I had mine removed after experiencing stones. There’s some serious pain for men. If I knew then what I know now, I would still have it, but I didn’t discover this fitness/nutrition world until about 2 years afterwards. :(
For my diet, I’m more primal than strict paleo and I love avocados/guacamole*. I found that when I ate a decent amount with a meal, the meal would go right through me. After tweeting with Robb Wolf about my issues, he suggested I start taking some digestive enzymes. The key ingredient being ox bile. I now take Super Enzymes by NOW and they help a lot. I don’t take them with every meal, but I do take a couple before eating if I’m having something that affects me like the guacamole does. I’ll still get some gas (great for clearing a room), but the meal isn’t trying to evacuate my system an hour after eating.
I don’t have issues with most meals, but I’ve been able to identify which ones will create problems and take the enzymes accordingly. For you, I would say be mindful of what you eat. Make notes when things affect your bowels. Take enzymes when needed based on previously gathered data on your diet.
Your mileage may vary.
Sorry if this reply was graphic. I have no issues talking about my bowels and laugh at farts.
*Being from California originally, I’m contractually obligated to like avocados. It’s a good thing I like them.