Why Your Gallbladder is Necessary and How to Keep It Healthy
When a friend of the family recently announced her upcoming gallbladder surgery after discovering a gall stone following a gallbladder attack, I had to ask, why? It was her first gall bladder attack, and yes, they are excruciatingly painful, but to agree so quickly to surgery was deeply concerning. It wasn’t the first time that a friend or family member had rushed to have their gallbladder removed, and not all were without repercussion. In answering the above question, I feel pretty confident that it comes down to education and support. This is why after studying and teaching about this condition for over forty years I felt compelled to share the following information. Shouldn’t we be asking why there is an epidemic of gallbladder surgery and how can we take better care of this organ? It is my hope that the information contained in this article may empower you to take another look at why your gallbladder is necessary.
Unfortunately, it is not very likely that you will be encouraged to forgo gallbladder surgery by a doctor, nurse or surgeon, or that they will tell you that keeping your gallbladder is a realistic option. There are a few reasons for this and one is that the Western mechanistic model of allopathic medicine uses drugs and surgery as its main tools, and if all you have is a hammer, everything looks like a nail. In other words, all of the reference points are within the model and alternatives are rarely considered, let alone known, used or understood. If you want to learn about alternatives you will need to seek an alternative practitioner like an acupuncturist, herbalist, naturopath, or chiropractor. Medical practitioners who are serious about Integrative and Complementary medicine are also seeking out alternative practitioners in order to learn what is not being taught in medical school.
Another reason you will most likely hear from your doctor or surgeon for having a cholecystectomy is that 1 in 5 newly diagnosed patients with acute cholecystitis who do not have surgery readmit to the emergency room within about 12 weeks. Also, people who have a medical procedure to eliminate gallstones have them return 50% of the time and 80% of those return to have their gallbladder removed. Those are not bad odds considering most of those people are probably not making dietary or lifestyle changes, but it is still being used as an argument as to why you should just go ahead and get the surgery.
In my experience, the main reason most people choose to have their gallbladder removed, in addition to lack of reliable alternative information, is because most people aren’t willing to make the necessary dietary and lifestyle changes that would keep them gallstone free, or to follow a protocol that could help to eliminate existing gallstones. It takes time to empower ourselves with information that could help us understand what may have caused the problem in the first place and most people don’t know the right questions to ask when seeking alternatives. We also live in an instant gratification society and when it comes to physical pain, most people will take the easiest and quickest route to avoid and prevent it. This makes us vulnerable to the drug and surgery pushers who capitalize on fear and cause us to make hasty decisions that may not be in our best interest long term.
I think it’s important to note here that I am not a medical doctor and that surgery and drugs can be lifesaving. So please make your informed decisions in partnership with your health care provider. I recommend that you continue to be monitored as gallbladder disease can be serious and life threatening. The information presented here is for educational purposes only so that you can make an informed decision. I am an herbal practitioner in the Energetic Model aligned with the Wise Woman and Western European Herbal Traditions, and drawing from the wisdom of Chinese Medicine and Five Element Theory.
In Chinese Medicine, Five Element Theory is the study of relationships and organ systems are paired within each of the five elements. The gallbladder is a yang organ (hollow), paired with the liver, a yin organ (solid), and corresponds with the Wood Element. Yin balances yang and when the gallbladder is removed it sets up an imbalance in the paired organ system that causes other systems to weaken and collapse. You can live without your gallbladder, but should you? I would suggest you read the literature for yourself, especially testimonials from people who suffered long term complications and quality of life issues after gallbladder removal.
Cholecystitis, or biliary colic, is the most common type of gallbladder disease as either an acute or chronic inflammation often due to gallstones blocking the duct and causing bile to build up. Bile is made in the liver and stored in the gallbladder until the body needs to digest fats. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, and the gallbladder doesn’t empty completely or often enough, it can harden into pieces of stone-like material forming gallstones. Two types of gallstones are cholesterol and pigment. For the purposes of this article I will be discussing cholesterol as they account for 80% of stones.
Gallbladder disease is more common in females, especially post-partum when estrogen levels are high. Gallstone related disease is a leading non-obstetrical cause of hospitalization in the first year postpartum. This is why I began researching this dis-ease over forty years ago as a practicing midwife. Most hormonal imbalances postpartum develop due to estrogen dominance. Birth control pills also increase risk and effect the ability of the gallbladder to contract and excrete bile.
Dietary factors are important considerations and one that you won’t see commonly discussed is vegetarian diets, which are implicated in gallbladder disease. In fact, you are likely to read that vegetarian diets can prevent gallbladder disease because it reduces the amount of cholesterol in bile and increases fiber in the diet. The fiber part is accurate, but the reason vegetarian diets are implicated is that very little bile is produced since the liver is not stimulated to produce it. This results in large fat molecules not being properly emulsified, making it difficult for lipase to bind, leading to incomplete or reduced fat absorption. Lipase is necessary for fat-soluble vitamin absorption (Vitamins K, D, E & A).
A shortage of the enzyme lipase may lead to high cholesterol. A deficiency of lipase, taurine, or lecithin can lead to a lack of bile and the formation of gallstones from cholesterol. Raw butter and cream is the highest source of lipase, with the highest source of lipase and lecithin being fertile eggs. Another cause of fat and mineral malabsorption, and inflammation, is gluten sensitivity.
One of the most important dietary considerations also happens to be the most deficient in the modern diet. It is the inclusion of the bitter flavor. When the time comes for the body to digest fats, the gallbladder contracts and pushes bile into the common bile duct that carries it to the small intestine where it aids in digestion. The bitter flavor is responsible for toning the gallbladder so that its action of contracting and pushing the bile into the bile duct is maintained. Our ancestors knew the importance of bitter, which also stimulates the production of saliva when introduced into the mouth and they included herbal bitters as part of their health regimen.
So, what are the risks of having or not having gallbladder surgery? While there is some chance of developing an infection necessitating emergency removal (5%), with a little support your body is capable of passing gallstones on its own. That said, cholecystectomy is the most common surgical procedure performed in the United States according to the Journal of the Society of Laparoendoscopic Surgeons with 1.2 million done annually and largely covered by Medicaid. In fact, cholecystectomy was the most common operating room procedure for Medicaid and uninsured stays while ranking 8th most common operating room procedure among patients with private insurance. The increase in surgeries can largely be attributed to the advent of laparoscopic surgery and the laparoscopic cholecystectomies in the early 1990s.
Bile duct injury continues to be a significant complication and is the leading cause of litigation against general surgeons. While the advent of laparoscopic procedure has substantial benefits (outpatient, quicker recovery, less pain) these did not come without risk, most notably a doubling of the rate of major biliary tract injury. Injury to the bile duct often results in additional surgical procedures, increasing the risk of morbidity and mortality.
Cholecystectomy also increases the risk of bowel cancer because without your gallbladder, bile drips continuously into the digestive system and can also cause diarrhea and may lead to higher cholesterol levels. It can leave you sticking close to the bathroom and no longer tolerating certain foods.
So when a friend of the family recently announced her upcoming gallbladder surgery, I had to ask, Why not try a simple alternative before undergoing surgery? And why not implement some simple changes that might leave you never having another gallbladder attack again?
Some people claim that a gallbladder cleanse or flush can help break up stones and empty the gallbladder, but that is not recommended here. It is good to remember that the body is naturally able to cleanse and flush itself when supported properly and that is the approach and philosophy of the Energetic Model and Wise Woman Tradition.
Our goal is to increase the amount of bile created by the liver and secondly to assist the easy passage of that bile through the liver and gallbladder. Certain herbs can bring about an increased production and flow of bile, including bitters. This may be enough to help break down existing stones and carry that debris through the duct. Recommendations below are generalized suggestions, do not include dosages and are not meant to be a complete protocol. To learn more about the liver and gallbladder, or when and how to do a flush, Please consider enrolling in Love Your Liver: Spring & the Wood Element at Five Element Academy.
Dietary & Lifestyle Recommendations:
• Increase your exercise to 2-3 hours a week to reduce risk
• Increase fresh fruit and vegetables
• Include bitter greens like romaine lettuce and dandelion
• Increase water and soluble fiber intake
• Eliminate gluten and potential food allergens, and foods high in sugar and carbohydrates. The more refined and processed food the higher incidence of gallstones. Go for high fiber, low sugar.
• Include parsnip, apple (particularly Granny Smith) radish, pear, seaweed, lemon, lime, raw butter, cream, milk, egg, avocado, parsley, barley, beets, and cucumber in the diet.
• Apple cider vinegar daily
• Use olive, coconut and flax seed oils.
• Raw, fresh pressed apple juice may soften gallstones and can help them pass.
• Acupuncture may be effective in relieving pain and spasm, reducing inflammation and volume of the gallbladder and restoring proper function. In combination with Chinese herbs, Acupuncture may be highly effective.
• Lose weight slowly if necessary. Obesity increases your risk for developing gallstones.
• Eat slowly and mindfully
• Avoid large meals
• Vitamin C can help change cholesterol to bile
• Potassium Iodide, Iodine and Seafood high in iodine (helps dissolve cholesterol)
• Fish oils and Omega 3s
• Disodium Phosphate – supports liver and gallbladder functions (Standard Process brand)
• HCL acid and pepsin
• Bitter roots like Dandelion, Burdock, Yellow Root, Yellow Dock
• Take herbal bitters daily before meals
• Drink mildly bitter teas like Chamomile
• Turmeric reduces inflammation
• Anti-lithic herbs, also known as “stone breakers” can help dissolve stones taken in tinctures or teas: corn silk, gravel root, stone root, parsley root, and enteric-coated peppermint oil.
• Spasmolytic, Chanca Piedra for relaxing smooth muscle and expelling stones
• Castor oil packs can relieve pain and can support the passing of stones.
The use of castor oil packs in aiding gallstone passing cannot be over emphasized. This and the use of bitters and herbal infusions were well known by our ancestors. It is this Wise Woman Tradition that has brought us this far and we would do well to not lose sight of it. Let your care provider know, “I’ll keep my gallbladder, thank you!” And then ask for their support and guidance to make the wisest and most informed choice.
Disclaimer: Talk with your doctor before trying to treat gallstones on your own. If you have yellowing of the eyes, fever or chills, and intense abdominal pain, seek medical care immediately.
Love Your Liver: Spring & the Wood Element at Five Element Academy
Characteristics of Medicaid and Uninsured Hospitalizations, October 2012, Lorena Lopez-Gonzalez, Ph.D., Gary T. Pickends, Ph.D., Raynard Washington, Ph.D., and Audrey J. Weiss, Ph.D.
Laparoscopic Cholecystectomy and Newer Techniques of Gallbladder Removal, Jeffrey B. Comitalo, MD. JSLS 2012 Jul-Sept; 16(3): 406-412.
Trauma Acute Care Surgery, Mestral C, Rotstein O, Laupacis A, et al. A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy. 2012;74(1):26-30.