Who Needs a Gall Bladder Anyway?

Gall stones is a common disorder that affects 15% of people over 50 years. Having a gall stone attack can be extraordinarily painful and often results in gall bladder removal, but what is the gall bladder? and what is the impact of having it removed?

What is your Gallbladder? 

The Gall bladder is a tiny sac that sits next to the liver. The gall bladder holds bile, a digestive juice produced by the liver, that is used for the breakdown of dietary fats.

The gall bladder extracts water from the bile to create a concentrated liquid. Eating fatty food causes the gall bladder to squeeze this bile concentrate into the small intestine.

What are Gall Stones?

Gall stones are small stones made from cholesterol or a mixture of bile pigment and calcium salts that forms in the gall bladder.

Gall stones are usually the result of the crystallisation of excess cholesterol in the bile or when the gall bladder does not completely empty and left-over pigment combines with calcium salts.

Often gall stones are present and we are unaware as they sit at the bottom of the gall bladder and cause no symptoms. Symptoms and complications occur when a stone blocks one of the ducts which can cause infection or inflammation leading to pain.

Symptoms?

The most reliable presentation of cholecystitis (inflamed gall bladder) is an intense pain beneath the right rib cage often occurring between midnight and 3am. The pain may radiate to the right shoulder, and may be accompanied by nausea and low appetite. Other common symptoms include:

• pain in abdomen and back, infrequent but severe
• extreme abdominal pain after eating fatty foods
• jaundice
• fever and pain (if gall bladder or bile duct becomes inflamed)

Causes and Risk Factors

Gall stones are more likely to occur in women, overweight people and those with a family history of gall stone attack.

There is no single cause for gall stones. In some people the liver produces too much cholesterol and this excess cholesterol may form crystals in the bile. The gall bladder may not empty efficiently, and changes in the components of bile may also contribute to stone formation.

Gall Stone Diagnosis

Diagnosis may be established via physical exam and x-ray or ultra sound. Other diagnostic tests may include ERCP involving endoscope, HIDA scan which is a nuclear scan that assesses the function of the gall bladder, or an MRI of liver, biliary and pancreatic systems.

Complications 

Biliary colic occurs when the gall stone moves from the body of the gall bladder into the cystic duct, the resulting obstruction causes severe pain and fever.

Choleocystitis is the inflammation of the gall bladder. This might occur when a gall bladder duct is blocked by a gall stone and results in infection and inflammation, causing severe abdominal pain, vomiting and nausea.

Jaundice occurs when a gall stone blocks the bile duct leading to the bowel. The trapped bile enters the blood stream instead of the digestive system. Bile pigments cause a yellowing of skin and eyes, and the urine may become orange or brown.

Pancreatitis is the inflammation of the pancreas. This complication may occur if a gall sone blocks the duct down near the pancreas causing pancreatic enzymes to irritate and burn the pancreas, they may also leak out into the abdominal cavity.

Cholangitis is the inflammation of bile ducts, when a duct is blocked it can become infected causing pain, fever, jaundice and rigors.

Infection of the liver may occur if main bile duct becomes blocked.

Cancer of the gall bladder is very rare complication.

Treatment 

When there are no symptoms present generally no treatment is given. If there is a risk of gall stones developing, dietary modifications may be recommended such as reducing or eliminating fatty foods and dairy.

Lithotripsy uses a machine that generates sound waves that shatter gall stones, this therapy is only used when gall stones are small and soft.

Medication that may dissolve gall stones is rarely used due to side effects and variable success.

Surgery is the most common treatment when a blockage occurs causing inflammation or other  complications.

Surgery

During surgery the bile ducts and the artery that serves the gall bladder are clamped shut using permanent clips, the gall bladder is cut free using laser or electrocautery, then the gall bladder with its gall stones is removed.

Orthodox recommendations post surgery is to rest for 3-5 days and avoid heavy lifting and physical exertion. The digestive system may take a few days to settle and you may experience bloating, abdominal pain, and changes to bowel habits. There may be a small risk of diarrhoea and fat malabsorption.

Gall bladder removal means that there is nowhere to store the bile so it is continuously dripped into your intestine. Doctors say that there aren’t too many consequences from removing it.

Food and Gall Stones

Diets high in fat and cholesterol and low in fibre appear to play a role in gall stones.

If individuals are overweight they should try to gradually and safely lose weight, there may be a link between rapid weight loss and the formation of gall stones. Crash dieting causes the liver to release more cholesterol into the bile, this disrupts the normal balance of cholesterol and bile salts. The extra cholesterol may crystallise forming gall stones.

Avoid fatty and highly processed foods. When you eat fatty foods your gall bladder tries to squeeze, if a gall stone is blocking the outflow of bile it is “squeezing against a closed door” and this is where the pain occurs.

Please note: orthodox practitioners will advise low fat diary, whilst it may be best to avoid dairy you should never replace it with low-fat dairy.

Natural Treatments

In the instance of a gall bladder attack, the ‘Gall Bladder Flush’ often has good results however this treatment requires caution and supervision so people with gall stones should see a Natural Health Practitioner for guidance with this.

Natural Therapies for the Prevention and Treatment 

Natural prevention and treatment for gallstones aims to help to correct liver dysfunction and holistically improve  health, the treatment targets cholesterol because gall stones are often made from cholesterol.

• Reduce overall fat intake, especially trans fats. Natural fats such as butter and olive oil are better but still need to be used in moderation.
• Omega 3 supplementation
• Niacin is helpful with cholesterol and skin problems
• Sunlight converts excess cholesterol reserves stored inside the skin into D2 which is later converted by the liver into D3
• St Marys Thistle (Silybum marianum) is a well researched and  clinically proven liver tonic
• Dandelion (Taraxacum officinalis) another well researched liver tonic
• Vitamin C improves cholesterol status in the body
• Turmeric increases the solubility of bile
• Apple cider vinegar stops the liver from making cholesterol (present in most gall stones),  malic acid in apples may soften gall stones
• Peppermint oil may assist by stimulating bile and other digestive enzymes, also terpenes present in peppermint oil may dissolve gall stones
• Psyllium is high in soluble fibre which binds to cholesterol to enhance it’s elimination, also may prevent constipation which is associated with gall stones.
• Lemon juice stops the liver from making cholesterol so keep up with your morning lemon juice in warm water!
• Spices and herbs to stimulate liver and gall bladder include turmeric, ginger, black pepper, asafoetida, and artichoke leaf.

What should I expect after gall bladder removal?

Post cholecystectomy you will have difficulty digesting and assimilating fats. This can lead to problems such as skin disorders, vision and eye problems, fatty tumours, bruising, stroke, atherosclerosis

Some people develop frequent loose watery stool, diarrhoea. This usually lasts a few weeks to a few months. Diarrhoea after gall bladder removal occurs because bile is released directly into the intestines. Normally the gall bladder collects and concentrates bile releasing it when you eat to aid the digestion of fats. When the gall bladder is removed the bile that drips into the small intestine is less concentrated and drains more continuously where it has a laxative effect.

Diet tips post gall bladder removal

Limit the amount of fat you eat at one time, small amounts are easier to digest while larger amounts can remain undigested and cause gas, bloating and diarrhoea.

To normalise the bowel movements increase fibre slowly over a few weeks, sudden increase can exacerbate gas and bloating.

Eating smaller more frequent meals may allow a better mix with available bile. Reduce the amount of fats you eat at one time. Larger amounts of foods or fats may remain undigested causing flatulence, bloating and diarrhoea.

Avoid foods such as caffeine, dairy, greasy foods and very sweet foods that often contribute to diarrhoea.

Emed’s Final Word

By following the advice in this article the worst that will happen is that your health will improve. It makes sense that removing one of your digestive organs will create imbalance in your digestive system. It is always astounding to hear that people undergoing surgery and other medical procedures are not always given practical advice about diet and lifestyle.

Without the organ that breaks down fats you WILL have trouble breaking down fats!

When confronted with the reality of potential cholesytectomy you may wish to try some of the natural remedies first, however it is always best to seek naturopathic advice before commencing any new treatment. If you have concerns or questions about gall stones or gall bladder health call us at Emed to arrange a Free Initial Consultation with one of our Naturopaths today.

Further Reading 

• Vitamin C, The Latest Research on Why You Need It
• Curcumin
• Foods That Love Your Liver

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