What You Don’t Know About Gallbladder Removal

These data are taken from the medical literature.

• More than 700,000 Americans have their gallbladder removed each year.

• After gallbladder removal-cholecystectomy surgery, about 10-15% of patients will eventually have pain and digestive problems; is known as post-cholecystectomy syndrome.

• Common symptoms of post-cholecystectomy syndrome are pain, gas, bloating, indigestion of fatty foods, gastritis, sphincter of Oddi dysfunction, chronic pancreatitis, bile reflux, bile acid diarrhea.

• Currently, gallbladder surgery does not relieve biliary pain in 10%-33% of people with gallstones detected.

• After the introduction of the laparoscopic technique in 1989, the cholecystectomy rate increased by 60%.

You lost your gallbladder. If you were told that laparoscopic cholecystectomy would be a simple, relatively safe, painless, cosmetically beneficial, and scar-free procedure, that’s true. It is also true that the postoperative period and recovery would be quick. However, if you were told that the gallbladder is just an unnecessary sac for bile storage or that everyone can live after gallbladder surgery without any symptoms, this is not entirely true.

Many people do not realize the important role of the gallbladder, particularly when it comes to bile in the digestion of fats and fat soluble vitamins, cholesterol metabolism, acid-alkaline balance, detoxification, influence on pancreatic and sphincter function of Oddi, gut motility, etc.

The digestive system is a combination of digestive glands and chambers where digestion occurs. All the organs, such as the mouth, salivary glands, esophagus, stomach, liver, gallbladder, pancreas, duodenum, small and large intestines, function like a well-organized orchestra. The nervous system and blood messengers-digestive hormones regulate this orchestra. The gallbladder is an essential player in the digestive system. Therefore, without the gallbladder, the digestive system will never function normally.

To understand that, let’s go into the basic anatomy and physiology of the gallbladder and biliary system. Biliary is a medical term showing the relationship to bile or the bile duct. Two digestive glands, such as the liver and pancreas, produce bile and pancreatic juice, which are the core of proper digestion. The liver constantly produces bile. It is a yellow-green, liquid, bitter alkaline solution composed of water, minerals and bicarbonate, cholesterol, bile acids, lecithin, and bile pigments. Bile is concentrated in the gallbladder. When fatty foods come from the stomach, the gallbladder contracts and the concentrated bile passes into the duodenum to promote digestion.

Bile has a few functions.

First, bile helps pancreatic lipase break down fats, promoting their absorption in the small intestine. Without concentrated bile, humans cannot normally absorb fat and fat-soluble substances and vitamins.

Second, there is the sophisticated mechanism that regulates the contraction of the gallbladder and the simultaneous opening of the muscular sphincter of Oddi valve between the bile and pancreatic ducts and the first part of the small intestine called the duodenum. If the sphincter of Oddi is closed, the gallbladder is relaxed. I call it the pendulum effect.

Third, the bile acids within the bile may be in a soluble form or may be precipitated. The alkalinity of the bile keeps the bile acids in a soluble form. On the contrary, acidity causes their precipitation. Precipitated bile acids are very aggressive corrosive substances that irritate the bile ducts and the sphincter of Oddi, causing spasms and inflammation. In the gallbladder, bile is concentrated by 4-5 times, while the concentration of aggressive bile acids also increases. Not surprisingly, the gallbladder is more prone to irritation and inflammation; therefore, it is a prime target for the surgical knife.

Fourth, acidic changes in the bile can lead to the creation of gallstones.

Fifth, through the bile the human being eliminates fat-soluble toxic substances, alcohol, drugs, some medicines, bile pigments, heavy metals, etc. These toxins also irritate the gallbladder, bile ducts, and sphincter of Oddi.

Sixth, under normal conditions, bile does not enter the pancreatic duct. Even a small drop of bile in the pancreatic duct can cause the activation of digestive enzymes, self-digestion of the pancreas. Thus, pancreatitis begins.

Seventh, bile is the natural regulator of intestinal motility. There is biliary constipation and diarrhea due to bile acids.

Eighth, bile and pancreatic juice normally play an essential role in promoting beneficial gut bacteria. The low quality and quantity of these fluids can lead to small intestinal bacterial overgrowth (SIBO) and Candida yeast overgrowth.

Without the gallbladder, the pendulum effect is broken and sphincter of Oddi dysfunction develops. This muscular valve closes, the pressure inside the common bile duct increases, causing pain and cramps. High pressure within the common bile duct can cause biliary pain and pancreatitis.

Without the gallbladder, the liver continually produces hepatic bile that accumulates in the bile ducts. When the sphincter of Oddi cannot withstand the increased pressure within the common bile duct, it opens and unconcentrated bile from the liver passes into the duodenum, whether or not food is there. It can cause indigestion, especially fatty foods and irritation of the duodenal walls from acidic bile. The irritated duodenum contracts chaotically to cause bile to reflux into the stomach and esophagus, causing persistent heartburn, gastritis, ulcers, or Barrett’s esophagus. Instead, precipitated bile acids enter the large intestine and cause bile acid diarrhea.

I describe very briefly the problems that can cause post-cholecystectomy syndrome. They do not depend on surgery. Brilliant technique and experience, sophisticated equipment in most cases are not the reasons for pain and indigestion in people after gallbladder surgery, but the absence of gallbladder is.

We can’t put the gallbladder back in. Therefore, we need to focus on healthy eating habits and lifestyle, alkalizing bile and pancreatic juice, cleansing the whole body with restoring beneficial gut bacteria, detoxification, etc.

Post-cholecystectomy syndrome is the real problem involving millions of Americans. There is no silver bullet or magic treatment for it. Working for 40 years with patients without a gallbladder, I am sure that the treatment has to be not only symptomatic but also focused on the root of the problems. I’m sure that person without a gallbladder has to be treated when they feel well. I am sure that the treatment has to be less dangerous than the disease. I am sure that only the combination of conventional medicine with the various methods of alternative medicine, such as healing diet, herbs, nutritional supplements, drinking Karlovy Vary healing mineral water at home, acupuncture, colon hydrotherapy, abdominal manipulation are the key to keeping the person out of pain and digestive problems.

The information contained herein is presented for educational and informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. This information should not be used to replace the services or instructions of a physician or qualified health professional.