver necessary for fat digestion. A “gallbladder attack” is the common term for biliary colic or acute cholecystitis. This typically occurs when a gallstone blocks the cystic duct, causing a buildup of pressure and inflammation within the organ.
The Mechanism Linking Gallbladder Attacks and Diarrhea
Diarrhea can occasionally accompany a gallbladder attack due to the disruption of the body’s normal bile circulation. Bile acids are usually released in measured amounts into the small intestine after a meal to help break down dietary fats. The gallbladder acts as a reservoir, regulating this release. When the gallbladder is inflamed or its duct is blocked, the coordinated release of bile is impaired, disrupting its flow into the digestive tract.
This can result in bile acids being improperly processed or released in an unregulated manner. Normally, over 95% of bile acids are reabsorbed in the terminal ileum, the last section of the small intestine, and returned to the liver.
If bile acids reach the large intestine (colon) in excessive amounts, they act as an irritant and draw water into the bowel. This process, called osmotic diarrhea or bile salt malabsorption, causes watery stools and can lead to urgent bowel movements.
Key Indicators of an Acute Gallbladder Attack
While diarrhea may occur, the most telling symptom of an acute gallbladder attack is intense pain. This pain is typically located in the upper right side or upper middle part of the abdomen. The discomfort is often steady and severe, sometimes radiating to the right shoulder blade or the back.
The pain from an attack frequently starts suddenly, often following a large or fatty meal. Unlike some other types of abdominal pain, the discomfort associated with acute cholecystitis is persistent and will not resolve within a few hours.
Other common accompanying symptoms include nausea and vomiting. More serious indicators requiring immediate medical attention are fever and chills, which suggest an infection or severe inflammation. Jaundice, characterized by the yellowing of the skin and eyes, may also occur if the blockage affects the main bile duct.
Digestive Changes After Gallbladder Removal
Surgical removal of the gallbladder, known as a cholecystectomy, is a common treatment for recurrent attacks. Following the procedure, a condition called Post-Cholecystectomy Diarrhea (PCDS) can develop. This chronic diarrhea can affect an estimated 20% to 50% of people who undergo the surgery.
Without the gallbladder to store and concentrate bile, the liver continuously secretes bile directly into the small intestine. This constant, unregulated flow can overwhelm the small intestine’s capacity to reabsorb the bile acids, which then pass into the colon, causing the same irritant and water-drawing effect that leads to chronic loose stools or watery diarrhea.
Management strategies for PCDS often begin with dietary adjustments, such as limiting high-fat or overly sweet foods that trigger greater bile production. Increasing soluble fiber, found in foods like oats and bananas, can help add bulk to the stool and slow transit time. For persistent cases, medications known as bile acid sequestrants, such as cholestyramine, are often prescribed. These medications work by binding to excess bile acids in the intestine, preventing them from irritating the colon and causing diarrhea.