Gallbladder Problems And Gut Inflammation

Gallbladder disease can include inflammation, infection, stones or blockage of the gallbladder. Gallstone disease is a very common problem in Australia, with around 25% of the population developing gallstones before the age of 50. Research tells us that inflammation in the gut and leaky gut can be caused by gallbladder issues, and in turn, poor gut health and leaky gut can also cause gallbladder issues.

We believe it’s worth investigating this relationship if you have troubling symptoms.

What is your gallbladder and what does it do?

Your gallbladder is a small, pear-shaped organ that stores and releases bile. Bile is the fluid your liver produces that helps digest fats in food you eat and the absorption of cholesterol and the fat-soluble vitamins A, D, E, and K. It is a mixture of cholesterol, bilirubin and bile salts. Your gallbladder is located in the upper right part of your abdomen and sits below your liver.

Your gallbladder is connected to other parts of your digestive system through a series of bile ducts called the biliary tract. After it has been stored in the gallbladder, the biliary tract carries bile from your liver to your small intestine. [1]

When dietary fats enter the small intestine, they are sensed by enteroendocrine cells, which release the hormone cholecystokinin. Cholecystokinin, in turn, stimulates contraction of the gallbladder and the release of bile into the small intestine. [2]

What kind of things can go wrong with your gallbladder?

Types of gallbladder disease include:

• Cholecystitis: inflammation of the gallbladder tissue
• Gallstones: hardened deposits of digestive fluid that can form in your gallbladder.
• Chronic acalculous gallbladder disease (in which the natural movements needed to empty the gallbladder do not work well)
• Gangrene or abscesses
• Growths of tissue in the gallbladder
• Congenital defects of the gallbladder
• Sclerosing cholangitis: the backup of bile flow in the liver or in the biliary ducts
• Tumours of the gallbladder and bile ducts
• Gallstone pancreatitis: when the pancreatic bile duct is blocked by a gallstone causing inflammation of the pancreas [3]

More about gallstones

What are gallstones exactly?

There are three main types of gallstones:

Cholesterol stones

If the liver produces too much cholesterol, cholesterol crystals may form in bile and harden to become stones. These often appear yellow in colour. Cholesterol stones can grow to significant sizes, large enough to block bile ducts.

Pigment stones

Numerous, small dark stones form because of changes in other bile components or because the gallbladder fails to empty normally. These appear dark brown or black due to the bile containing too much bilirubin.

Mixed stones

These are the most common type and tend to develop in batches. They are composed of cholesterol and salts. [4]

Symptoms of gallstones

If you have gallstones, you may have no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, however, you may experience:

• Sudden and rapidly intensifying pain in the upper right part or centre of the abdomen
• Pain radiating between the shoulder blades and in the right shoulder
• Nausea or vomiting

If gallstones are left without treatment, the gallbladder may become inflamed. This is known as cholecystitis and can lead to irritation, inflammation, and pressure. You may experience infection and perforation with fevers, chills, nausea, vomiting, yellowing of the skin (jaundice), and light clay-coloured stools. [5]

It’s not clear what causes gallstones to form. Doctors think gallstones may result when:

• Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
• Your bile contains too much bilirubin. Bilirubin is a chemical that’s produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
• Your gallbladder doesn’t empty correctly. If your gallbladder doesn’t empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones. [6]

Who is more susceptible to gallbladder problems?

There is no universal cause for gallstones however there a number of known risk factors which include:

• Being female
• Being age 40 or older
• Being overweight or obese
• Being sedentary
• Being pregnant
• Eating a high-fat diet
• Eating a high-cholesterol diet
• Eating a low-fibre diet
• Having a family history of gallstones
• Having diabetes
• Having certain blood disorders, such as sickle cell anaemia or leukemia
• Losing weight very quickly
• Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
• Having liver disease [7]

The Functional Medicine approach to gallbladder issues

The Functional Medicine approach to treating gallbladder problems is to look for root causes and treat the body holistically, meaning, that we aim to understand how issues are connected and how they affect each other.

Intestinally permeability (leaky gut) and the gallbladder

Understanding the gut-biliary connection is vital in getting to the bottom of gallbladder problems. Leaky gut, which is when the gut lining becomes permeable and porous, lets toxins and unwanted matter into the bloodstream, creates inflammation not only in the intestinal tract, but throughout the body, including the gallbladder.

If you eat a food that your digestive system cannot properly break down, this can cause chronic irritation to the lining of your small intestine and give you leaky gut. If your gut is inflamed, it will not produce sufficient levels of the hormone cholecystokinin (CCK), which means your gallbladder won’t get the message to contract properly. [8]

When there is inflammation in the biliary system and bile is not flowing well into the gut, it can create an imbalance in the gut microbiome, development of parasites and overgrowth of small intestinal bacteria (SIBO). In fact, lack of bile entering the intestine can cause leaky gut and an alteration in gut bacteria.

Celiac disease and gallbladder issues

Celiac disease can cause the erosion of the small intestine lining. Studies involving people with celiac disease who don’t maintain a gluten-free diet have shown that their gallbladders don’t empty properly following a fatty meal, potentially resulting in the development of cholesterol gallstones. Studies have also found that people with celiac disease who do not follow a gluten-free diets also had gallbladders that emptied slower that those who were not celiac. Once they started a gluten-free diet, they regained normal gallbladder function with the usual pace of their gallbladders emptying. [9]

How to eat well to avoid gallbladder issues

Gluten is a clear culprit when it comes to leaky gut. Gluten is found in wheat, rye, barley, spelt, triticale, kamut and many processed foods that contain any of these grains. A gluten-free diet has been shown to help restore normal gallbladder emptying in those with celiac disease. Eating regular meals and avoiding prolonged fasting or rapid weight loss can also help prevent gallstones. [10]

Addressing food allergies, sensitivities and intolerances and reducing the amount of processed food and processed vegetable oils you eat, will also heal a leaky gut and reduce inflammation in the gallbladder.

Foods to eat to heal your gallbladder

• Lots of fibre to support digestion – pulses, beans, nuts, seeds, fresh fruits and vegetables
• Beets, artichoke and dandelion greens to detoxify the liver and improve bile flow, which, in turn, breaks down fat.
• Potassium-rich foods – avocado, leafy greens, tomato, sweet potato and bananas.
• Healthy fats in moderation – extra virgin olive oil, avocado oil and coconut oil
• Sprouted nuts and seeds
• Raw plants which are naturally high in water, electrolytes, antioxidants and fibre but low in salt and fats.
• Lean protein foods such as chicken, turkey, grass-fed beef, bison and wild-caught fish [11]
• Curcumin, dandelion, milk thistle, and ginger to stimulate bile flow

Lifestyle recommendations for a healthy gallbladder

• Maintain a normal weight – if you are overweight, your likelihood of developing gallstones increases significantly, especially for women. Ensure you lose weight at a slow pace so that you don’t increase biliary cholesterol saturation.
• Manage your stress – chronic stress can increase bile retention, increase gallbladder hypertrophy, and inhibit gallbladder emptying.
• Increase the amount of exercise you do on a daily basis
• Remember birth control pills significantly increase the risk of developing gallstones [12]

How can Functional Medicine help me with gallbladder issues?

At Advanced Functional Medicine, our expert health practitioners will assess your symptoms and run a series of tests for further investigation. These include:

• A stool test for inflammatory markers, leaky gut, gut bacteria and toxins
• Testing for high ALT, AST, bilirubin, LDH, GGT, ALP, and 5ʹ-nucleotidase. [13] If you test on the high scale for these, this can indicate gallbladder dysfunction.

When we get to the root cause of your issues, we will assist you with making healthier lifestyle choices, including reassessing how your current diet is affecting your symptoms. Supplements and herbs may also be useful in symptom management and rebalancing your biochemistry.

Call us to find out more.