Make your bile go the extra mile
“Gall bladder ‘attacks’ are widely agreed to be the most painful, common disease dynamic today”
Tracy Harrison, founder of School of Applied Functional Medicine
I continue to be amazed at how ready conventional medicine is prepared to say that we don’t need a certain body part. Gall bladders have been portrayed as being of such low importance that, once removed, people often forget to mention it to clinicians. And when they do, its “oh, didn’t I tell you,? I don’t have a gall bladder any more” as if it is an insignificant fact.
Obviously you can survive without a gallbladder (GB), otherwise its removal (cholecystectomy) wouldn’t be such a common surgery. However, surviving without an organ and living a healthy life without it are two very different things. Post GB removal you are at far greater risk of developing fatty liver, diarrhoea, constipation, biliary issues, indigestion, not to speak of the deficiencies that can materialise in essential fatty acids and fat-soluble nutrients. Not great, eh?
Before I go into any greater detail of exactly what happens when you don’t have a GB, lets just take a brief look at the role of the GB. The GB is essentially just a sack, but it’s a sack with a very key function and that is to collect, concentrate and store bile.
So what is bile and what is its job?
Bile is essentially a thick substance, made of bile salts, cholesterol, bilirubin and water. It is made (‘synthesised’ if you are being medically posh) in the liver (about 2 cups a day) and then transported via a network of fine ducts to the GB. Here it collects and concentrates (by removing some of the water) while waiting for a signal from your latest meal (especially the fat content of your meal) which causes it to be ejected by the GB contracting, into your small intestine.
Here it does a number of very key jobs, by far the most significant of which is to emulsify fats in our diet, allowing them to be absorbed, and also enabling the absorption of fat-soluble vitamins (A, D, E, K).
As well as being critical to the digestion of fats, it is the vehicle which the liver uses to transfer toxins (hormones eg estrogen, heavy metals eg lead and mercury, and a whole bunch of chemicals) into the intestines for elimination via the normal route.
What happens if the gall bladder is removed?
Yes, you are there already. There is nowhere to collect the bile. Why does that matter? Because although the liver is constantly producing drops of bile, dealing with the fat in a meal requires a big dollop (medically posh = bolus) of the stuff, released all in one go. Also, the ability to concentrate the bile has been lost, causing it to be less effective in fulfilling its job.
A change in bile chemistry isn’t the only thing that occurs after GB removal. Surgeries are rarely perfect. It is possible to injure the ducts. Adhesions (scar tissue) can form following surgery – some people are more prone to this. Remnants from the duct that once connected the GB to the common bile duct may cause problems. And dramatic changes may occur in the liver itself due to the absence of the GB. It is widely estimated that 10-15% of the population experience some form of post-cholecystectomy syndrome. So interesting that a seemingly disposable organ can wreak such havoc on our bodies once removed.
But what you can do to help post-cholecystectomy syndrome needs to be the subject of another article. What I want to focus on today is to help you spot GB problems coming and know how to protect yourself from ever having to discuss a cholecystectomy with your doctor!
So where do the problems originate?
As the gall bladder is literally just a sack, problems in the gall bladder are nearly always as a result of upstream issues in the liver, which is where bile is made.
There are several things that can go wrong with bile, but one of the primary ones is that it can become too thick, sluggish, gumming up the works, making it difficult for it to flow smoothly through the bile duct system into the gall bladder. And this is usually caused either by a suboptimal ratio of ingredients in the bile (high cholesterol, dehydration, too few bile salts). The excess cholesterol ends up forming crystals or ‘gallstones’ which can build up in the bile ducts or GB, and which can eventually grow to a size that blocks the neck of the GB.
Signs and Symptoms?
It is good to recognise this early on, ideally prior to actual gallstone formation, or at least soon after while stones are small. If you start to feel pain in your right upper quadrant, (and sometimes in the mid back area too), especially after eating when the gall bladder would naturally be pulsing in order to squeeze out the bile to help us digest that meal, that is clue that a there is probably a little stone in there which is gumming up the works. It’s the early stage of a blockage.
Other signs are floating/lighter, stick-to-the-loo stools, resistant acid reflux, gas after eating fatty foods.
Remedies and solutions!
I want to tell you about a fabulously simple remedy that has been shown in clinical studies to be very effective at dissolving gall stones. It’s called D-Limonene, an extract from citrus fruits, usually oranges. Its often used in counter-top cleaning products to emulsify the grease and enable you to clean easily. Well, it does the same in the bile system, starting in the liver.
It is available as a supplement, and if a client of mine had these dynamics, I would recommend they take 1000mg/day for about a month. It is actually quite safe to take for multiple months even.
Another supplement which can improve bile flow and composition is Taurine, whose relevance is as an ingredient of bile salts, and I would recommend 1000mg/day.
NB: You can increase the emptying of the GB with Extra Virgin Olive Oil, artichoke and digestive bitters, but this shouldn’t be done while there is immediate risk of stones, as increased emptying may precipitate a blockage.
Other things you can do to keep your liver healthy and your bile nice and thin and flowing well
The juice of certain vegetables can do wonders for the liver and biliary system. Beetroot, apples, and ginger all support bile formation.
Beetroot is probably the best vegetable for your liver as it contains important liver healing substances, including betaine, fibre, iron and folate. Betaine has so many health benefits. But inter alia it encourages the liver cells to get rid of toxins. Additionally, betaine has been shown to protect the liver and bile ducts against toxic chemical substances that get in through certain meds and pesticides.
(While I am at it, and just in case you need extra incentive to co-opt beetroot into your diet, beetroot has not only been linked to the healing of the liver but also a decrease in homocysteine, better stomach acid production (v important – see my article), prevention of free-radical formation in LDL, and prevention of lung, liver, skin, spleen, and colon cancer).
Apples contain malic acid which helps to open the bile ducts that run through your liver and reportedly soften and release the stones. Apples are also high in pectin which helps maintain a healthy cholesterol balance. Eating pectin-rich foods is known to reduce the risk of gallstones.
Ginger is reported to increase gut motility and bile production. You can add ginger to food dishes or eat it raw. Be careful, though, as it is spicy and pungent. You only need a small amount.
Other foods that protect the liver and increase bile production are bitter foods such as radicchio, radishes, globe artichokes, watercress, grapefruit. Lemon and ginger in hot water first thing in the morning is a brilliant way to start the day. Coffee is also a bitter, believe it or not.
Wrap Up
In these simple ways you can hugely improve your chances of holding on to an important body part for ensuring wellness downstream. Remember: removing the gallbladder doesn’t address the root cause; it just takes away the victim. Bile duct stones can still cause problems post cholecystectomy. Go upstream. Support the liver and the bile ducts!!!