Gallstones are a fairly common disorder affecting around 10-15% of the US population.1 Gallstones, also known as cholelithiasis, can also lead to inflammation or infection of the gallbladder, known as cholecystitis.1 Many patients do not experience symptoms from gallstones, but if they develop cholecystitis, their healthcare provider may recommend removal of the gallbladder to prevent further infection or pain.1 While gallbladder removal is generally considered to have limited influence on a patient’s life, less is known about the potential influence of the gallbladder on other digestive processes.
To understand the relationship between the gallbladder and irritable bowel syndrome (IBS), ulcerative colitis (UC), and Crohn’s disease, we analyzed data from 1,146,795 patients with diagnoses of cholelithiasis or cholecystitis who retained their gallbladder and compared them to 809,206 patients who went on to have their gallbladder removed. Patients with a history of IBS, UC, or Crohn’s disease before having gallstones were excluded for analysis of the condition for which they had a historical diagnosis. We adjusted for patient age, race, ethnicity, Social Vulnerability Index, rural or urban classification, BMI, and various comorbidities, including cancer, HIV, cystic fibrosis, splenectomy, or organ transplants.
In the one to three years following cholelithiasis or cholecystitis diagnosis, patients who had their gallbladder removed were 19% less likely to be diagnosed with Crohn’s and 18% less likely to be diagnosed with UC compared to those who did not have their gallbladder removed. In contrast, patients who had their gallbladder removed were 14% more likely to be diagnosed with IBS.
A sensitivity analysis assessing the relationship of biliary perforation and gallbladder removal showed a high correlation, which aligns with previous findings.2
