Two and a half-ish years ago (late February 2024) I had emergency surgery to remove my gallbladder. I had been meeting with a nutritionist about my digestive issues for a couple years (after trying to figure diet improvements out myself), and working my way through tests and specialists trying to hunt down the source of my issues: H. Pylori test, low FODMAP+ elimination diet, trying to regulate my cortisol levels better, taking a proton pump inhibitor, probably more I don’t remember… Turns out, I just had atypical symptoms and/or described them poorly, which made me skeptical* when I finally got the diagnosis.

I do think someone ought to have referred me to a gastroenterologist years earlier. (This was building up for a long time — looking back I had a memorably bad attack in October 2019, but that wasn’t the first one. The doctors I talked to before said it sounded like IBS.) The gastroenterologist dx’d me using an abdominal ultrasound right away — I had lots of gallbladder sludge. But I spent years trying weird remedies like aloe vera juice and slippery elm bark, which are supposed to coat your throat and protect it from acid reflux.

Eating without a gallbladder

Digestive enzyme pills

Your gallbladder stores up bile and releases it when you eat a fatty meal. Now I don’t have anywhere for bile to store up — the same amount of bile just flows regardless of what I’ve eaten. I take a digestive enzyme before meals that I suspect may be hard to digest. I tried a vegetarian one but switched to one with ox bile that works better (sorry / thank you oxen). Sometimes I’ll think I’m fine then as I’m eating realize I should have taken one — I’ll take it up to 15 minutes after eating, though before is better.

Foods I can’t* eat post-gallbladder

- leafy salads

- large quantities of raw veg (potentially with fat)

- cooked broccoli

- peanut butter (in dishes / baked seems fine) and peanuts (in a sizeable quantity anyway)

- spicy foods — I can do mild Thai curries but not Indian — Indian pizza is also out 😔

- coffee cake with thick buttery streusel

- whole milk drunk straight (not sure about this, but I drank it so infrequently anyway it’s easy to cut out)

- pure dark chocolate (brownies and chocolate chip cookies seem fine, chocolate pudding is ok) — luckily I’m not big on chocolate

Foods that (surprisingly?) cause no trouble

- ice cream

- milkshakes

- whole fat Greek yogurt

- beans and lentils

- oatmeal

- raw apples and carrots (at least in moderation)

- nuts other than peanuts

Foods I should definitely take a digestive enzyme with

- quiche

- fried foods (like fake meat burgers and tater tots)

- pizza or anything else with large amounts of cheese

My new eating habits

I can also get tripped up by eating too much at once. I now eat three main meals plus aim for two snacks (late afternoon and evening) to get enough calories. This is probably healthier, it’s just marginally annoying that it feels like I’m always either eating, digesting, or hungry 😂 (Plus I like laying down to read, but while I’m digesting I need to sit upright.)

Ginger chews work surprisingly well as a response to indigestion (I can’t take antacids with one of my meds). I get acid reflux only occasionally now (less than once a month?), and usually only if I lay down too soon after eating.

Since surgery

My IBS symptoms are greatly improved, to the point I suspect the IBS was the gallbladder all along. I do still get bloated at night sometimes — I find that taking my evening medicine at 9:30 and 11pm “reawakens” my digestive system, plus I often have my late snack between 9-10pm.

I only recall one instance of phantom gallbladder pain. Some of my back pain seems to have fallen off after the surgery — I suspect gallbladder pain was being referred there. (It can be referred to the upper back / shoulders.)

My largest scar from the laparoscopic surgery, right under my sternum, has loosened up some — it pulled at first if I stood up straight so I caught myself kinda stooping. The nerves seem to have mostly reconnected — there’s one part of the scar that feels numb-ish, and I have low sensation for about an inch below that.

Maybe this sounds like a bad deal if you have a choice about keeping your gallbladder or having it out, but this feels more predictable and thus easier to manage than inconsistent gallbladder attacks that I couldn’t trace back.

So what caused my gallstones anyway?

After my surgery, women who’d had their gallbladders out came out of the woodwork — seems to be quite common for women past their late thirties. Apparently women who take birth control pills are much more likely to have gallbladder problems*. I’ve been taking birth control pills steadily since 2008.

I also wonder whether losing weight contributed — fast weight loss can exacerbate gallstone formation. I started some medications that suppress appetite in 2021 and lost 20+ pounds relatively quickly.