What is a gallbladder and what does it do?
The gallbladder is an organ which can be found underneath your liver, on the upper-right side of your abdomen. It is there to store bile produced in the liver. When we eat, the bile is released helping us to digest our food by breaking down the fat, and absorb the fat-soluble vitamins A, D, E and K.
The absorption of fat is important to our overall health as it has a role in many of our bodily functions, including our hormonal and brain health.
Bile also helps the elimination of toxins and waste products from the body.
The gallbladder and the gut microbiome
Of course, the gallbladder is part of our digestive system, our gut. But, in terms of our gut microbiome, bile can help to protect us against bacterial growth in the small intestine. This means it can help regulate the microbiome, reducing the risk of imbalances and SIBO.
In the large intestine, bacteria produce secondary bile acids by removing amino acids from bile salts. These bile acids are reabsorbed and travel in the blood to the liver where they help digest fat. Any secondary bile acids that are not absorbed are eliminated in the stools. This recycling process helps to keep our digestive system working well, with amount of bile acids kept in balance.
What can go wrong with a gallbladder?
Gallbladder disease is the umbrella term for problems related to this organ. The most common is probably gallstones (hardened deposits that form in the gallbladder), but sometime more than one problem may occur that is related to the other.
Potential gallbladder problems include:
- Cholecystitis (inflammation of the gallbladder)
- Porcelain gallbladder (calcium deposits that cause the gallbladder wall to harden)
- Bile duct infection (infection due to an obstruction in the gut)
- Bile duct stones (gallstones that have passed into the bile ducts, or stones that have formed there)
- Abscess (empyema)
- Gallstone ileus (a gallstone that has travelled into the intestine and caused an obstruction)
- Perforation
- Polyps, which may cause an obstruction
- Cancer
For a relative small organ, that is quite a list of potential health problems!
Common symptoms of gallbladder disease can include:
- Pain on the mid to upper right side of your abdomen – this may radiate to the back or right shoulder blade
- Flatulence
- Nausea
- Chills and mild fever
- Frequent loose stools
- Pale coloured stools
- Jaundice (yellowing of the eyes and/or skin)
- Dark urine, not related to a lack of fluids
It is important to consult your GP if you experience these symptoms.
Risk factors
While these are not causes, gallbladder disease is typically associated with the “Five Fs”: Fair, Fat, Female, Fertile and Forty. This suggests women with high body fat levels who have had children or are pre-menopause, over forty years of age and light skinned are potentially at greater risk of problems. Of cause, this is a generalised association and anyone who experiences the above symptoms or feels unwell should consult their GP!
Other possible contributors to gallbladder and bile duct problems include:
Genetics
If you have relatives who have experienced gallstones, you may be at greater risk of developing them yourself.
Cholesterol build-up
A build-up of cholesterol may contribute to inflammation. The hormone oestrogen can increase the amount of cholesterol in bile, while the risk of a build-up of cholesterol in the gallbladder can be increased by:
- pregnancy
- sudden weight-loss
Trauma or injury
Parasites
Thankfully, parasites are rare in the gallbladder, but they may be found in the liver and biliary ducts. The majority of infected people will not have symptoms. Symptoms may show with severe infection. The best way to reduce your risk of infection is to follow good hygiene and food safety practices, and to avoid potentially contaminated food and water when travelling.
Other health problems
A variety of health problems are associated with gallbladder problems, including:
- enlarged lymph nodes
- pancreatitis and liver damage
- type 1 or type 2 diabetes
- Crohn’s disease
- a high level of bilirubin in the bile
- thyroid disease
Diet
Diets high in trans fats (typically found in fried foods and ultra processed food products) and/or refined carbohydrates (white wheat products and sugary foods) are associated with increased risks.
Smoking
While smoking hasn’t been definitively linked to the formation of gallstones, it has been negatively associated with the digestive processes:
- Delayed emptying of the gallbladder
- Inflammation of the digestive tract (increasing the risk of Chron’s Disease and peptic ulcers).
Alcohol
While moderate alcohol intake may be beneficial for some individuals in terms of gallstone risk, heavy alcohol intake may increase the risk of gallstones as a result of its effect on the liver.
Low vitamin D
Low levels of vitamin D has been associated with ineffective gallbladder functioning. This “gallbladder stasis” may increase the risk of gallstones forming.
Stress
Stress may contribute to gallbladder problems by its overall impact on the functioning of the digestive system.
Potential effects of gallbladder removal
In severe cases, doctors may recommend that you have your gallbladder removed. If this happens your body will no longer store bile until it is needed; instead it will pass into your small intestine as it is made. This may reduce your ability to digest fat in your food as well as affect your absorption of the fat-soluble vitamins. It may therefore be necessary to avoid meals that are high in fat (there is no need to eliminate fat completely in the long-term!). Diarrhoea may be a temporary side effect of this following gallbladder surgery.
Studies have found that gallbladder removal can reduce total blood cholesterol and LDL (‘bad’) cholesterol levels.
When having the gallbladder removed, it may be helpful to remember that this is addressing the symptoms and not the cause. It is good to think about what contributed to the gallbladder issues and make changes help protect your health from further issues. Gallstones may still form in the bile ducts after the gallbladder has been removed.
What can you do to help your gallbladder? Here’s 5 things…
- Enjoy a diet rich in a variety of whole plant foods to help maximise your nutrient intake from food. Include wholegrain cereals, and aim for at least 7 portions of fruit and vegetables per day (2 fruit and 5 vegetables) and/or 30 portions of different plant foods per week. Fibre and vitamin C in particular are important for gallbladder health.
- Eat foods high in calcium such as leafy greens, dairy products, calcium-set tofu, and bony fish.
- Drink coffee. While you shouldn’t drink more than a few cups a day (and preferably not in the afternoon or evening) caffeine has been found to support gallbladder health. Of course, if you are sensitive to caffeine or need to avoid it for medical reasons, do not add it to your beverage menu!
- Choose foods containing “healthier” fats such as nuts, seeds and oily fish.
- Manage your intake of refined sugar – try to avoid large amounts of this food daily.
These suggestions are to support the general good health of your gallbladder. If you have problems with your gallbladder you should discuss diet with your doctor who may refer you to a dietitian for advice. As a nutritional therapist I am able to support gallbladder health with my clients, but this support is based around any diet and lifestyle guidance given by medical professionals.
