Question:

I`ve had ulcerative colitis for many years. Recently I had to have my gall bladder removed. A couple months later my feet started swelling and it was determined to be edema due to protein deficiency. I was given a protein IV which resolved the problem.

Now, about a month later, my feet are swollen again. I`m on a pretty low fat diet due to the colitis, but I get a decent amount of protein in my diet, regularly eating turkey, chicken, eggs, and cereal with soy milk. I`ve been told that due to my colitis, I have a problem with protein absorption. I never had a problem with this before the gall bladder was removed, and I`m pretty sure I often went with eating less protein before that surgery and never had a problem. Now, I feel like I should be getting enough and I`m having edema problems. Would the gall bladder removal be causing some of this or do I just need to seriously increase my protein requirements? Any other thoughts?

Oh, and I`m a 38 year old white male and I`m not on any medications because the normal colitis meds seem to make me worse instead of better.

Answer:

Thanks for your question.  It sounds as though you’ve had quite the ordeal since your cholecystectomy (gallbladder removal).

From what you are describing (lower extremity edema), you may be experiencing protein deficiency again.  This is not due to your diet being too low in protein, but it may be too low in calories if you are following a very low fat diet.  When you don’t consume enough calories, your body will use protein (from lean muscle tissue) for calories, which depletes albumin in your blood.  Albumin is a protein responsible for maintaining fluid balance in the cells.  When albumin levels become too low (either due to the stress of surgery, too little protein in the diet, or too few calories resulting in protein wasting), edema can occur.

You said that your protein absorption may be affected by your colitis.  If this were the case, you would be experiencing diarrhea fairly frequently, which you don’t mention.  I don’t believe the edema is due to gallbladder removal, but rather your body may not have recovered fully post op (nutritionally) and your albumin level may still be depleted.

My suggestion would be to meet with a Registered Dietitian who can evaluate your calorie and protein intake and estimate your requirements.  Without knowing your height and weight, I cannot do this online.  Continue to eat a high protein diet, but you may just need more calories from other foods as well.

Finally, while a low fat diet may be beneficial for your colitis, allowing a bit more fat in your diet may increase your calorie intake and prevent further protein depletion.  I hope this information was helpful.  Good luck!

For more information:

Go to the Diet and Nutrition health topic.