In an effort to determine the relation between demonstrable disease of the biliary tract and persistent symptoms of colonic dysfunction, the records of 300 patients were reviewed. The group consisted of 294 patients in whom gallbladder disease was found at operation and 6 in whom it was demonstrated at autopsy. The predominant symptom was abdominal pain. It was located in the right upper quadrant in 81, radiated to the back in 25, and extended to the right shoulder in 10. It was true biliary colic in only 156 cases. Thirteen patients were asymptomatic. There were 140 patients with multiple gastrointestinal symptoms characteristic of irritable colon. The evidence is interpreted to mean that the postcholecystectomy syndrome and related disorders are frequently part of the irritable colon problem and that good results cannot be expected from surgery unless it is supplemented by dietary measures.