Talk About Gall!

I always find it frustrating when modern medical practices "fix" a patient, only to set them up for serious problems on down the road that they then again, must "fix", since they didn't explain and won't admit the consequences of their original "fix".  This is especially true for patients who have had their gallbladder removed.

While it doesn't always hold true, the classic patient who has gall bladder problems, and eventually ends up with it being removed, fits into the four F's: fat, female, fertile, forty.  They are usually forty plus year old women who are still menstruating that are overweight.  In my experience, it seems these demographics are changing.  I am seeing the age group become younger, where it is often women in their twenties or even teens who are developing problems with their gallbladder.

What needs to be understood, is that with few exceptions, gallbladder problems are a combination of issues with fat digestion and liver congestion.  It is the job of the liver to produce bile, which is a conglomeration of fat soluble toxin and hormone byproducts, cholesterol, and bile acids.  It is put into the gallbladder for storage and concentration until a significant amount of fat is eaten, at which time the gallbladder contracts and squeezes the bile into the digestive tract.  When the liver is not functioning correctly or is congested with toxic buildup (we'll talk more about this in a later blog), the bile will not be made properly, and will have components that are more likely to form stones or are irritating to the gallbladder.  These patients will also often have sex hormone alterations such as heavy menstrual cycles, PMS, or dysmenorrhea.  They may also be prone to mood fluctuations, depression, or stress intolerance due to the wide reaching effects of sex hormones on the body.  When fat is eaten, it stimulates the gallbladder to empty its contents into the digestive tract.  The intensity of the signal to dump bile is determined by the amount of fat eaten.  A diet that fluctuates between high and low fat, or is always low fat, creates abnormal feedback to the gallbladder, leading to impaired fat digestion.

Regardless of how the patient developed gallbladder dysfunction, medicine's dominant answer is "let's just take it out, you can live without it".  And so, the downward health spiral begins; the patient loses their gallbladder, and is sent home without being given the knowledge that they now are set up for serious problems on down the road, while the original problem is never investigated, found, and addressed.  Is the gallbladder a "vital" organ?  No, you can live without it.  You can't, however, be truly healthy without it if you aren't providing your body with bile replacement therapy.

Medicine looks at gallbladder removal as common and with minimal consequence to the patient, especially in today's world of laparoscopic surgery.  They seem to feel that as long as they reconnect the common bile duct to the small intestine, the bile will continue to be made, put into the small intestine, and the patient will be fine.  While this may make some sense on the surface, when you really look at how things are supposed to work, we again see that medicine is content to leave patients sick and on the road to other illness, as long as they can fix or hide today's symptom.

Bile is an integral part of our overall health.  Without the proper amount of bile at the right time, we cannot digest and absorb fats or the fat soluble vitamins A, D, E, or K.  Medicine purports that as long as we have bile in the intestine, that's good enough.  This is similar to the dishwasher saying that as long as they put soap in the sink sometime, they'll be able to clean that greasy skillet.  Does it matter that the dish soap has been dripping into the sink for the past few hours, and most of it has gone down the drain, just as the bile does when there is no reservoir, i.e. gallbladder?  Can you clean that greasy skillet if you only have a few drops of soap?  Probably not very well.  And, if there is no grease to be "cut" by the soap, what is the soap doing as it goes down the drain?  Does it have any potential to do damage to the drain?  Soap doesn't, but bile can.

Bile is our fat emulsifier, just like soap.  It allows us to take fats and put them into a form that can combine with water so it can be absorbed.  With only small amounts of bile when fat is present in the small intestine, fat often passes on through, leaving the patient with foul smelling stools that are tan or grey colored, and the patient feels bloated or gassy with any amount of fat eaten.  Along with the fat itself not being made ready for proper absorption is the issue of vitamins A, D, E, and K.  Vitamin A is necessary for eye and liver function, as well as being an antioxidant.  Vitamin D has so many different functions in the body that it would take a book to explain it all, but just a few things include bone health, immune function, brain function, and cancer prevention.  Vitamin E is our premier antioxidant for fat soluble toxins, and Vitamin K is necessary for not only normal blood clotting, but is part of how calcium gets into our bones.  When the gallbladder is removed and the bile isn't where it needs to be when it needs to be there, we become deficient in all of these vitamins, and our health begins to slowly degrade.

In addition to the vitamins that are left to be passed along, the normal fats aren't processed correctly either.  While some would welcome less fat entering their body (and medicine has drugs which do exactly that), this causes problems as well.  Our brain is 60-65% fat.  Our stress and sex hormones are all fat based.  Your immune system relies on fat based molecules to communicate.  Without the right fats, our body doesn't work well either.  Eventually, we end up with higher rates of osteoporosis, cancers, brain dysfunction like depression and anxiety, dry cracked skin, increased risk of infections, and a whole host of other abnormal function, just because we removed a simple little bladder, and didn't replace its function.

So what happens to the bile that is being dumped down the drain?  Any hunter will tell you that bile is extremely damaging to any tissue it touches.  They are very careful when working around this little sac due to its caustic contents.  Without fat to mix with and emulsify, it continues down the digestive tract, looking for things to emulsify on its way.  What it may find is that the lining of the intestine can be a ripe target.  It can irritate the lining as it passes along, which can create other digestive problems.  The good bacteria in our intestines are also at risk of being attacked, which can leave the gut wide open to opportunistic bacteria and yeast that create a whole host of other issues.

To say the least, removing the gallbladder is a serious long term health risk.  If left uneducated, the patient is walking down a path of slowly degrading health that could have been prevented with a simple bile replacement.  Easy and relatively inexpensive, we can save these patients from years of suffering and putting huge a drain on health care dollars, by adding bile in supplemental form when they eat any amount of fat once their gallbladder is gone.  Will medicine recommend this?  They haven't yet, and I have a hard time believing it will happen any time soon.  That means it is up to those of us who are working to help patients achieve real health to educate the population so they can take action on their own.

Without a gallbladder, fat and fat soluble vitamins become problematic for the patient, plain and simple.  Modern medicine needs to wake up and realize what they are dooming these patients to in the future; a life of slowly degrading health that could be easily remedied.  Talk about gall!

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