Ask a doctor on the topic of Internal medicine

intestinal problems

November 23, 2012 | 20,00 EUR | answered by Dr. med. Kathrin Hamann

Hello,
In December 2011, my gallbladder was removed with 3 very large stones.

About 1 month later, I noticed the following, which continues to this day:

I have no problem with certain foods. I can eat everything in the evenings and have no complaints. Regardless of whether it is high in fat, large quantities, alcohol, etc., my body seems to handle it fine. However, if I eat more than just a toast for breakfast (e.g. a large breakfast on Sundays), after about 15 minutes I have a very urgent need to go to the bathroom. In 95% of cases, I have loose stool, sometimes very watery. After that, I either feel fantastic or tired. Similar during lunch: if I ate very little in the morning and eat a good lunch, it's the same. Not real pain, but a pulling sensation with sudden bowel movements. The pulling is always at the level of the bladder. I can almost set my clock by it: always 15-20 minutes after the meal. This does not happen if a) I have eaten everything in the morning, or b) have had one or two small meals before. Like I said... never in the evenings.

The question that arises for me: where does this come from? Why is it like this? Do I need to do something about it? Is it harmful if I continue to live like this? So if I have a toilet nearby, it doesn't bother me because it is also a relieving feeling, but I can't imagine that it is healthy if the stool is never formed and there is something behind these symptoms.

I have asked my general practitioner as well as the surgeon, as one often hears about post-cholecystectomy syndrome. My general practitioner only said it couldn't come from the gallbladder and there was something with a "barrier" or something like that and it would straighten itself out. The surgeon says something similar. But I still have concerns. Furthermore, I also don't tolerate coffee, energy drinks, and other highly caffeinated beverages that strongly stimulate my intestines. Then I usually have an immediate urge to defecate with loose, sometimes watery stool. Is it harmful if I still continue to drink coffee? I can't find anything about this on the internet. Most people seem to be plagued with the opposite and have constipation. I can't remember the last time I skipped a day of using the toilet.

Thank you for your help.

Dr. med. Kathrin Hamann

Good day,

Do you drink coffee with milk? Do you eat your toast with butter? These contain proteins that usually stimulate the gallbladder to contract. However, in the absence of collected bile from the no longer present gallbladder, there can be a quick passage through the intestines, leading to a rapid bowel movement. This is mainly due to the proteins in milk, cheese, butter, or margarine.

Caffeine and theine (from coffee, Red Bull, black tea) stimulate bowel activity, so after just one cup of tea or coffee, you may feel pressure in the intestines and the urge to have a bowel movement. This is not uncommon. Often, a kind of conditioning is also involved. In the morning, the intestines are filled with the night's digestion, which wants to be emptied quickly, especially in the morning.

Additionally, the movement in the morning after a night of rest in bed affects bowel movements. This movement of the body, the upright posture instead of lying down, also influences bowel movements in the morning. This can happen after the first bite (so-called gastro-colic reflex) or after the first cup of coffee.

Your question about what you can do about it?
Actually, nothing. As mentioned above, it is not uncommon. Be happy about a functioning bowel with successful bowel movements. Conversely, if you were suffering from constipation, your suffering would be much greater.

Do you have any questions about this? I am happy to help you further.

All the best and a speedy recovery!

Kind regards,

Dr. K. Hamann