Is it true that after having the gallbladder removed there is a greater risk of colon cancer caused by the constant release of bile into the small intestine? Also, can taking bile acid supplements help to prevent colon cancer caused by this condition, and as these seem to all be made from bovine bile, are they safe? Are there any supplements or nutritional alternatives to help with this condition?

The idea that having the gallbladder removed affects the risk of colon cancer was explored in a study of nearly 56,000 patients in Great Britain’s General Practice Research Database. The investigators, from the University of Pennsylvania, found a very small increased risk of colon cancer among these patients. Their data suggested that of every 10,000 patients who had their gallbladders removed, 119 would develop colon cancer within 10 years. That compares to a slightly lower rate of colon cancer among the same number of British patients in this study who didn’t have gallbladder surgery: 86 of them developed colon cancer in the same period of time. No higher risk of rectal cancer was seen among the patients who had gallbladder surgery. The study was published in the August, 2005, issue of the American Journal of Gastroenterology.

I discussed your question with Tieraona Low Dog, M.D., director of The Fellowship at the Arizona Center for Integrative Medicine. She noted that the explanation for this very slight increase in colon cancer risk might be due to the poorly digested fat and the bile acids, both of which are irritating to the colon. Dr. Low Dog said that some individuals feel better if they take a basic digestive enzyme after having their gall bladder removed. Various enzyme products are available to help the body digest fat. Dr. Low Dog explains that some of these contain ox bile, while others contain lipase (available from both animal and plant sources).

Whether this strategy might reduce the slight increase in colon cancer risk is unclear, Dr. Low Dog said. Whether you have had gallbladder surgery or not, Dr. Low Dog recommends addressing the risk of colon cancer by avoiding processed red meat, limiting red meat to no more than 12-18 ounces per week, eating plenty of fiber-rich foods, including fresh fruits and vegetables, exercising regularly and maintaining a healthy weight. I agree, and I also suggest speaking with your physician about taking low dose aspirin – two baby aspirin (162 milligrams) every day. Beginning at age 50, regardless of the status of your gallbladder, everyone should be screened periodically for colon cancer.

Author: Andrew Weil, M.D.