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We read with interest the article by Konings et al entitled ‘Global prevalence and gastrointestinal symptom burden of individuals with a history of cholecystectomy’, recently published in Gut 1. The findings emerging from this relevant research invite re-evaluating the long-term consequences of an intervention that is usually perceived as harmless in routine practice.2 In this sense, robust population-level evidence supports the association of previous cholecystectomy with a significantly increased gastrointestinal symptom burden, defined by the constellation of altered bowel function manifestations.1–3 Among these, meteorism represents a constant,3 4 with a plausible mechanistic explanation residing in postcholecystectomy-related alterations of bile acid flow, gut motility and microbiota composition, ultimately promoting aberrant intestinal fermentation.5 6