It is estimated that approximately 700,000 gallbladders are removed each year. It is now rivaling hysterectomies in the number of procedures performed each year. The surgical removal of the gallbladder is a cholecystectomy. The frequency of this surgery is up from 500,000, on average, the years prior to the laparoscopic technique being introduced in the 1990’s. It appears since the surgical technique became faster, less expensive, and less invasive, the frequency went up. There is no evidence that anything occurred within American culture after the 1990’s to merit increased removal of the gallbladder. Even though the gallbladder is not a vital organ, there is concern it is being removed too often and too quickly. Just because you do not need an organ to survive (vital) does not mean that it is indispensable.

We are huge fans of gallbladders and think everyone should keep theirs whenever possible. Not unlike “The Little Engine That Could”, when the gallbladder is struggling to do the job it needs to do, there are ways to support it in order to, in most cases, avoid surgery and restore it back to healthy function. The gallbladder may be small, but it is mighty.

What is the Gallbladder?

Your gallbladder is a pear-shaped organ under your liver. It stores the bile that your liver produces. Bile is continually secreted from the liver into the gallbladder where it is concentrated and stored, like a reservoir. This concentration of bile that occurs in the gallbladder is crucial for adequate fat digestions. Bile is then reabsorbed into the bloodstream to aid in digestion and deliver nutrients to the body. When your body needs bile to digest foods, the gallbladder squeezes bile through the bile ducts into your small intestine to break down fat from meals.

If there is build up of the things that make up bile like cholesterol, bile salts, and bilirubin, the excess hardens into gallstones. The liver is partially responsible for managing what goes into the gallbladder, so a healthy liver and gallbladder go together. Your gallbladder is responsible for:

  • Nausea/vomiting
  • Fatty or greasy stools
  • Dry hair, eyes, brittle nails, itchy skin, skin rashes
  • Diarrhea, bloating, cramping, excessive gas
  • Pain between shoulders on right side and/or upper-right quadrant pain
  • SIBO (small intestinal bacterial overgrowth)
  • Abdominal pain
  • Headache/migraines
  • Chemical sensitivities (perfume, cologne, tobacco smoke)
  • Hypothyroid
  • Weight loss resistance
  • Causes and Risks of Gallbladder Complications

Potential causes of gallbladder issues include long-term low fat dieting, vegetarian/vegan diet, hypothyroid, high estrogen levels, impaired digestion, imbalance of gut bacteria and pro-inflammatory foods, and chronic infections (especially viral). Gallstones tend to run in families and women are more likely to experience gallbladder problems in part because of the effects of high estrogen on bile production. It is increasingly common for pregnant women to experience gallbladder attacks during and after pregnancy. This is due to high estrogen levels during and after pregnancy. Because of birth control, hormone disrupting chemicals, and general modern lifestyle contributing to hormone imbalances, many women spend years in an estrogen dominant state contributing to the development of gallbladder/liver issues.

Conventional Treatment of Gallbladder Issues

This is a pretty simple explanation. Surgically remove the gallbladder and follow a low fat diet for the rest of your life. There is essentially no real treatment for a sludgy gallbladder (biliary stasis). In all other organ related cases, surgical options are on the table AFTER all other available treatments have failed. However, with the gallbladder, it is removed at the first hint of an issue. This propensity towards surgery first with gallbladders can cause long term side effects that are often dismissed by surgeons. Additionally, after surgery, there is no liver and/or digestion support given and it is estimated that over 50+% of people who have gallbladder removed do not see any improvements in their digestive issues.

Side Effects of Gallbladder Removal

There are over 44 reported side effects from gallbladder removal. The top six reported side effects after surgery include:

  • Pain in Upper right quadrant of abdominal region or right shoulder pain
  • Nausea or Vomiting or Abdominal Cramping
  • Sporadic fever
  • Changes in bowel habit – especially diarrhea and light or chalky stools
  • Fatigue
  • Change in urine color – becomes more dark

These symptoms come from a variety of issues that occur when you don’t have your gallbladder. When you don’t have a gallbladder, the liver continues to make bile, but there’s no longer a place to store it, or concentrate it. Bile then slowly trickles into the intestines so if you eat a fatty meal, there’s not enough bile available to digest the fat since bile is the primary method of proper fat digestion. Fat malabsorption can be the cause of diarrhea, bloating, nausea and even heartburn.

Poor digestion of fats isn’t a small thing when it comes to your overall health and long-term health. Without a gallbladder you may not be able to digest essential fatty acids like omega 3 and omega 6 fats. These are both crucial to adequate hormone and brain function and are key players in managing inflammation. Fat soluble vitamins are dependant on good fat digestion to be absorbed so without a gallbladder, you may not absorb vitamins D, E, A, and K very well. Some phytonutrients like lycopene, lutein and carotenoids are fat soluble so absorption is impaired without a gallbladder. Even if you take extra of these nutrients, without enough bile you still will not absorb them well.

If you have had your gallbladder removed and suffer from dry, brittle hair, dry skin, dry eye, premature aging of skin, weak nails, low mood, anxiety, depression or impaired cognitive function, these could be signs you are not digesting fats adequately because of your gallbladder removal. Some of these symptoms could also be related to thyroid function which can also be inhibited by gallbladder removal. The gallbladder is also a key player in conversion of T4 to active T3 which is the main thyroid hormone.

Functional Medicine Treatment

A functional medicine approach to a healthy gallbladder includes taking care of the liver too. It supports the liver and bile secretion for life after gallbladder removal when it has already been removed. It is important to note that your gallbladder problem didn’t just happen spontaneously overnight even though the pain associated with a gallbladder attack can happen very suddenly. It started with an unhealthy liver and a poorly functioning digestive system which was likely developing for years. An unhealthy liver will not make quality bile and inadequate bile will not effectively digest fats, remove toxins, and increase risk for developing stones.

3 Essential Supplements after Gallbladder Removal

  • Vitamin D3– since fat soluble vitamins are challenging for the body and vitamin D is so critical in a multitude of body functions, supplementing is key, especially in winter months
  • Ox Bile– taking ox bile daily in rotating doses supports the body’s bile production and helps to replicate the intended function of the gallbladder
  • Digestive Enzymes– bile is essential for proper breakdown of foods as they enter the intestines and digestive enzymes can support this process- especially lipase which aids in fat digestion

These three supplements will help support the very basic needs of the body after gallbladder removal, but it is important to work with your functional medicine practitioner to be sure your detoxification, digestion and absorption are optimized after gallbladder removal to prevent nutrient deficiencies and chronic disease- including autoimmune disease.

It is not uncommon for symptoms related to gallbladder removal to take time appear as deficiencies take time to develop. Don’t wait for poor digestion, essential fatty acid deficiencies and consequences of low vitamin D to set in before supporting your body if you have already had your gallbladder removed.

In the event you are experiencing gallbladder issues or gallstones and are considering gallbladder removal, be sure to work with a functional medicine practitioner to support your liver and gallbladder to remove gallstones without surgical intervention. Even a simple 3 day cleanse of bone broth, green apples and vegetables with appropriately designed supplement plan can stimulate better liver and gallbladder function. Some practitioners will use more aggressive one-day cleanses that often show good results in removing gallstones completely and therefore avoiding surgery.

Final Thoughts

Your gallbladder is important and should not be given up to surgery without a fight. Just because an organ is not vital to your survival does not mean it isn’t vital to your health. Daily habits that support a healthy liver and gallbladder can prevent issues from developing. If gallbladder issues do arise, there are treatment options instead of surgery. If surgery does need to occur or already has occurred, be encouraged- there are ways to support your liver in ways that can prevent ongoing issues. We have seen first hand patients who have been suffering from chronic health issues related thyroid, essential fatty acid deficiency and nutrient malabsorption trace the start of their hair loss, fatigue, diarrhea, cramping, bloating, and mood disorders back to a few months after their gallbladder removal. Don’t let this be you. We know it is not always possible to avoid gallbladder removal, but your long-term health does not have to suffer because of it.

Our functional medicine practitioners focus on inflammation causing triggers that lead to chronic degenerative disease. See our Overland Park providers for your digestive needs.