Bring on the bile…

This week, after a reader request, we take a closer look at this undervalued organ, explore how lifestyle changes can help keep your gallbladder healthy, and discover how to optimise your health after gallbladder removal surgery (cholecystectomy).

What does the gallbladder do?

The gallbladder is a small, pear-shaped organ situated just below the liver. Its main function is to store and concentrate bile (a digestive enzyme) produced by the liver, and secrete the bile into the small intestine to assist in fat digestion.

When fat molecules are broken down into smaller particles, the body can readily absorb vital fat-soluble vitamins – A, D, E, and K -as well as essential fatty acids (Omega-3, -6, and -9).

Additionally, bile also assists in toxic waste removal from your system and triggers the release of digestive enzymes in the small intestine.

Why are cholecystectomies so common?

Gallstone disease (GD) occurs when bile crystallises in the gallbladder, forming small hard stones that inflame the gallbladder and prevent it from performing its function.

There are different types of gallstones – cholesterol gallstones (formed by excess cholesterol in the bile), black gallstones (formed by excess bilirubin excretion into bile), and brown stones (associated with bile duct infections). In this article we focus on recommendations related to cholesterol gallstones – the most common, and most easily preventable through lifestyle factors.

There are numerous genetic and lifestyle-related factors related to GD onset. Genetic risk factors include: advanced age, being female, and a family history of GD.

Lifestyle factors include: Obesity, diabetes, a high-calorie/high-carbohydrate and low-fibre diet, lack of physical activity, and rapid weight loss or cycles of rapid weight loss and gain.

The most common medical recommendation for treating GD is, unfortunately, a cholecystectomy.

How do you prevent GD?

The first step in preventing GD is to look at ways to prevent or treat the afore-mentioned lifestyle-related risk factors for developing the disease.

Diet is an important first step. Our typical “Western diet” – large portions of animal protein, refined carbohydrates, sugar, and fried fatty foods, with hardly any fresh fruit or vegetables – places excessive strain on the gallbladder.

This type of diet can also contribute to diabetes and obesity (two other risk factors for developing GD).

Research shows that including generous portions of vegetables in your diet (with an emphasis on whole foods) may be beneficial in preventing GD.

Studies also found that regular nut consumption (raw nuts are a great source of unsaturated fats), reduced the risk of GD in both men and women.

For gallbladder health, eat smaller portions and consume less fatty foods in one sitting (to avoid overloading the gallbladder).

Additionally, lower your saturated fat consumption (animal products such as meat, poultry, dairy, and eggs), and opt for unsaturated plant-based fats (raw nuts and seeds, avocados, olives) in order to support lower cholesterol levels.

Exercise is also essential. Aim for at least 20 to 30 minutes of moderate to high-intensity exercise a day.

If you are not used to exercising, start slowly by taking a 10 to 20 minute walk three times a week, then increase the duration and intensity as your fitness levels increase.

What if I’ve had a cholecystectomy?

The gallbladder stores and concentrates large amounts of bile to secrete once a meal is consumed, which means that the digestive system gets a “boost” to help break down fats.

Once the gallbladder is removed, there is a constant trickle of bile directly into the small intestine.

This means that the amount of bile injected at once cannot increase when a meal is consumed, which means the body cannot digest fats and absorb the nutrients in those fats as effecively.

There is also an increased risk of weight gain, as inadequate
bile reserves means that fat molecules pass directly into the bloodstream and get stored as fat before being broken down into a soluble form.

To make sure that your body gets the nutrients it needs, and to prevent toxic overload, it is important to adjust your diet. In the absence of a gallbladder, healthy bile is even more critical. Foods that increase bile production include beets, artichokes, cumin, capsaicin (found in chillies and peppers), and Omega-7s (found in macadamia nuts and deep sea anchovies).

Also avoid foods that are difficult to break down with limited amounts of bile – cut out all foods cooked in excessive amounts of oil.

Water-fry, dry-fry, or steam your vegetables instead.

Eat plenty of fresh vegetables and fruits, and limit your intake of foods that are naturally high in saturated fats (such as meat, eggs, and dairy products).

Instead, eat small quantities of plant-based fats (discussed above) at a time.

Lastly, it is also advisable to look into supplements to support bile production – good quality bile salts, and an ox bile supplement with meals will help your body to absorb the fat-soluble nutrients in your food that are necessary for optimum health.

Remember – consult your medical practitioner before taking a new supplement, and conduct research to find the best quality supplements for your specific needs.

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