Dealing with Gallbladder Disorders

The message that your gallbladder is sending could very well be this: Beware the effects of bad nutrition. In recent years surgeons have been increasingly removing gallbladders, presumably in an attempt to treat gallstones and related disorders. But the gallbladder is fundamental to your well-being. Among other functions, it stores bile, a powerful fat-emulsifying substance that the liver makes from cholesterol. A healthy gallbladder works with flawless precision, releasing bile just when it’s needed to help digest food. It also absorbs nutrients and keeps your cholesterol levels in check.

Even as many doctors subscribe to the myth that eating fat and cholesterol leads to gallstones, research indicates that eating too little fat and too many carbohydrates in the form of grains, sugars and starches actually leads to gallbladder ailments.

1. The organ has one fundamental purpose: to help you digest food, specifically fats. Meddle with the performance of its job—as you do when you don’t eat enough fat to keep it in working order—and you endanger its health. Instead, the bile just sits in the organ, losing water and thickening.

Upsetting the Bile Balance
When you eat a meal that contains fat, the gallbladder releases bile into the small intestine. The bile breaks down the fat so the body’s tissues can absorb it, also enabling absorption of fat-soluble nutrients such as vitamins A, D, E and K. But the wrong food choices can toss a variety of diet-related wrenches into this machinery. For example:
• Without adequate protein, the liver won’t produce enough bile for the body to digest fats and allow nutrient absorption. After a while, stores of fat-soluble vitamins, especially vitamin K, decline. With time, outright deficiencies can occur—along with the illnesses they trigger.
• A diet high in sugary foods or refined carbohydrates has the same consequences.
• Frequent fasting—even just skipping breakfast—also sets the stage for a drop in bile production and usage.
• A low-cholesterol diet disrupts the system in two ways: First, the liver makes bile acids from cholesterol, so a scarcity of the raw ingredients causes a drop in production. Second, the main way the body gets rid of cholesterol is through bile metabolism, which transforms a third to a half of our total cholesterol into bile acids.

The Growth of Stones
Besides nutrient deficiencies and impaired digestion, the biggest repercussion of gallbladder dysfunction is the formation of gallstones, which can block bile ducts and cause nausea, abdominal pain, indigestion and inflammation. If gallstones are not treated, they can become steadily worse and ultimately prove fatal.

Approximately 80 percent of gallstones are composed mostly of cholesterol. As bile stagnates or thickens, cholesterol concentration increases. Cholesterol crystals eventually form, becoming like grains of sand in a gallstone “pearl.” So, if excess cholesterol is the basis of gallstones, why doesn’t a low-cholesterol diet solve the problem? It doesn’t work that way. People with high cholesterol levels in their blood are not any more likely to develop gallstones or gallbladder problems. In other words, dietary cholesterol (as opposed to cholesterol made by your liver) is not an important risk factor for gallstones.

What, then, are the risk factors for gallstones? Depending upon which study you read, women are anywhere from four to eight times more likely to get gallstones than men.

2. Pregnancy and estrogen therapy raise the odds a woman faces, as do obesity, diabetes and aging. We can’t do much about gender and age, but diet is a common denominator in obesity and diabetes. In too many instances they are provoked by an insulin disorder that’s caused by eating high-sugar, high-carbohydrate foods. Eating a lot of refined carbohydrates has also been identified as a risk factor for gallstones.

3. Rapid weight loss also has been implicated. In the last few years researchers have debated whether it’s the speed with which pounds are dropped or the composition of the diet plan, but upon closer inspection, the culprit repeatedly proves to be a low-calorie, low-fat diet.

4. Dietary fat and cholesterol promote normal gallbladder function.

5. If you take cholesterol-lowering drugs, be aware that they can raise the risk of gallstone formation.

6. Consuming sufficient healthy fat while shunning sugar and other carbohydrates empty of nutrients promotes gallbladder contractions and prevents gallstones better than anything else. So, long before surgery becomes a necessity, look at changing your diet. It’s a lot safer. For a list of nutrients that assist in gallbladder health, see Supporting Your Gallbladder with Supplements.

Selected References:
1. Tseng, M., Everhart, J.E., Sandler, R.S., “Dietary Intake and Gallbladder Disease: A Review,” Public Health Nutrition, 2(2), 1999, pages 161-172.
2. Everhart, J.E., Khare, M., Hill, M., et al., “Prevalence and Ethnic Differences in Gallbladder Disease in the United States,” Gastroenterology, 117(3), 1999, pages 632-639.
3. Boland, L.L., Folsom, A.R., Rosamond, W.D., “Hyperinsulinemia, Dyslipidemia, and Obesity as Risk Factors for Hospitalized Gallbladder Disease. A Prospective Study,” Annals of Epidemiology, 12(2), 2002, pages 131-140.
4. Festi, D., Colecchia, A., Orsini, M., et al., “Gallbladder Motility and Gallstone Formation in Obese Patients Following Very Low Calorie Diets. Use It (Fat) to Lose It (Well),” International Journal of Obesity and Related Metabolic Disorders, 22(6), 1998, pages 592-600.
5. Gebhard, R.L., Prigge, W.F., Ansel, H.J., et al., “The Role of Gallbladder Emptying in Gallstone Formation During Diet-Induced Rapid Weight Loss,” Hepatology, 24(3), 1996, pages 544-548.
6. Michielsen P.P., Fierens, H., Van Maercke, Y.M., “Drug-Induced Gallbladder Disease. Incidence, Aetiology and Management,” Drug Safety, 7(1), 1992, pages 32-45.

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