- With Mayo Clinic gastroenterologist
Michael Picco, M.D.
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Michael Picco, M.D.
Michael Picco, M.D.
Dr. Michael F. Picco has been with Mayo Clinic since 1999. He is board certified in internal medicine and gastroenterology. Dr. Picco is an assistant professor of medicine at Mayo Clinic College of Medicine and a consultant in gastroenterology at Mayo Clinic in Florida.
He has authored numerous publications in the area of gastroenterology, including original research, editorials and textbook chapters. He works with a team of gastroenterologists that takes care of complex gastrointestinal conditions and has a particular interest in diarrheal illnesses and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). He is also active in medical education in training new gastroenterologist and internists.
"MayoClinic.com is an invaluable resource for patients and their families," Dr. Picco said. "Informed patients are better able to participate in their own health care. A patient's participation is vital to the treatment of his or her disease. I hope to assist in helping patients understand their digestive problems and current treatments that are offered. This will allow for better communication between patients, their physicians and other health care professionals."
Dr. Picco serves as a reviewer of new research for several medical journals in the area of gastroenterology and is an active member of the American Gastroenterological Association, American College of Gastroenterology and the Crohn's & Colitis Foundation of America. He serves on numerous committees that address physician training, research and clinical practice in gastroenterology, both at Mayo Clinic and at the national level.
"Patients need to know about their disease, what to expect, the latest treatments and side effects so that they can make informed decisions about their health care. Gastrointestinal disease affects not only patients but also their families. My goal is to assure that our Web site provides accurate, reliable information and resources for patients. We must always provide the latest, most cutting-edge information to assist patients in dealing with their medical problems," Dr. Picco said.
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Question
Chronic diarrhea: A concern after gallbladder removal?
I had my gallbladder removed six months ago, and I continue to have problems with diarrhea. Is this unusual? Is there anything I can do about it?
Answer
from Michael Picco, M.D.
It's not clear how many people develop diarrhea after surgery to remove their gallbladders (cholecystectomy). Studies have found as few as one in 100 people undergoing gallbladder surgery or as many as one in three develop diarrhea. The diarrhea may last for years.
The cause of diarrhea after gallbladder removal isn't clear. Some experts believe that it results from an increase in bile, especially bile acids, entering the large intestine — which may act as a laxative.
Treatments you and your doctor may consider for controlling your diarrhea include:
- Anti-diarrheal medications, such as loperamide (Imodium A-D)
- Medications that impair absorption of bile acids, such as cholestyramine or aluminum hydroxide
Talk to your doctor about your options. You may also consider limiting foods that can worsen diarrhea in general, including:
- Caffeine
- Dairy products
- Greasy foods
- Very sweet foods
- Fisher M, et al. Diarrhoea after laparoscopic cholecystectomy: Incidence and main determinants. ANZ Journal of Surgery. 2008;78:482.
- Fort JM, et al. Bowel habit after cholecystectomy: Physiological changes and clinical implications. Gastroenterology. 1996;111:617.
- Ros E, et al. Postcholecystectomy symptoms: A prospective study of gallstone patients before and two years after surgery. Gut. 1987;28:1500.
- Sauter GH, et al. Bowel habits and bile acid malabsorption in the months after cholecystectomy. The American Journal of Gastroenterology. 2002;97:1732.
- Hearing SD, et al. Effect of cholecystectomy on bowel function: A prospective, controlled study. Gut. 1999;45:889.
- Phillips SF. Diarrhea after cholecystectomy: If so, why? Gastroenterology. 1996;111:816.
- Hutcheon DF, et al. Postcholecystectomy diarrhea. JAMA. 1979;24:823.
- Arlow FL, et al. Bile acid-mediated postcholecystectomy diarrhea. Archives of Internal Medicine. 1987;147:1327.
- Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/index.htm. Accessed Jan. 26, 2009.
