My mother has her gallbladder removed many years ago she avoids tomato and sour stuff and now sometimes when she eats a little bit of like potato she has severe pain in abdomen and which lasts like 12 hours and this occurs every time she eats some stuff like a little bit of tomato or potato
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Based on the textbook research, here is a thorough breakdown of what is likely happening with your mother.
Postcholecystectomy Syndrome — What's Going On
After gallbladder removal, a significant minority of patients (10–15%) develop recurring abdominal symptoms. This is called postcholecystectomy syndrome. The term covers several different underlying causes, and your mother's symptoms — episodic, severe abdominal pain lasting ~12 hours triggered by specific foods — fit this pattern well.
Here are the most likely explanations:
1. Sphincter of Oddi Dysfunction (SOD) — Most Likely Cause
This is a key suspect for episodic, severe, long-lasting biliary-type pain after cholecystectomy.
The sphincter of Oddi is a muscular valve controlling bile and pancreatic juice flow into the small intestine. Without the gallbladder acting as a reservoir and regulator, this sphincter can become dysfunctional:
- It may go into spasm or become abnormally tight (hypertonic)
- When you eat fatty or acidic foods (tomato, potato skin), the gut sends strong hormonal signals (especially cholecystokinin/CCK) to release bile — but if the sphincter doesn't relax properly, pressure builds up behind it, causing severe cramping pain that can last hours
- Pain is typically in the right upper abdomen or epigastrium, and can radiate to the back
The 12-hour duration is characteristic — this is genuine biliary-type colic, not a quick muscle cramp.
— Harrison's Principles of Internal Medicine, 22nd Ed.
2. Why Tomato and Sour/Acidic Foods Trigger It
Acidic foods and fatty foods are among the strongest stimulants of CCK (a gut hormone that signals the biliary system to release bile). With the gallbladder gone:
- Bile drips continuously into the intestine rather than being released in controlled bursts
- Acidic or high-fat foods still strongly stimulate biliary sphincter activity
- If the sphincter is dysfunctional, this creates a mismatch — strong stimulation with poor drainage → pain
Potatoes, especially when fried or with skin, can also have a significant fat and starch load that triggers this same response.
3. Other Causes to Rule Out
These are less likely given the pattern, but worth considering:
| Cause | What It Is | Why Less Likely Here |
|---|---|---|
| Retained common bile duct stone | A stone left in the bile duct after surgery | Usually causes pain with jaundice or fever |
| Bile gastritis/reflux | Bile dripping back into the stomach | Causes burning discomfort, not severe 12-hour pain |
| Irritable Bowel Syndrome (IBS) | Most common "missed" pre-existing condition | Usually doesn't cause 12-hour pain episodes |
| Peptic ulcer / GERD | Unrelated GI condition unmasked after surgery | Tomatoes worsen this too, but pain pattern differs |
| Bile salt diarrhea | Excess bile in colon → loose stools | Different symptom — diarrhea, not severe pain |
— Sabiston Textbook of Surgery; Harrison's Principles of Internal Medicine
What Should Be Done
Your mother should see a gastroenterologist. The workup would typically include:
- Abdominal ultrasound + MRCP (MRI of bile ducts) — to check for retained stones, dilated bile duct, or structural problems
- Liver function tests during or shortly after a pain episode — elevated liver enzymes point toward bile duct obstruction (SOD)
- HIDA scan (hepatobiliary scintigraphy) — assesses bile flow and can detect SOD
- If SOD is confirmed: endoscopic sphincterotomy (a minor procedure to widen the sphincter) relieves pain in ~45% of cases long-term
In the meantime, she should strictly avoid foods that trigger episodes — particularly acidic foods (tomatoes, citrus, vinegar) and high-fat foods, as these are the strongest stimulants of biliary sphincter activity.
Important disclaimer: This information is based on medical textbooks and is for educational purposes only. Given the severity and duration of her pain episodes, she needs a proper medical evaluation — these symptoms should not be self-managed long-term.
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