Preventing Gallstones and Unnecessary Gallbladder Surgery

I get a lot of questions from practitioners about clients who have gallstones, cholecystitis (inflammation of the gallbladder), or who have already had their gallbladder removed.

What special considerations are needed to manage these types of issues?

Well first, let me just say that I feel there is a lot of unnecessary gallbladder surgery.

Yes, you can survive without your gallbladder, just like you can survive without your tonsils and your appendix, but I think it’s important to have your gallbladder if at all possible. I always look at what interventions are possible outside of surgery.

In particular, a lot of people have surgery as a result of a gallstone attack, which can be painful, but are often fairly harmless if treated. When people are doubled over in pain they go to the hospital or doctor and the doctor immediately wants to cut out their gallbladder. Not to say that all gallbladder surgery is unnecessary, but a lot of gallbladder surgery is unnecessary.

I have a lot of suggestions relating to how to help your client during a gallstone attack, as well as how to help them after gallbladder surgery should they go that route, but first let me talk a bit about the gallbladder and what is going on when a client is having problems in the first place.

What functions does your gallbladder perform?

Your liver produces bile and the bile gets concentrated in the gallbladder and stored there. When you eat a fatty meal the bile gets released from the gallbladder and starts to break down the fats into little tiny globules. Then lipase that is secreted from the pancreas mixes in with the tiny globules and bile, emulsifying the fats.

The gallbladder also secretes bicarbonate that mixes with the bile (as it goes into the duodenum) and alkalizes the food that has become acidic from the stomach. The bile goes from a pH of 2.2 to about a pH of 8 in the duodenum. This alkaline environment is needed to begin starchy food digestion with the amylase enzyme that the pancreas secretes.

So to summarize, your gallbladder:

• Stores and concentrates bile
• Secretes bile when needed to break down fats
• Secretes bicarbonate into the small intestine creating an alkaline environment needed for starchy food digestion.

What causes gallbladder problems?

People experience a few different issues relating to their gallbladder, the most common being the formation of gallstones. Gallstones occur when cholesterol and other substances found in the bile form solid stones. These stones can be small or large, and many times go completely unnoticed. It is estimated that 20% of the adult population in the U.S. have stones, but only 1-3% of those actually experience any symptoms.

The problem occurs if the stone passes from the gallbladder into the small intestine or becomes stuck in a bile duct, both of which can cause pain. Inflammation and even infection can then occur.

There are a number of things that can lead to gallbladder issues:

• Food allergies (especially eggs, wheat, coffee, pork, and onions).  Eating allergy-causing foods stimulates the swelling of the bile ducts. The swelling reduces the flow of bile from the gallbladder, and causes the pain and other symptoms connected with a gallbladder attack. Caffeine, especially, such as in coffee, can stress out the gallbladder.
• Inadequate stomach acid
• Lack of exercise
• Weight fluctuation: A large weight gain or even a rapid weight loss. When you have a rapid weight loss, you have a lot of toxicity that the liver is dealing with, so the bile tends to get thick and sluggish.
• Childbirth: Frequency increases risk.
• Birth control pills or synthetic hormones: Females are more prone to get gallbladder disease than males because of the effects of estrogen and birth control pills.  Estrogen dominance has a huge impact on the health of the gallbladder. Considering that estrogen and the mineral copper closely parallel one another, many women have copper toxicity problems due to estrogen dominance, and then gallbladder problems because some of those bile salts are copper salts – that’s where the bile gets its green color from – copper! You don’t have to be on The Pill or taking hormones to have a gallbladder problem related to your hormones – it can be from inefficient hormonal detoxification. Guys, too – you can have testosterone and estrogen problems.
• NSAIDs: and other anti-inflammatories can take their toll on the liver and gallbladder. Other medications can, too, but NSAIDs more often, especially for chronic users.
• Smoking
• Alcohol: This is individualized, but obviously too much alcohol is not healthy for your liver, gallbladder, or the rest of your body
• Constipation: Makes the bile really thick and sludgy, which causes gallbladder issues like gallstones.
• Excess refined and artificial sugars in the diet: Aspartame (Nutrasweet) and other excitotoxins (MSG)
• Refined carbohydrates – these, along with the bad fats, are where the oxidation (free radical damage) and the inflammation comes from, and it can take its toll on the gallbladder because of its effect on cholesterol
• Bad fats – these include the obvious partially hydrogenated “trans” fats, but also those refined polyunsaturated vegetable oils that so many think are good to eat – corn, soy, canola, safflower, sunflower, peanut, cottonseed, and grapeseed
• Parasites
• Hispanics, Native Americans, and Caucasians of Northern European descent are most likely to be at risk for gallstones.
• Heredity: If you have first degree relatives who have had gallbladder issues you are more likely to have them as well.

How can you help clients prevent and heal gallbladder issues?

If your client is feeling right shoulder pain, or feeling a pain under their right rib-cage, they may have a liver/gallbladder problem brewing.

If you test your client and they have high cholesterol, high LDLs, low HDLs, a little bit high or even a lot high on alkaline phosphatase; GGT, LDH, SGOT, and then they also have a uric acid that’s decreased, that would be a good sign that there is liver/gallbladder stress. They don’t have to have all of these, just a few.

So how can you help that client? Or what advice can you provide to prevent issues in the first place?

First, here are some diet and lifestyle recommendations to protect and heal the gallbladder:

• Breathe and relax before eating
• Chew thoroughly
• Avoid sugar, refined carbohydrates, gluten, and alcohol
• Avoid trans and bad fats
• Identify and eliminate food allergies
• Eat essential fatty-acid-rich foods (chia, flax, hemp, and pumpkin seeds)
• Eat chlorophyll-rich foods (as well as bitter greens which stimulate the bile)
• Drink lots of water
• Don’t overeat – it overtaxes your fatty metabolism
• Don’t skip meals – it causes buildup of bile
• Regular cleansing – give yourself a break from heavy-duty foods; try green juices, green smoothies, greens, and bitters.

Supplements that support your liver/gallbladder: 

• Bitters to stimulate bile production
• Lipase
• Taurine
• Vitamin C
• Liver cleansing herbs: milk thistle, dandelion, yellow dock, and burdock root
• Liver stimulating herbs: fennel, anise, and cayenne
• Lemons and beets: great foods for your liver and gallbladder – they help to keep bile healthy and non-viscous
• Lecithin
• Peppermint oil
• B vitamins

What if my client is having a gallstone attack?

First, I am not suggesting that you treat a gallbladder problem on your own. It’s really a good idea to have a practitioner on board that has the right knowledge to guide you. For example, it’s important to do ultrasounds to diagnose the size and location of gallstones.

But there are some things you can recommend if a client is experiencing an attack but doesn’t want to go to the hospital for surgery.

• Fasting can be very helpful especially if your client is in an acute stage.  Have them fast and sip lemon water slowly so that the duct doesn’t go into spasm and cause a blockage.  Take one-half of a fresh squeezed lemon and mix it with about 6 oz of water and sip it (don’t gulp it down) over the next 30 minutes
• Juicing
• Fermented beets – thins the bile
• Foods and herbs that thin the bile: turmeric, milk thistle, artichoke, and dandelion
• Apple Cider Vinegar – contains malic acid, which softens the bile.
• Anti-inflammatory herbs – turmeric, ginger, boswellia, and quercetin.  Ginger also helps with the nausea.
• Antispasmodic herbs – valerian and chamomile
• Cold pack – You can also try a cold pack over the area of your gallbladder – the upper right quadrant of your abdomen. Place the cold pack about half way over your ribs and half over the abdomen.  Make sure it is wrapped in a towel, and not directly on the skin.  This should give some relief to the heat the spasms create.

How can you manage a client post gallbladder removal?

As I said earlier, a person can live without a gallbladder, but it is important to realize the digestive/elimination functions that they won’t have naturally happening without a gallbladder. You need to help them address these functions through diet and supplements.

There are a couple of things that happen when your gallbladder gets removed: you no longer concentrate the bile so you are not very efficient and effective at breaking down fats. You also don’t neutralize the food bolus from the stomach effectively, so you have inefficient absorption of carbohydrates. And then, finally, you don’t have that alkaline secretion to help keep the digestive lining nice and healthy.

When you work with your client, here is a list of special considerations that need to be implemented. Your client needs to:

• Avoid fried foods and trans fats.
• Minimize or avoid dairy.
• Avoid fats cooked with sugar.
• Reduce grains (since they now have an inefficient digestion of starch without the gallbladder’s bicarbonate).
• User bitters before meals (to stimulate bile production and movement).
• Supplement with lipase (fat digesting enzyme).
• Supplement with bile salts (helps your body emulsify the fats; 2 with all fatty meals, 5 days on, 2 days off, until feeling well; cycle on and off).
• Avoid late night snacking (letting the body heal and detox).
• Add hemp seeds, chia seeds, algae, flax, walnuts; the essential fats.
• More protein – to repair the stomach lining (supplement with protein powder, green powder, or spirulina powder if you need to).

Learn more about what I teach my practitioners about the digestive functions, along with other body and endocrine systems, in my Nutritional Endocrinology Practitioner Training program.   Discover the curriculum modules and other aspects of the program.  Enrollment is by application only, and you can apply at this link – http://www.NEPTApply.com.  After you apply, you’ll be directed to schedule a time to speak with us and have your questions answered.