Gallbladder Removal

Gallbladder removal is the most common operation in North America. Every year, more than half a million people in the United States have their gallbladder removed. Most are suffering with some sort of abdominal discomfort, bloating and nausea and are found by ultrasound to have gallstones or by HIDA scan to have a narrowed gallbladder outlet. Therefore the deduction is made the gallbladder is causing the pain, and after being told they really don’t need a gallbladder the offending organ is removed. Nonetheless after surgery up to13-40% of patients will have persisting abdominal pain after cholecystectomy. This is known as postcholecystectomy syndrome. How can this happen, since the gallbladder was the problem. Clearly something is wrong here with the medical reasoning since removing the gallbladder has not addressed the problem of nausea, gas and bloating.

The gallbladder has an important function in digestion. It regulates the flow of bile which is then used to digest fats. The liver makes about a quart of bile a day which isthen stored in the gallbladder where it is released in a controlled manner. After gallbladder removal the bile is said to be able to pass directly into the small intestine for fat digestion. However there is no regulation meaning that eating fats can cause a massive outburst of bile release leading to an urgent need to evacuate. For many this is not socially acceptable and therefore most patients learn to avoid fats. This is not a great idea since it means may patients miss out on the all important omega -3’s which are extremely important for cardiac health, inflammation, depression, mania, and diabetes.

It should be fairly obvious by now that having the gallbladder removed, while making the surgeon richer, gives you about a 70 percent chance of solving the pain problem and can present you with a whole new host of problems. Clearly having the gallbladder removed should be a carefully considered decision since once it is removed there is no going back. Cutting out a body part to solve a problem is treating the symptom, not the cause.

The presence alone of gallstones is not a problem. Many people live very long lives with large amounts of gallstones. However it is important to remember that not all gallbladders can be saved. The gallbladder can become infected and if it burst, like an appendix, can be life threatening. Gallstones can also travel and block the sphincter of Odhi which is the opening of the bile duct into the small intestine. Blocking all outflow from the liver and pancreas can lead to a life threatening inflammation of the pancreas called pancreatitis. For this reason if inflammation, fever, jaundice or sever pain is present it is imperative to seek medical care.

The holistic approach is to improve bile flow and slowly dissolve the gallbladder “sludge”. Bitter herbs like gentian, yellow dock or dandelion are the best way to stimulate bile production and improve fat digestion. Milk thistle, artichoke and turmeric all help thin the bile. Choline is also very useful for thinning the bile and can be taken before each meal. Removing refined and processed food from the diet and adding fiber also can decrease gallstone buildup. Adding acid such as betaine hydrochloride sugar will also help the body dissolve cholesterol. Without sufficient acid the cholesterol builds up into cholesterol gallstones. The herb golden coin grass is popularly has been used for centuries by Chinese medicine practitioners with success to slowly and safely dissolve gallstones. It is also important to point out that the extremely popular gallbladder flush consisting of mixing olive oil with epsom salts can also be dangerous and can cause vomiting, diarrhea and abdominal pain. Also the tiny green balls that are passed and often called gallstones have been studied and shown to result from the saponification of the olive oil with bile salts.

Taking bile salts after the gallbladder has been removed will help the body continue to process fats. Choline also supports digestion of fats and in combination with the bile salts may be helpful with gas and bloating. The hydrochloric acid and digestive enzymes can help to stimulate digestion which was most likely part of the root of the problem in the first place. Remember that avoiding the essential oils like omegas threes can have serious health consequences for your heart and your brain. I recently saw a patient who had his gallbladder removed ten years ago. Because of the “postdump” syndrome he avoided fish oil. His C Reactive protein, which is one of the most powerful markers of inflammation and cardiovascular risk, was extremely elevated. Three months of fish oil along with the other supplements I just suggested have brought it down to a more acceptable range. (As an aside when people have trouble with fish oil it often is from a dysfunction of the gallbladder, and following some of the above suggestions can be helpful in aiding digestion.)

Although in this article we have only talked about the gallbladder it may serve as an example as to why in general removing a body part is not a great idea. In Chinese medicine all body organs have an energetic as well as a physiologic importance. For instance according to tradtional Chinese Medicine removing the gallbladder weakens the liver which can then lead to depression. This is not something that most Western surgeons understand. When someone who is about to profit economically from your surgery suggests removal of an organ such as the uterus or ovaries because “you don’t really need it”, it is wise to consult a more functionally literate practitioner who understands the longterm physiology of the body as a whole.

Mary Ackerley MD, MD(H), ABIHM is a classically trained psychiatrist and homeopathic physician who specializes in the holistic treatment of depression, anxiety, bipolar disorders, digestive disturbances and hormone replacement therapy.

She can be reached through her clinic MyPassion4Health at 520-299-5694 or online at MyPassion4Health.com