What happens to bile when the gallbladder is missing?

When the gallbladder is removed, bile still continues to be produced by the liver. However, since the gallbladder is responsible for storing and concentrating bile, its absence affects the way bile is delivered to the small intestine:

1. Continuous Bile Flow: Without the gallbladder, bile flows continuously from the liver into the small intestine instead of being stored and released as needed. This can lead to a decrease in the concentration of bile salts, which are essential for the digestion and absorption of fats.

2. Impaired Fat Digestion: The reduced concentration of bile salts impairs the emulsification of fats in the small intestine. Fats require bile salts to be broken down into smaller droplets so that they can be efficiently digested by enzymes and absorbed. As a result, individuals who have undergone cholecystectomy (gallbladder removal) may experience difficulty digesting fatty foods, leading to potential malabsorption and nutrient deficiencies.

3. Diarrhea: The continuous flow of bile into the small intestine can also lead to diarrhea. This is because the bile salts irritate the intestinal lining, causing increased fluid secretion and faster movement of food through the digestive tract.

4. Postcholecystectomy Syndrome: Some individuals may develop postcholecystectomy syndrome (PCS) after gallbladder removal. PCS is a group of symptoms that can include abdominal pain, diarrhea, bloating, gas, and indigestion. It is thought to be caused by changes in bile flow and digestion after the removal of the gallbladder.

Despite the absence of the gallbladder, the liver continues to produce bile, but its flow and function in the digestive process are altered, leading to potential digestive issues, particularly with the digestion and absorption of fats.