Do I Really Need my Gallbladder (my surgeon wants it out…) ?

Nature is very efficient.  Good designs, no waste.  The purpose of the gallbladder is to store a small repository of bile, which serves many important functions.  Bile requires a good deal of energy and biological resources to produce in the body.  It is vigorously recycled.  It is what makes the color of a healthy stool dark brown.  The main purpose of bile is to break down fat into absorbable components, namely essential fatty acids.  In order for anything you eat to become useful nutrition, it needs to be broken down (catabolized) into tiny sub-units in order to fit through the micro-capillaries in the villi of the small intestine.  This is where all nutrient absorption occurs: starches and carbs break down to glucose, proteins break down to amino acids and fats break down to essential fatty acids before absorption.  Bile is essential for breaking down fats in the diet.  It is produced in the liver from recycled red blood cells (the average red blood cells lasts about 4 months), plus cholesterol, plus bile salts (which are a variety of minerals).  This dark, potent goop is produced very slowly and deliberately by the liver cells, and production cannot be dialed up on demand.  When you eat a meal containing a larger amount of fat, more bile is needed.  Therefore the gallbladder, while not as essential as the liver itself, is very handy for storing extra bile for when that big fat meal comes along.  From a standpoint of human evolution, feast or famine was a fairly common dilemma in the days before grocery stores.  The gallbladder was probably more necessary in primitive humans and that’s why the huge numbers of gallbladders that are extracted and dumped into medical waste annually (at an average cost of about $12,500 per removal) aren’t usually killing people.  Nevertheless, it’s always a great idea to try a nutritional approach to your healthcare problem before committing to a definitive surgery — unless of course there is an urgent or life-threatening need to have a tumor removed or a wound repaired.

If your upper abdominal pain is significantly correlated to eating fatty foods — usually within the hour — and occurs in the upper right quadrant, up under the right ribcage, sometimes with a sharp pain that radiates through to the right shoulder blade, then some degree of gallbladder congestion is likely. Gallstones are easier to prevent than to reverse.  It’s important to try to eat approximately the same amount of healthy fats on a daily basis.  It’s generally not a good idea to commit to a completely low-fat diet because that is not compatible with good health.  Your brain and nervous system, and all your hormones are made primarily of fat molecules.  You need fat, especially cholesterol and the Omega 3 oils, to stay healthy.  However, if you go for many days without eating much fat, the bile in the gallbladder may stagnate.  Eating fat daily promotes the flow of bile through the liver and out of the gallbladder into the upper small intestine.  When bile stagnates it tends to form first a kind of thick sludge, then “sand”, then “gravel” and finally may coalesce into one solid stone.  This stone may be as big as a robin’s egg.  I choose that simile because the color can be aqua-blue as well.  The duct through which the bile flows into the intestine (the common bile duct) is absolutely, definitely, not designed to accommodate passage of anything nearly as large as a robin’s egg.  So you’d better believe this hurts like heck.  Even having sand or gravel push through the duct can be very painful.  Once you are in the throes of a gallbladder attack you can try heat over the upper right abdomen as well as ingesting several thousand milligrams of magnesium — both serve as muscle relaxants.  Dioscorea (wild yam) can also be an effective anti-spasmodic if you take several teaspoons of a standardized tincture every hour for up to 6 hours.  Additionally, plant terpenes (such as menthol and camphor) may be used long-term under physician guidance to chemically dissolve stones.  I don’t recommend trying this alone at home.  Hopefully, you won’t find yourself in this dire situation.

If you get upper right abdominal twinges after eating fatty foods, such as a bowl of ice cream or a cheeseburger, then you should consider using bile stimulants and digestive enzymes regularly in your diet.  The enzyme that helps digest fat, produced primarily in the pancreas, is called Lipase, and this can be found at most health food stores.  Use according to label instructions when eating fatty foods.  Some of my favorite “cholagogues” (agents that promote bile production and flow) are beets and artichokes.  Artichokes are in the thistle family, and many thistles, most notably Milk thistle (Silybum marianum) are very helpful for liver health, including promoting bile production and flow.  If you have gallbladder problems (not debilitating attacks) you should eat artichoke hearts (preserved in water, not oil) on a regular basis.  A wonderful way to prepare beets is to gently simmer them in a pot of water for 30-45 minutes until easy to pierce with a fork.  Let them cool and slip off the skins.  Then dice them and place into a clean glass jar with a lid.  Cover with the liquid from some plain yogurt, or the left-over pickle juice from your favorite preservative-free pickles (my favorite brand is Bubbies).  This will lightly pickle your beets and you can keep them in the fridge for 7-10 days.  Eat several pieces of pickled beets several times weekly.

Other cholagogues include dandelion root (Taraxacum officinale), turmeric (Curcuma longa) and boldo (Peumus boldo).  Never eat fried food.  Drink plenty of fresh water.  Take 1-3 grams of Vitamin C daily.

The solubility of your bile is a major component of your tendency to form sludge or stones.  This is the “flow” part of the equation.  A diet high in processed foods, particularly refined carbohydrates, is well established to reduce the solubility of bile.  A diet high in soluble fiber (apples, steel-cut oats, celery, dark leafy greens are examples of good day-to-day choices) is very important in the prevention and reversal of gallstones.  Another nutrient, related to B-vitamins, that promotes bile solubility is lecithin (also known as phosphadidylcholine).  Lecithin granules are rather pleasant tasting and available at most health food and grocery stores.  Take 1 rounded tablespoon (500 mg)  daily in applesauce or yogurt or oatmeal.

I do not recommend the so-called “liver flush” using olive oil and lemon juice.  Remember, it’s a bolus of fat that sets off the touchy gallbladder.  The “stones” that people claim to see passing after these flushes are simply globs of solidified olive oil.