Gallbladder Health Part I: Be Good to Your Gallbladder – It’s There For a Reason
Gallbladder problems including gallbladder attacks are very common reasons for which people seek medical care. The pain and discomfort can unfortunately result in the removal of the little green organ followed by dietary restrictions (often low fat). But of course, all of our organs are there for one reason or another and although we can live without the gallbladder, removing it is simply removing a symptom of a problem, not the actual cause. In this two-part article on the gallbladder I’ll discuss why you have a gallbladder, why you should want to keep it (and keep it healthy), warning signs that your gallbladder isn’t working well, risk factors, and natural treatments and lifestyle changes you can make to improve your gallbladder and overall health; yeah! If I can just save one more gallbladder I’ll be a happy guy.
Gallbladder Physiology: Bile is so Good for You
Let’s take a brief lesson in gallbladder physiology here, and I’ll make it interesting and relevant to your everyday health. The gallbladder is a small organ that sits tucked up underneath the liver in the upper right side of your abdomen. It concentrates and stores bile produced by the liver, and along with the enzyme lipase secreted by the pancreas, it aids in the digestion of fats in the gut. When fats from food enter the digestive tract they stimulate the secretion of a type of hormone called cholecystokinin (CCK) in the upper part of the small intestine – the duodenum. This, along with the stomach’s secretion of hydrochloric acid, signals the gallbladder to release some of its approximately 50mL of bile into the gut to help aid in digestion of those fats. Since by most, it’s viewed as a “storage tank” and nothing more, it’s often seen as only a nuisance when it comes to digestive problems and pain – expendable at the first sight of problems and removable with surgical ease. But there’s so much more to it than just storage.
Bile is a lovely dark green/yellow-brown fluid and contains about 10% bile salts. The bile acids (salts) have a strong relationship to hormonal regulation as they share many of the same synthesis pathways as hormones. This is why people with hormonal problems, especially women with estrogen dominance, are more susceptible to gallbladder problems. The more hormonal stress on the body the lower the bile acids which in turn disrupts normal hormonal metabolism. It’s not a coincidence that many women have their gallbladder removed at the same time they have a hysterectomy.
Speaking of hormones, just a few years ago it was demonstrated that the gallbladder also plays a role in insulin regulation and that β-like cells that produce insulin in the pancreas also occur in the gallbladder. Insulin is also metabolized by the liver and can therefore have an effect on the bile salts – so diets high in refined carbohydrates and those with insulin resistance will also be more likely to have troubles with their gallbladder.
Bile also increases the absorption of fats and especially the fat soluble vitamins A, D, E, and K. We all know the push for vitamin D by every doctor and health food store today. Consider that if you have an unhealthy gallbladder then your absorption of vitamin D, as well as the other fat soluble vitamins necessary for good health, will also be impaired. So just because your vitamin D level may be low as revealed by a blood test, doesn’t mean you should go vitamin D supplement-crazy; that’s not necessarily addressing the problem.
Bile and Cholesterol
A small percentage of bile is cholesterol but the majority of bile acid is made from cholesterol; actually about half of the cholesterol our body makes per day is used to make bile acid. These bile acids are recycled from the intestines and back to the liver and gallbladder. However if there are problems with digestion, such as an all-too-common poor diet, then the salts can become “dirty” – the bile becomes thick like a vehicle’s oil that is way past the oil change date.
Stones in the gallbladder
Eventually this thick, dirty bile can accumulate and form a gallstone, also known as a cholelithiasis. Usually these stones contain some or a significant amount of cholesterol, so it’s often cholesterol that gets blamed for causing the stones when really it’s an issue with oxidative stress, inflammation, and digestive problems caused by other factors, (discussed in a bit). Gallstones in the gallbladder can lead to cholecystitis, which is an inflammatory condition of the gallbladder. The stones leaving the gallbladder can also obstruct the bile ducts which can be life threatening, especially if a stone blocks the pancreatic duct leading to pancreatitis.
Also, low levels of bile salts can be a reason for gallstones; this problem would ultimately fall on a production problem with the liver.
Should You Remove Your Gallbladder – You Don’t Need it Anyway (?)
The surgical removal of the gallbladder is called a cholecystectomy. This is a common procedure that with rare exception, is unnecessary and does not address the problem. Some people who have had their gallbladder removed will see absolutely no change in their symptoms while others may have their symptoms 100% resolved. Others who have had a cholecystectomy may no longer be able to eat high fat foods as their body is unable to handle too much fat digestion at once due to the removal of their bile storage tank. However, the body in its infinite wisdom can often form a new little storage pouch in the area of the common bile duct to store some bile for when it’s needed.
So how do you know if your gallbladder is at the point of becoming a life threatening emergency or you’re simply experiencing gallbladder troubles that perhaps can be dealt with in a non-surgical manner? Well, without giving specific medical advice for every situation, a good rule is to look at the severity of the signs and symptoms. Someone who is having a gallstone attack typically has pain in the upper right side of the abdomen and/or pain in-between the shoulder blades, more often below the right shoulder. It’s uncomfortable and can get to the point of being very painful. Sometimes nausea and vomiting can occur which can last for minutes to hours. Now if the pain and vomiting get worse and worse then you should of course seek medical attention. (Gallbladder attacks and heart attacks can have very similar symptoms – heart attacks don’t always have pain down the left arm only.) Typically gallbladder attacks don’t just come out of nowhere where the person never had any symptoms of a gallbladder problem and now all of a sudden they have a huge stone lodged in their bile duct. So you have to know the symptoms of poor gallbladder function so you can address the issue before it gets too out of hand.
Gallbladder referred pain areas
When Your Gallbladder Isn’t Working Too Well – Gall Bladder Problems: Signs & Symptoms
There are many signs and symptoms of a gallbladder that isn’t functioning very well and most people just think they’re common “normal” symptoms so they think nothing more of it. Then, “all of a sudden” they get a major gallbladder attack and are puzzled as to how it could have happened to them. Well, I’m hopefully going to keep you from being surprised!
- Constipation. Yes, a major reason for constipation is a poorly functioning gallbladder. When fat enters the small intestine it has to be metabolized by those bile salts and the lipase from the pancreas; (you learned this already, right?). But if the bile isn’t released efficiently from the gallbladder then the food and its fatty contents must wait longer and longer in the small intestine to be metabolized. So they wait. And wait. And wait. And you get constipated. So don’t necessarily think that you need more fiber, or you need probiotics if you’re constipated – consider your gallbladder.
- Aside from constipation and the referred pain areas discussed (upper right abdomen and right shoulder area), another symptom of an unhappy gallbladder is burping after or while eating a meal – especially one containing fat. Typically this person will also feel “heavy” and even perhaps bloated if they’re having problems digesting a fatty meal because their gallbladder isn’t doing its job. Burping can be from eating too quickly too but burping from a gallbladder problem usually accompanies heaviness.
- Another symptom of a gallbladder issue is peeling of the skin on the palms of the hands and the soles of the feet. This is due to an inefficient fat metabolism system as well as metabolism problems with vitamin A (fat soluble). I’ve seen patients present with some pretty wild looking palm and sole peeling that nobody was ever able to understand why. This too, is often a gallbladder problem.
Finally, and I discuss this in my articles on sleep, the horary time (acupuncture meridian) for the gallbladder is 11pm to 1am. So if you can’t fall asleep until after 1am or if you’re asleep before 11pm but then awaken between 11pm-1am it could very well mean your gallbladder is stressed. Also note that liver is next, from 1-3am, and this is the most common time a person has sleep difficulties for many, many reasons – caffeine, hormones, stress, medications – just to name a few, and all these can also affect the gallbladder too as well as bile production in the liver.
In Part II of Gallbladder Health I’ll discuss how to prevent problems with your gallbladder as well as natural treatments for optimum function of your gallbladder PLUS emergency help to calm down or resolve a gallbladder crisis.
I am speechless…all I can say is bravo! This is an amazing site. I have been seated in one position for hours reading. Thank you, Thank you, Thank you. You are by far one of the most informative and wise Dr.’s I have come accross in awhile. Please continue I truely believe you are helping many, many lives.
Thank you!
I am so glad I find you site after my GI came back with H. Pylori infection in my gut. I am shocked because I don’t have ulcer or many uncomfortable symptoms like many people do and I don’t take any medicine at all. But I do feel my right arm and back have some cramps and I thought because too many typing on computer. After I read your article I do think I have some gall bladder unhappy issue but I think is it because I have H. Pylori in stomach? After many research and read some of successful stories to eradicate the bacteria, I asked the medical stuffs to try nature way for couple of months first they got upset with me. I am so afraid of the antibiotic –prevpac to screw up my whole digestion systems, I really wish you practice close by our area! What shall I do?
Sorry I can’t advise on-line. I can tell you that H.Pylori is, like most infections, opportunistic. So it’s there because of other problems. Typically low stomach acid allows H.Pylori to grow, and as you know from reading these articles, stomach acid (HCL) can also result in gallbladder problems (the low acid doesn’t trigger the gallbladder to release the bile).
My husband was just told that his gallbladder is only functioning at 18% and should consider having it removed. He’s not having pain when he eats, but he does have horrid indigestion and is on prilosec. his symptoms, are just not feeling well, no energy, no get-up-and-go. which is not like him at all.
I guess the question is, will removing the gallbladder fix this, or is there something else going on?
You never know if it “fixes” the problem until after it is removed. Many improve, many don’t, some get worse. Removing the organ, as I say in the article, is not addressing the problem, but dealing with the symptom. In rare cases it does need to be removed (too much damage/inflammation); if he’s interested in keeping it then he needs to find a doc who treats this naturally.
Thank you so much for the response, it seems already address my problem too.
I have started to take natural remedy from last week, amazingly my body cramp is gone and feel good.But I know it doesn’t mean I don’t have the bacteria anymore…Besides taking L.Glultamine, mastic gum, broccolive,oil of oregano, probiotic,…..which all claims to either kill or inhibit h.pylori…also I change diet from grain and less fat diet (my bad- I use grapeseed oil too, I though they are good) to more good fat diet and cut carb almost completely in order to kill bacteria), more weigh work-out.
May I ask …have you had pylori patient before? If I can’t reach you since I live in Plano, Texas; can you refer Dr. around my area who can monitor my case? Thank you again!
I have seen many patients with h.phylori. I don’t use the antibiotics though some may need them. Really needs to be case-by-case.
Sorry I don’t know anyone in Plano.
Thank you, Doc!! Wish one day you will publish an article about H.phylori here. I may try to see if I can get in line with your consultation service, it seems the waiting list is pretty long, anyway…. Thank you again to put these valuable articles in website to teach us!!
Consult is 2 months wait. Office visit currently 8 months.
I’ve had problems all my life with constipation and with all the symptoms that you describe with the gallbladder issues. I remember as a child (5 years old) I would have to take medicine to make me not have constipation and a few years ago after the hospital didn’t listen to me that I was have problems with my appendix and they just pushed it off as a “woman” problem, I had to go back a few days later by ambulance to get gutted and was sent home with my stomach wide open to heal from the inside out, now my point is they let me know that I had two large gallstones. I have always had problems with my stomach/back hurting and my primary care physician never even looked into it because I have severe hypertension. So that problem needed be looked into first. (born with it) Now I get violently ill when using the restroom and I will go (one time) up to 6 days without being able to go at all. The pain is unbearable but somehow I make it through. My question is: After so many days of have constipation there is a mucus film on my bowel is this common when having issue with the gallbladder? Thank you for you time! I really appreciate it!
Common – but not normal. Most likely from widespread gut inflammation.
Angie,
Clearly you have been let down by western medicine, do yourself a favor and seek help through a holistic doctor. You will be pleasently surprised.
Really enlightening! Unfortunately, I have not heard this advice from any other doctor here in the states. I ended up taking homeopathic remedies from a physician in Oman. They worked! I eat almost all foods except those with caffeine and high fat or fried. (Sometimes I do have those but very rarely.) And I still have my gall bladder!
Dear Doc,I have many of the symptoms in your article about the gallbladder .This is been going on for about 8 months.No sharp pains though.Starting Medicare March 1 and waiting till then to do something about it. Went to my doc about another issue last week and talked a little about what was going on.He said he would line me up for a sonogram first then go from there.He sounded like removal if there was a problem. I,ll keep up with your suggestions and talk to him about them .Your name will not be used. Thanks Robert.
TELL ME IF NAUSEA IS PRESENT IF YOUR GALLBLADDER IS DISEASED.I FEEL PRETTY GOOD IF I DON’T EAT THINGS LIKE MAYONAISE, FRIED FOODS.DRINK CAFEINE.. i AM ALSO HAVE DIABETES AND REFLUX. WHAT DO YOU THINK?
THANKS MARILYN
Nausea can be a sign of a gallbladder problem, but it can mean other things too.
I had a gall bladder attack recently, and unlike the one I had almost two years ago this one was NOT followed by daily pain that was barely relieved with low fat foods and pain medication. Instead, this time around when I eat small lowfat meals such as papaya and veggie soup with brown rice at times and avacados too, for example, I feel pressure like my food is having a hard time going down. I also feel it in my throat too. Its not painful, but its uncomfortable and i find myself burping a lot. I have no problems using the restroom and I didnt feel this way before. Im baffled as to what it could be. Could this be an after effect from the attack? Will it go away soon? Also, if its a digestive issue brought upon by the attack, could enzyme pills safely help get me back to normal?
Thanks so much for your article! Blessed I came across it
Could be the affect of insulin on your gallbladder. You might remove any offender until the GB settles down. Personally I don’t use enzymes other than betaine HCL sometimes.
Insulin in the gallbladder? Is that a good or bad thing? For how long? Im doing a little better now-eating small meals.
Thank you so much for responding btw!
Not good; it’s explained in the articles.
My problem is the feeling of wanting to burp but you can’t burp! That is accompanied with a pain in the upper right shoulder blade, and then when you finally are able to burp really big, that pain in the shoulder is gone. No nausea , no constipation, no diarrhea……..some days worse than others with the burping and back pain.
This was so helpful. I had my first attack last night and went to the ER. How can I get to part II if this information. Thank you again!!
http://www.drgangemi.com/2012/08/gallbladder-health-prevention-treatment/
Dr.Gangemi,
My daughter’s boyfriend, who is 19, has had his gallbladder out. A low fat diet is best, but as 19 year old boys are wanting to eat the occasional high fat burger or plate of biscuits and gravy…he suffers after. Is there anything he can do (yes, we know AVOID is best!) that can help the digestion process of the occasional high fat treats?
Follow the advice I give in Part II.
Hello Sir, I have read above part but i’m unable to understand because i am from Enginnering background.
I Have a Question?
One month before my Mother( age 42) had undergone Nephrectomy(Right Kidney Removal) due to Frequent Urine Problem. During that Surgery Doctor came to my Father & said that Gall Bladder is attached to the Kidney So they have to remove it. As Doctor Recommended it , My father said Ok.
After 2-3 weeks of surgery my Mother is slowly recovering , but she feels pain in back side during night. When i approached the Doctro he said it’s not a problem ? Is that Right.
I googled some sites in that Gall Bladder may form again after 6-7 months after removal. Is that Right ?
What is Purpose of Gall Bladder and what is diet should be taken if it is removed ? Any Medications or any Care should it be taken ? As my Dr. Says nothing is required ?
My Mother still suffering from frequent urination during nights( more than 10 times) .What should i Do ? Please Respond me Sir DR.GANGEMI
Please read Part II – most of your questions can be answered there. Thank you.
Awesome article!!! I have gallstones and dont want my gallbladder taken out but I need help big time
First of all, thank you for the wonderfully informative article!
I’ve had gallbladder pain for over a year now, but only recently found out that is what it was. The ultrasound showed no stones, but the HIDA showed a lower empty rate than normal. My doctor isn’t pushing the gallbladder removal which is nice. I want to be trying for children sometime in the nearish future, and am concerned about potential problems during pregnancy. I have already spoken to my OBGYN and have a call into my GI doctor, but I found your site am interested in any suggestions you may have for a healthy gallbladder during pregnancy.
I am vegetarian aside from eating fish so my diet consists of mainly fruit & veggies, fish, rice/grains, beans, eggs, dairy, some soy products, and the occasional chocolate indulgence. I am 31 years old with an average weight and have a light-moderate exercise routine about 3x/week for 30-45 minutes. I have cut out caffiene and alcohol from my diet, which seems to have helped some. With all of the above, I still have relatively frequent uper right quadrant pain (at night and in the mornings), with increasing frequency around my periods. On average do women with gallblader problems before pregnancy have more issues during pregnancy and is there a pregnancy safe way to treat the pain?
Thank you for you time!
This is not uncommon with vegetarians, as you may have learned from reading the articles. Insulin issues are a big culprit with the gallbladder, which is common in low protein – high grain diets. Though it’s good you’re eating some fish & eggs. Something to consider, or reconsider, is your diet.
I had a HIDA scan 2 weeks ago; my gall bladder has an EF of approximately 2.2%. I am scheduled to have my gall bladder removed next week. I have had ALL of the symptoms but no stones or cholecystitis. I do have, and have had, persistent right upper quadrant pain, that radiates to my right middle back below my shoulder blade, for 6 months now. I found this information to be very helpful. Thank you!
Gudday sir, thank you very more for this very lecture i once sourced for.sir i am currently surfring from gallbladder infection for almost one year.and i was immediately told to remove by my doctor and a little beat scare and believing there is an alternative,though i still observes pains.sir how would i go about it.
For someone in your situation I’d advise you seek some holistic practitioner who deals with these cases, if you’re interested in trying to keep your gallbladder.
I have been having acid reflux. Burping after eating, and I do have alot of gallstones. However no one has described my other issue. The pain is severe. It starts pit of my stomach, then goes up way up into my jaw and head. It sort of feels like brain freeze, like when u eat or drink something too cold, only much much worse. I have had several attacks. One lasting the entire night. But no one has mentioned that. So to your knowledge has anyone ever complained of this?
I’ve heard that once or twice, not common. Usually something digestive going on. I recently saw a woman who had headaches only when she drank cooler than room temperature water. I had to do several things to correct it; there is typically not one specific problem resulting in the symptom.