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If you or someone you know has issues with their gallbladder, tolerating fatty or rich meals, or has even had their gallbladder removed. This is the post for you.
We should start this with what a gallbladder actually does... the gallbladder is the little green organ that sits underneath the liver and beside the small intestinal entrance. It's sole job is the store and concentrate bile that is produced by the liver. The coin purse of the liver if you will.
When we eat, it releases this bile into our duodenum (the top of the small intestine) to help us break down and absorb fats from food. Bile is made of bile salts (glycine and taurine), phospholipids, cholesterol, conjugated bilirubin, electrolytes, and water. These are not only important for the absorption of dietary lipids (fats) and fat soluble vitamins but are signalling molecules with diverse endocrine (hormonal) and paracrine functions.
Bile regulate bile acid levels and pH, lipid and glucose metabolism and modulate temperature and energy homeostasis. Another primary function of bile that bile salts help with is the removal of toxins. Toxins are secreted into the bile and eliminated in feces. A lack of bile salts can cause a buildup of toxins in the body. Some notible 'toxins' include bilirubin and cholesterol. Yes I know, it's made of cholesterol, how does it help remove cholesterol? Well, the bile acids promote secretion of free cholesterol, excess broken down 'stuff' and xenobiotics (foreign stuff/ chemicals) - and part of the process of making bile salts includes transporting excess cholesterol to the intestine from the liver. Once there we hope that there's enough insoluble and soluble fibre to help carry these cholesterol particles away. This avoids reabsorption of said cholesterol, and thus it is removed. So essentially it is both made from and carries cholesterol from the liver.
That said, it seems to be a VERY common problem to have either poor digestion/ production of bile - or issues with the liver that cause low bile levels. This is definitely not ideal as that compromises our nutrient absorption and removal of toxins. Signs that you have low bile:
Constipation
Gas, bloating, belching
Fullness after eating and nausea
Stomach pain or burning
Deficiency of fat soluble vitamins (A, D, E, K) (i.e. dry, itchy skin; poor eye sight).
Acid reflux and GERD
This also puts you at risk of infections in the small and large intestine due to the compromised digestion and pH changes. This can include H. pylori, C. difficile and SIBO (small intestine bacterial overgrowth). Herbs that are helpful to improve bile flow from the gallbladder include; Dandelion, Greater Celandine, St Mary's Thistle, and Globe Artichoke.
THE REMOVAL
Occassionally, in those prone, you can develop gallstones or blockages in the bile ducts which lead to inflammation of the gallbladder. If your gallbladder is removed via a cholecystectomy you still have to deal with the effects of low bile - just now it's a forever issue. Hospital and GP education around this area is so poor. You will likely have issues with fatty foods and yellowing or floating stools when you don't have a gallbladder. This doesn't mean your whole digestive tract is mucked, but you do have to be more conscious and take extra care.
Your liver IS still producing bile, but as there's no coin purse - it is dripped into the small intestine as it's made and not in concentrated amounts when you eat. So how can you support your bile and digestion? You can stimulate the liver using bitter greens and bitter herbs to increase the production of bile around eating. Herbs that are particularly helpful here include Globe Artichoke, St Mary's Thistle, Bearberry and Greater Celandine. These, or herbal digestive tonics, would need to be consumed with every single meal to ensure proper digestion and breakdown of the fats. Also remember, you are supporting the removal of toxins at the same time.
Sometimes, this isn't enough and you may need to consider supplemental enzymes or bile salts (UDCA and TUDCA). There is no harm in choosing this route either, but don't use it as an excuse to fall on bad eating habits.
DIET
Depending on your choice of therapy after gallbladder removal, your diet will likely need to change - I'm guessing not too far off what you had to do before it got removed anyway....
Most allopathic practitioners would suggest avoiding high-fat foods, fried and greasy foods, and fatty sauces and gravies. To instead, choose fat-free or low-fat foods. Low-fat foods are those with no more than 3 grams of fat a serving.
However, should you be supporting your bile and liver with the appropriate tools - these should still be a tolerated but less voluminous part of your diet. You should not have issues with eat a homecooked meal that contains a normal amount of fat, but you may get some symptoms with a burger for example. I would recommend getting some digestive enzymes for those occassions where you know your digestion and bile needs more support (i.e. eating out or eating the occasional junkfood). After all, you have had an important organ removed from your body. I have also found that eating a regular clock times across the day aids better digestion as the body likes a schedule to a certain extent. A strong cup of globe artichoke tea with, or just before meals is my next top tip.
Following this, should you need additional support - seek the guidance of a registered naturopath (like me)!