By Dr. Shellie L. Rosen, PhD, DOM, L.Ac.
As we age, changes in metabolism and digestion make conditions such as gallbladder disease more common. Gallstones affect millions of adults worldwide, with women twice as likely as men to develop them. Gallstones can silently progress before causing symptoms that are serious enough to require surgery. Knowing the symptoms and which herbs and supplements may help can enable you to better understand what actions to take for yourself or someone you know.
When bile flow is disrupted, or when a gallstone forms (due to excess cholesterol or bilirubin crystallizing), the gallbladder’s bile ducts can become obstructed. The area becomes congested and inflamed, leading to symptoms such as bloating, gas, or indigestion; severe upper-right abdominal pain after eating; pain that radiates to the back or shoulder; nausea; and vomiting. Sometimes an unexplained elevation in liver enzymes or even gallstone pancreatitis can occur due to a bile duct obstruction. Do not ignore symptoms. An ultrasound is a simple, noninvasive way to assess gallbladder health and determine whether surgery is appropriate.
Often, stones remain small and unnoticeable, requiring no intervention. However, when stones grow, accumulate, or block the bile ducts, gallbladder removal (cholecystectomy) may be recommended. Once symptoms appear, it is essential to seek medical guidance, as dietary changes are unlikely to dissolve already-formed stones. If you need your gallbladder removed, avoiding very high-fat meals can help reduce biliary colic, preventing an “attack” that could lead to pain or an urgent need for surgery.
Bile is stored in the gallbladder, but after surgical removal, it flows directly from the liver to the small intestine. A 2019 review in Current Medical Chemistry notes that changes after gallbladder surgery can include diarrhea, abdominal discomfort and bloating, and, in some cases, changes in lipid metabolism or vitamin absorption. Some people restrict fat to help mitigate post-surgery symptoms, but there is insufficient evidence to support the long-term benefits of this approach. In fact, the body relies on healthy sources of fat for many biological processes.
The best way to adjust to the body’s new bile pathways after surgery is to focus on small portions of whole foods with healthy fats and to stay hydrated. Since bile helps the body digest fats, talk to your doctor about your need for fat-soluble vitamins (A, D, E, K).
Digestive enzymes are beneficial when we have digestive weaknesses. Enzymes that help digest fat, such as lipase, can be especially helpful. When liver enzymes are elevated, milk thistle may be beneficial. A 2021 review in Frontiers in Pharmacology reported that silymarin extract from milk thistle provides antioxidant and anti-inflammatory liver support, helping to stabilize liver enzymes in metabolic and inflammatory liver conditions.
Bile acids or artichoke extract may also help with fat digestion, but make sure to discuss this with your health care provider. Increasing bile may not be the best approach since bile flows continuously after surgery. Pay attention to digestive symptoms and bowel movements to see if enzymes or bile acids make a noticeable impact on your daily routine.
Some people have a genetic gallbladder vulnerability, so give grace to the condition. If you have had your gallbladder removed, continue to care for your digestion through healthy living and, if needed, consider herbs or supplements to support your health moving forward. Abundant blessings!
