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Dr. Rajesh Patel, MD.
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Ask the Doctor!
December 2009
Q:
I’m having my gallbladder removed soon and came upon several articles that said removing your gall bladder increases your chance of colon cancer. Have you heard of this or know why?
-- - Roni Ann, Cobden, IL
A:
This is a very interesting and long-debated topic. According to the current consensus, there does seem to be a statistically increased risk of colon cancer after undergoing surgical removal of the gallbladder (cholecystectomy). This association can possibly be explained by the fact that an absent gallbladder will lead to quicker passage of bile acids and less breakdown of fat. In turn, there may be higher chances of structural disruption to the intestinal lining, possibly leading to an abnormal growth.
Given this moderately positive correlation, one may wonder if an elective cholecystectomy is really a good option. However, it is critical to realize that this common procedure has a significant role in the prevention of disease and it is often life-saving. A cholecystectomy may be performed for several reasons including the presence of inflammation/infection (cholecystitis), gallstones (cholelithiasis), or cancerous tissue.
Be especially mindful of any red flags like fullness or pain in the right upper abdominal area, as well as right shoulder pain, nausea and vomiting. Symptoms are often related to eating heavy meals. Gallbladder disease may also present with symptoms mimicking other conditions or have no symptoms at all.
A cholecystectomy can be performed through either an open method (one incision) or through laparoscopy (multiple, smaller incisions). The latter method is generally preferred due to a shorter recovery time. Patients who undergo a cholecystectomy may begin to experience some symptoms such as bloating, abdominal pain, nausea, vomiting, and diarrhea. This is commonly known as "Post-Cholecystectomy Syndrome" (PCS). As with any surgery, a cholecystectomy may also carry risks such as possible damage to surrounding tissue, bleeding, and/or infection.
In most cases, the benefits profoundly outweigh the risks in terms of this procedure. And despite an appreciable association, the minimal risk of colon cancer should not deter an individual from undergoing this important surgery when indicated. Furthermore, we can preemptively screen ourselves for colon cancer through a routine colonoscopy at age 50. So we try to detect colon cancer in all individuals, regardless of whether or not someone has had a prior cholecystectomy. Like with all medical issues, it is important to thoroughly discuss the pros and cons of any procedure with your doctor. Together, you will come up with the best plan geared to your specific needs.
Submit your questions to askthedoctor@nowoodennickels.org
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