The Unhappy Gallbladder

The gallbladder is a storage organ under the liver that holds bile. Bile is made in the liver, and then put into small ducts, which empty into the extrahepatic bile and cystic ducts where it flows into the gallbladder. From the gallbladder, during meals, the bile flows out back into the cystic duct and then down the common bile duct (which merges with the pancreatic duct), out into the duodenum, right by where the stomach enters its contents after a meal.

Bile a fat emulsifier that breaks down the fat globules we eat into much smaller globulins which can then be digested by the pancreatic lipase enzyme. Also, the liver dumps processed toxins, drugs, chemicals into the bile to detoxify the body.

There is a very important ratio in the gallbladder: Cholesterol/bile (+) lecithin.

The five main ways that a gallbladder can cause problems is via: gallstones, biliary colic, and cholecystitis, under-functioning of the gallbladder, and post-cholecystectomy (removal of the gallbladder) diarrhea.

Gallstones (cholelithiasis):

Gallstones are a very common problem, with nearly 1 million Americans every year experiencing an attack and over 500,000 gallbladder removals occurring. There are several different types of gallstones but in the US, the vast majority are cholesterol based, whereby cholesterol saturates out of the bile and forms a nidus upon which a stone develops. High cholesterol, a very fatty diet, sudden weight loss, pregnancy, prescription estrogens, family history, being overweight, being female, all of those have an implication in developing a gallstone.

Gallstones are diagnosed via an Abdominal Ultrasound, and its helpful to know how many exist and their size. Many times a naturopathic physician can help a patient avoid removal of their gallstone.

Most patients with gallstones do not know they exist until they suffer from either biliary colic or cholecystitis.

Biliary Colic

Biliary colic occurs when a gallstone temporarily gets stuck in the opening of the gallbladder, and the gallbladder creates spasms in an attempt to dislodge it. Biliary colic occurs in general after meals, and creates a sharp, oftentimes, colicky pain, spasms and relaxing; although sometimes the pain is just steady. There is oftentimes nausea and sometimes vomiting with the pain. The pain may radiate into the back, under the right shoulder blade. Biliary colic only lasts 1-5 hours, in general, but it is generally the experience that sends patients to the ER or their physician, where a gallstone is then diagnosed with an diagnostic ultrasound and the removal of their gallbladder is recommended.

At times, patients can develop a worse irritation to the gallbladder, called cholecystitis.

Cholecystitis

Cholecystitis is the inflammation of the walls of the gallbladder, . It typically happens in patients with a history of biliary colic. This creates steady pain, which can be very bad; like colic, this may often time occurs with nausea and vomiting, and the pain can shoot also into the lower right shoulder blade area of the back. Unlike biliary colic, cholecystitis can last for 2-3 days. A couple of problematic complications with cholecystitis—a stone may fall out of the gallbladder and obstruct the common bile duct (choledocholithiasis) and if that happens than an infection (cholangitis) can occur. The obstruction and infection are medical emergencies and need to be treated at the ER. The physicians at AIMS can discern a regular event of cholecystitis with the more serious complications.

Naturopathic physicians can oftentimes help preserve a patient’s gallbladder even with gallstones and a history of biliary colic or cholecystitis.

We will:

Do a diet diary to see what type of diet a patient tends to eat.
Do a food allergy test—medical studies have shown that some foods irritating the gallbladder more than others and should be avoided in patients with gallbladder concerns.
Teach the patient to do some helpful hydrotherapy techniques to reduce inflammation in the gallbladder.
Give medicines to help decrease the size of the gallstone and prevent new ones from forming.
Do a “gallbladder flush” when it is safe and appropriate for a patient to experience that.
Use powerful but safe botanicals which help form and secrete bile to keep the cholesterol more in fluid.
Use appropriate digestive enzymes to support gallbladder function.
Use anti-inflammatories to keep the gallbladder from easily becoming inflamed.
Work on patients to lose weight safely and to stop taking medications which might be harming the functioning of the gallbladder (like proton pump inhibitors).
Ensure the thoracic vertebrae are in alignment.
With this type of comprehensive treatment protocol many patients have been able to save their gallbladder.

Biliary Dyskinesia/Acalculous Cholecystopathy

Biliary Dyskinesia is a situation whereby the patient has right upper quadrant pain just like biliary colic or cholecystitis, but ultrasound does not reveal any gallstones are present. Not infrequently, then, we tend to see a (+) HIDA scan (Hepatobiliary scintigraphy using iminodiacetic acid); this test easily measure how well the gallbladder secretes bile and if the “ejection fraction” of the gallbladder is low, this shows the gallbladder is not functioning normally.

The treatment for this is, ironically, very similar to when the gallbladder does indeed have a gallstone problem, but we would especially promote the use of the botanicals which work to encourage the gallbladder to function in a more efficient manner.

Post-Cholecystectomy Pain and Post-Cholecystectomy Diarrhea

Many gallbladders, as mentioned above, are removed each year. Unfortunately, that does not always clear up the pain patients have been having; also, 33% of patients who have their gallbladder removed suffer from chronic dyspepsia, abdominal pain, and sudden cramping and diarrhea after eating. These conditions can oftentimes be helped by naturopathic medicine.

Post-Cholecystectomy pain (PCP) is a puzzling affair at times, when the patient presents with clear gallbladder pain but removal of the organ does not help with pain cessation. For naturopathic physicians, we look at certain nutrient deficiencies that have been associated with PCP. We may also explore obstacles to cure as if the patient had a gallbladder as the irritation to the system may just have transferred from the gallbladder to nearby structures, and so the cause is the same.

Post-Cholecystectomy Diarrhea (PCD) is a very common condition AIMS physicians have seen over the years. In 33% of people, their livers cannot produce enough bile after the gallbladder is removed, and so when they eat, the fat they ingest is not well digested. This causes maldigestion, cramping and a diarrhea which occurs generally 15-30 minutes after they eat, as the undigested fat roller-coasters along the 25 or so feet of intestines. This is generally very easy to treat with diet, possible food allergy removal and digestive aids to help the body absorb the fat ingested. Please be aware this is a serious condition, as if one cannot absorb fat, one cannot absorb the fat soluble vitamins such as Vitamin A, E, K, D, and the antioxidant carotenoids found in so many of our vegetables and fruits.

The physicians at AIMS are very knowledgeable in the gallbladder and how to return it to health, and keep it in a patient’s body, able to function without causing pain. If you have gallbladder problems, or know someone who does, a referral to AIMS may be the nicest thing you ever did.

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Arizona Integrative Medical Solutions
4657 S. Lakeshore Drive, Suite 1
Tempe, AZ 85282

Office Hours:
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Sat: 8:00-Noon

Our office is located near Baseline Road and Rural Road in Tempe, Arizona

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Monday: 8:30am - 5:30pm
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Saturday: 8:00am - 12:00pm

AZIM Solutions

Phone: (480) 284-8155
Fax: (866) 823-2115
4657 S. Lakeshore Drive Suite 1
Tempe, AZ 85282
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