The health and function of the gallbladder is often overlooked unless gallstones cause significant pain or require surgical removal. The vast majority of gallstones are asymptomatic. The reality is, the gallbladder is the root cause of many chronic gastrointestinal issues. You do not need to experience a “gallbladder attack” to have underlying concerns within the biliary system.
First, let’s delve into the biliary tract to understand gallbladder physiology.
The Biliary System
The biliary system consists of the liver, gallbladder, and bile ducts that work together to produce, store, and secrete bile. Bile is made in the liver and then travels through the common bile duct and into the gallbladder. The gallbladder is the storage reservoir for bile. When specific cells in the small intestine sense dietary fats, the hormone cholecystokinin is released. Cholecystokinin then spurs the gallbladder to release bile.
Bile is an incredibly important secretion that helps to emulsify fats in the diet. Bile is made up of bile acids, cholesterol, bilirubin, phospholipids, inorganic salts, and trace minerals. It is known as a powerful anti-inflammatory agent for its pivotal role in gut health and detoxification. Bile is essential for the digestion of fats within the body as well as the assimilation of fat-soluble vitamins A, D, E, and K, and cholesterol.
Gallstones are crystallized deposits of cholesterol and other bile constituents. Oftentimes they are obvious and easy to diagnose. When gallstones arise, people usually experience such strong symptoms that they need to visit the emergency room or have the gallbladder surgically removed. Interestingly, gallbladder removal surgeries are one of the most common surgeries people receive. Considering the health and function of the gallbladder should empower individuals to avoid unnecessary surgery and improve overall health.
Symptoms of gallstones include:
- Severe and sudden pain in the upper right abdomen and possibly extending to the upper back or right shoulder
- Fever and shivering
- Severe nausea and vomiting
- Jaundice (yellowing of the skin or eyes)
- Clay- or khaki-colored stools or dark urine
The underlying issue with many cases of poor gallbladder health isn’t gallbladder stones but instead biliary stasis. This is a condition in which the bile becomes overly thick and doesn’t secrete well to help digest fats.
Sometimes in individuals with biliary stasis, an ultrasound can show gallstones that have formed but not yet obstructed the gallbladder. However, for many people, overly thick bile is the problem. This can be identified with several symptoms.
Symptoms of biliary stasis include:
- Burping after meals
- Fish oil burps from fish oil capsules
- Fatty foods make you feel worse
- Floating stools
- Chronic constipation
Biliary stasis is especially common in overweight women over 40 who have had children. This is due to the effects of hormonal shifts on the gallbladder.
General Gallbladder Concerns
While we have differentiated between gallstones and biliary stasis, there are other red flags that could indicate gallbladder problems.
Other gallbladder-related symptoms include:
- Dry hair, eyes, brittle nails, itchy skin, skin rashes
- Diarrhea, bloating, cramping, excessive gas
- SIBO (small intestinal bacterial overgrowth)
- Chemical sensitivities (perfume, cologne, tobacco smoke)
- Weight loss resistance
These symptoms can be attributed to various underlying concerns. In order for restoration to occur and optimal health to be achieved, the root cause gallbladder function and biliary stasis must be addressed. Without proper gallbladder function, fat cannot be digested which can result in various symptoms throughout the body.
Undigested fats can lead to poor sphincter function in the digestive tract, especially the ileocecal valve between the small and large intestines. When the ileocecal valve is not functioning properly, it can cause bacteria from the large intestine to make its way into the small intestine, which usually does not have very much bacteria residing in it. This condition is called small intestinal bacterial overgrowth (SIBO). SIBO causes many symptoms, including gas and bloating, chronic constipation, chronic diarrhea, or alternating constipation and diarrhea.
Biliary stasis hinders the liver’s detoxification pathways which can increase the toxic burden within the body. When the liver cannot adequately detox hormones, toxins, and other metabolites, the entire body is impacted. As a result, the inflammatory load on the body increases.
Oftentimes individuals with biliary stasis or gallbladder concerns experience symptoms when dietary fats are consumed, even health-promoting fats such as coconut oil or extra virgin olive oil. We often see people with gallbladder problems experience “fish burps” after taking fish oils. Because dietary fats cause unwanted symptoms, individuals with gallbladder concerns often avoid fats. This can be problematic because health-promoting fats are essential for overall health, especially for optimal hormone and brain function. Avoiding fats can also lead to deficiencies in the vital fat-soluble vitamins A, D, E, and K.
Perhaps you find yourself supporting your gut through diet and supplements, but still experience gastrointestinal symptoms. This is an indicator that gallbladder health should be considered.
How to Improve Gallbladder Health
Thankfully, there are various strategies for supporting gallbladder health, fat digestion, and liver detoxification. Incorporating these dietary factors and supplements go a long way in supporting the body.
In order to improve and maintain your gallbladder health, consider these strategies:
- Eat more fiber. Aim for 25 to 40 grams daily.
- Avoid highly refined carbohydrates (white flour, sugar, potatoes, pasta, etc.).
- Avoid trans fats, hydrogenated fats, and processed vegetable oils.
- Consume plenty of essential fatty acids and omega 3 fatty acids.
- Eliminate food sensitivities. Gluten and dairy are the two most common.
- Heal the gut lining to break the cycle of gut inflammation, biliary stasis, lack of bile, and further inflammation within the gut.
- Promote bile flow with curcumin, dandelion, milk thistle, and ginger.
- Reduce or dissolve gallstones with beetroot, taurine, phosphatidylcholine, lemon, peppermint, or vitamin C.
- Support your body if it suffers low thyroid function or Hashimoto’s autoimmune hypothyroidism.
- If you have had your gallbladder removed, all of these strategies would be helpful. Also consider supplementing with ox bile with meals.
If you are experiencing any of the symptoms listed above, there is so much that can be helpful from a holistic perspective. You can be assessed for various markers on in-depth blood panels to understand liver, gallbladder, and thyroid function along with markers to understand nutrient deficiencies, inflammation, fatty acid profiles, and many others to help improve your overall health.