Q. After cholecystectomy for rapid weight loss, I experience postcholecystectomy syndrome. Please help.

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 24, 2020 and last reviewed on: Jun 06, 2020

Hello doctor,

Over a year ago, I scheduled an appointment to try to understand why I was rapidly losing weight. My gastroenterologist ran some tests and did an upper endoscopy as well as a HIDA scan. The upper turned out negative for all tests however the HIDA scan reported that my gallbladder was functioning at approximately 40%.

My GI then recommended a cholecystectomy as my gallbladder was not functioning properly. He did also suggest that I could try to repair it with my diet but then told me it would likely be fruitless and I should get the procedure right away. I did so promptly and experienced the typical symptoms. I am concerned about this only now because I believe I have postcholecystectomy syndrome due to the surgery. This would not be an issue relatively however I believe that my rapid weightloss was due to extreme stress and was mostly psychological. It seems to me that my practitioner should have advised me that gallstones occur commonly when rapid weight loss occurs. Furthermore, I believe that I could have benefited much more from keeping my gallbladder on a rigorous healthy diet and prescribing a biliary control. The latter that has taken place has resulted in a year long constant struggle to be happy and healthy.



Welcome to icliniq.com.

Well, I understand that a year back you have been diagnosed with gallbladder dyskinesia or dysmotility as reported by HIDA scan. I was wondering whether you have weight loss as the only primary symptom or associated with abdominal pain. Because gallbladder dyskinesia most commonly causes pain and diarrhea rather simply weight loss. Or one should have to have evidence that the weight loss was due to gallbladder dyskinesia and not otherwise, then surgery was probably the right decision. I cannot figure out whether you have other symptoms or not.

And now what sort of typical symptoms you feel suggesting you as postcholecystectomy syndrome (PCS). I can understand actually that symptoms of PCS can be at times very distressing and unbearable. The common symptoms are bloating after meal, freqeunt reflux or pain in the upper part of the belly, diarrhea after meals or sometimes otherwise, and this even can cause weight loss. This syndrome basically occurs secondary to an excessive pool of bile stored within a small bowel instead of gallbladder which is otherwise a sole bile reservoir. But PCS usually resolves within some time the maximum it can take is two to three years until the time your small intestine is adapted to it.

You can try tablet Cholestyramine 4 gm twice daily 1 hour before meal or 4 hours before meals. This is a bile sequestrant and will bind and remove excessive bile from the gut.

To be honest, I still do not understand the reason for your surgery year back but cannot completely argue with physician because I was not and he was the best person to decide while understanding your condition at that time.

The Probable causes:

Postcholecystectomy syndrome.

Regarding follow up:

Follow up in two weeks.

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