A Gallbladder Story
Knowledge is power – and this is so incredibly true when it comes to understanding the way our human body works. Once we truly comprehend how amazing the body is, we are more likely to treat it well – and less likely to believe all of the not-so-accurate health-related propaganda that’s out there.
So, in this article I want to spend some time explaining what the gallbladder does and how things can go wrong. I will give someinformation on what we can do to help this little organ in its time of need – but I firmly believe that nutritional advice should not be dished out willy nilly on the internet. We have our own unique bodies and stories, so rather than give you a sack of generalised advice which is hard to implement and pretty meaningless in the context of an impersonal blog, I would rather just have a chat about what this organ actually does and why it is so important.
The gallbladder is one organ that very few people think about or even talk about… a mention of its name usually invokes reactions like – “what does that do?”, “do we actually even need it?”etc… Unfortunately, the humble gallbladder has been relegated to “appendix status” in many ways – it exists, but it isn’t necessary for life. Well, to be fair, this is true. BUT it is also true that we can live with only one kidney, and we can survive with chunks of our stomach missing – but is it optimal? No. Is it ideal? No. And why is this? Because these organs (the little gallbladder included), serve some VERY important purposes. We tend not to think of our digestive organs as VITAL for survival – but without food we die, SO… they’re pretty important when you put it so simply. More than this, though, our digestive function can dictate our quality of life – and anyone with gallbladder issues will tell you that having problems with this organ can certainly be a life-changing experience.
Our gallbladder sits tucked away under our liver (on the right hand side of the upper abdomen), near our pancreas and small intestine. So, straight up we can see it is pretty important – it is surrounded by some digestive (and life-sustaining) powerhouses. The gallbladder’s primary function is to store and concentrate bile (which is originally produced in the liver) in between meals, where it waits to be released into our small intestine. Bile has a few important roles, but the digestion-related ones are our focus here: Firstly, they are high in bicarbonate, which helps to alkalise the digestive environment so intestinal and pancreatic enzymes can work better. Secondly, bile aids in the digestion and absorption of fat by emulsifying fat (breaking it down) so that the pancreatic enzyme lipase (which digests fat) can do its job easily. When a meal is particularly high in fats, the gallbladder receives a signal from the hormone cholecystokinin (CCK) to release its bile stores into the intestine. The liver also directly sends bile into the small intestine as required.
Now, this is where things get interesting – the way that bile flows and moves is dependent on a couple of things. It needs to be nice and thin (not sludgy), and it also needs to be able to move through the little gates called sphincters which separate the gallbladder and intestine. What makes our bile the right consistency then? Bile is made of a few different things but a key ingredient is cholesterol. Cholesterol production and metabolism is dependent, in part, on sex hormones (e.g. oestrogen and progesterone). So, if you have an imbalanced ratio of sex hormones (e.g. too much oestrogen relevant to progesterone), this may lead to changes in the flow of bile. It might become too thick and sludgy, which means it sits and accumulates in the gallbladder because it can’t be excreted properly. Interestingly, progesterone is also responsible for the relaxation of our digestive sphincters. If we have too much oestrogen (and therefore not enough progesterone), our sphincters tend to be constricted, making it harder for bile to pass through into the intestine. With all this talk of sex hormones like oestrogen and progesterone, you might be wondering if there are any differences between men and women when it comes to gallbladder disease. The answer is yes – women are twice as likely to suffer from gallbladder disease as men. Sorry ladies!
The most common gallbladder issue encountered, then, is the development of gallstones. These develop when the gallbladder fails to contract properly (usually because of a signalling issue with CCK), and/or when the bile is too thick. This causes bile to build up in the gallbladder, which is known as stasis. When sitting for long enough, the bile clumps together forming stones, which then cause irritation (and pain) every time the gallbladder tries to contract. Cholecystitis, or gallbladder inflammation, is another potential issue. The gallbladder can become inflamed when stones block ducts to and from the gallbladder, or when there is infection/damage. Most commonly, the removal of the gallbladder is the conventional treatment of choice for gallbladder disease.Now, I need to state upfront that OF COURSE there are times when gallbladder removal is imperative for both short and long term health. Gallstones lodged in the common bile duct, for example, are dangerous and may result in a medical emergency. Cases such as this require medical assessment and appropriate diagnostic testing to determine the best course of action. There are times, though, when removing the gallbladder (known as a cholecystectomy) is unnecessarily premature and invasive.
What I am talking about here are the situations where someone’s dysfunctional-gallbladder-story goes something like this (or mine – since I am lucky enough to have a gallbladder that isn’t always my friend): they will go to their doctor after realising that after they eat fish and chips (or an equally fatty, rich meal), they feel sick. They may be in excruciating pain in the upper right abdomen, which radiates to the right shoulder and back. This pain may last for hours (and can be as frightening as hell because you think you’re having a massive heart attack). They may vomit, have nausea, have diarrhoea, get chills,etc… So they invariably will get sent off for an ultrasound to check for suspected gallstones. For some, stones will be discovered. If the stones are large, in dangerous places, or if there’s lots of them, removal of the gallbladder may be the best option. But for others (and in fact, for many) there will be no evidence of gallstones and they will be sent on their way with a clean bill of health. Except for the fact that they feel sick every time they eat fish and chips (or insert any other offending food here…). Well what is going on with this subset of people? They MAY have micro-stones (teeny tiny ones not detected by ultrasound), but often they have a dysfunctional gallbladder which contracts so poorly that the gallbladder and its stored bile (which might already be too thick!) becomes super sluggish. There may not be anything physiologically wrong per se, but functionally, it is certainly not performing as it should.
This is where we need to remember that the gallbladder contracts under hormonal control, bile production is complicated, and the gallbladder receives bile from the liver. If our hormonal signalling system is not up-to-scratch, and/or our liver is sluggish, our gallbladder may likely become affected. Left long enough, this sort of dysfunctional gallbladder WILL result in stones and inflammation. Removing the gallbladder in those with dysfunctional gallbladders (and no obvious stones) is counterproductive because the underlying cause of the problem isn’t actually from the gallbladder itself. This is why an unacceptably high proportion of people who have had their gallbladder removed do not report feeling any better – and often come away with a whole new range of digestive issues. And to top it off, if someone who has had their gallbladder removed continues with the same diet and lifestyle, they will suffer enormous digestive consequences and find very little benefit from having the surgery. So, what to do if we hang onto our gallbladder then?
The key to treating gallbladder issues is to work with the liver. If we have a properly-functioning liver, we have digestive and hormonal systems which are working well in harmony. Hormones are able to be effectively produced and metabolised (in the liver), while the digestive system is able to receive all the cues it needs to function optimally (from our hormones).
Nutritional medicine comes to the rescue by considering things like:
- Avoiding inflammatory foods – these may be foods that you are personally intolerant to, or the key foods which cause sensitivity and inflammation such as gluten, dairy, soy, and corn.
- Steering clear of refined starches, sugar, vegetable oils, food additives and preservatives, as these also have highly inflammatory effects and are very taxing on our liver.
- Consuming a diet with lots of fresh fruit and vegetables (SURPRISE!!!), because aside from the awesome nutrients found in these foods, the fibre they provide is excellent for liver function and hormonal balance (and therefore bile consistency).
- Eating plenty of good quality fats – coconut oil, olive oil, nuts and seeds, avocado, oily fish. YES – you read that right… DO NOT AVOID FAT. If we do not actually eat enough (good) fat in our diet, the gallbladder rarely gets the signal to contract, so this just leads to more stasis.
- Adding more anti-inflammatory gems into our diet – think turmeric, fresh herbs, cinnamon.
- Include free range (or organic) meats and eggs in your diet and buy organic fruit and veg where possible – we need to reduce the load on the liver, and the more we can support it in its natural role of detoxification, the more it will be able to do its job properly.
- Limit alcohol and caffeine (especially if you notice gallbladder issues around a certain time in your menstrual cycle and/or when having these beverages).
- Drink either lemon juice or apple cider vinegar in water just before or with a particularly rich, heavy or fatty meal. This helps to encourage the release of digestive enzymes and sets the scene for optimal digestion.
- Practice relaxed, slow and stress-free eating. This encourages digestion while also improving hormonal signalling. So many digestive issues can be dramatically improved by practicing this technique.
If you think (or know) you have gallbladder-related digestive issues, or you have had your gallbladder removed, I would love to help! As well as the dietary changes above, there are a whole host of nutritional supplements which can dramatically improve gallbladder and liver function, as well as lifestyle modifications and other simple tricks.
My aim is to help you keep your gallbladder if and when safely possible. Because if it wasn’t important – we never would have been born with it!But if you have had your gallbladder removed don’t fear!! Let’s use this as an opportunity to work on having the best health you can get!
Health & Happiness,