If you are living sans a gallbladder (and thus sans bile), you may have noticed a few new problems springing up over time. This is because your gallbladder plays an integral role in digestion and the management of our hormones.
Common issues faced after gallbladder removal include unusual weight gain and just feeling like things are not the same. It’s true: things are not the same, and never can be.
Gallbladder removal surgery is a big deal for your body, and the result after surgery is a huge stress response. This stress response causes changes to your hormonal balance and metabolism, for weeks or months. Some of you will come out unscathed from the actual surgery, but may experience further side-effects of having no gallbladder.
Gallbladder removal and your reproductive hormones (oestrogen, progesterone)
We know that pregnancy, long-term use of oral contraceptives and hormone therapy all contribute to the formation of gallstones. The reason is because when oestrogen and progesterone are present in large amounts, the bile system is altered in a few key ways. We end up with a sluggish gallbladder, sticky bile that clumps together, and more cholesterol versus bile salts.
Bile helps us to clear sex hormones like oestrogen by binding to the hormone and escorting it out of the body safely. Many without a gallbladder suffer from what’s known as oestrogen dominance or relative oestrogen excess.
What is bile and what does it do?
Bile is the substance produced by your gallbladder that digests fat in your intestines. When you eat fat, your gallbladder squirts out bile into the intestine and emulsifies the fat so it can be digested. If you don’t have bile, and eat a fatty meal, the result is likely to be diarrhoea – all the fat that couldn’t be absorbed ends up in the toilet.
What is oestrogen excess or relative oestrogen dominance?
There are many reasons why we could end up in a state of oestrogen dominance – where there is more oestrogen than progesterone – but losing your gallbladder can add to this state. Progesterone and oestrogen typically balance each other out by opposing each other.
Bile, among other pathways of elimination of hormones, catches the oestrogen in the bowel, and instead of letting it get reabsorbed into your bloodstream, it is carried out of the body, inactive. This is an important method of eliminating oestrogens.
Your diet means a lot when you don’t have a gallbladder
The first issue without a gallbladder is your ability to digest fats is snatched away from you. No bile means very little fat digestion occurs. A very healthy, low-fat diet is therefore your safety net for not having wild diarrhoea after eating, but also in managing hormone clearance from your body.
A friend of a friend got her gallbladder removed in Melbourne, Australia, in an emergency surgery. Three weeks later she went back for her checkup, and explained that she’d had non-stop diarrhoea since she left the hospital. The doctor asked her what she was eating, and when she got to ‘cheese’, he laughed and said, “Oh dear, you can’t eat cheese! You can’t eat fat anymore. Didn’t anyone tell you that?”
No. They did not.
She went to visit her aunty, who had also had her gallbladder removed two decades prior, and relayed the conversation. Her aunty exclaimed, “Oh my goodness, I’ve had diarrhoea for 20 years and I had no idea why!” Turns out some doctors aren’t very good at post-op instructions.
Eat a very healthy diet high in fibre and nutrients – lots of vegetables. It can help to eat a vegetarian or vegan diet for a lot of the time, to help you adjust. A diet high in meat changes your gut bacteria to favour bacteria that unbind bound oestrogens, so anyone with a diet high in meat will find that they have more oestrogens floating around.
You are likely to have issues digesting milk, cheese, and yoghurt, as they typically contain high amounts of fat, but don’t opt for low-fat varieties except on the rare occasion. Skim or low-fat milk products are known to act like insulin, and insulin stimulates the ovaries to produce androgens (like testosterone). Testosterone is then converted into oestrogen in your fat cells, so the more fat you are carrying, the more testosterone is converted into oestrogen.
We use the 80:20 rule – if you do the right thing 80 per cent of the time, you can do what you like (within reason for your body) the rest of the time. Vegetarian or vegan cookbooks have a lot to offer us all in terms of making vegetables and legumes delicious, and getting all the nutrients you need to have a happy body.
You need to care for your liver, as your liver also processes your hormones. Liver care means stimulating liver detoxification and not overloading it. Overloading may include poor food choices, being in unhealthy/toxic environments, drinking too much alcohol or taking some medications/recreational drugs.
Each of you will have a different journey post-gallbladder removal, but you can make your existence much happier and healthier by following some guidelines. See a naturopath, nutritionist or herbalist for help during recovery, and as you go on your journey through life. Everything can be modified to account for your loss of bile and gallbladder!