As many as 20 million Americans have gallstones, according to the National Institutes of Health, but often, there are no symptoms. In fact, many people never experience discomfort and don’t even know they have gallstones, which may be as small as a grain of sand or as big as a golf ball.
But sometimes, the stones can trigger severe pain and other symptoms. In conventional medicine, gallbladder removal is the treatment of choice for patients with any symptoms of gallstones. There is no question that surgery is necessary in many cases. When a patient’s gallbladder is infected or severely inflamed, gallbladder surgery is required as a matter of life and death. But in some other cases, gallbladder removal may not solve the problem and may even be a mistake.
Studies show that gallstone symptoms, which can include abdominal pain, nausea, indigestion, bloating, and gas, don’t always disappear after surgery, although pain usually decreases significantly. In fact, a 2005 study published in the Journal of Gastrointestinal Surgery found that about 22 percent of patients continued to experience pain five years after their gallbladders had been removed. And a 2018 study published in the Korean Journal of Internal Medicine found that patients who returned to eating fatty animal foods after having their gallbladders removed continued to experience abdominal symptoms such as dyspepsia do bloating.
How Your Gallbladder Works
Medically considered non-essential, meaning we can live without it, the gallbladder is a holding tank for bile. The gallbladder itself does not make bile, a fluid made by the liver to break down fats in your digestive system.
When you eat fat, the gallbladder contracts and releases bile through ducts that lead to the small intestine. There, bile breaks down fat so that you can absorb nutrients, such as the fat-soluble vitamins A, D, E, and K. If the gallbladder is missing, the liver continues to make bile; however, without a reservoir of bile, the liver may not be able to keep up with demand, and fat digestion may become impaired.
- With or without a gallbladder, symptoms of insufficient bile include:
- Cravings for fried or fatty foods
- Not feeling satisfied after eating
- Craving sugar after a meal
- Itchy skin and eyes
- Dry eyes
- Headaches, especially pain in the right temple or on the right side of the head
- Pain or tension in the right fingers, hand, neck or shoulder, or under the ribs on the right side
What Causes Gallstones?
“Gallstones really develop from a deficiency of bile,” says Eric Berg, DC, author of The 7 Principles of Fat Burning. In addition to breaking down fat in food, bile also breaks down cholesterol and other substances that can accumulate into stones. Most often, says Berg, a bile deficiency is caused by one or more of the following:
Stress: It raises levels of the hormone cortisol, which depletes bile. This is why abdominal bloating is typically worse late in the day and subsides overnight, while we sleep and de-stress.
Switching to a vegan diet: Rare in a plant-based diet, saturated fat is one of the key triggers of bile production. In cultures that have been predominantly vegan for many generations, however, the body has adapted.
High estrogen levels: Birth control pills, hormone replacement therapy, pregnancy, or high intake of unfermented soy foods can cause estrogen to rise and thereby contribute to bile deficiency.
Low stomach acid: Because stomach acid activates bile production, low levels (due to taking antacids, for example) inhibit it.
Eating a lot of processed food: Preservatives and other toxic food additives, combined with a lack of detoxifying fresh vegetables, burden the liver and impair its ability to produce bile.
What to do if you have gallstones
Berg’s clinical experience with thousands of patients shows that these steps help enhance bile production, relieve gallstone symptoms, and may also help to gradually dissolve gallstones, especially small ones.
1. Before or at the start of each meal: take a supplement of bile salts, which are made from purified ox bile. If you’re vegetarian or vegan, there are no plant sources of bile salts, but taking concentrated beet powder can enhance your internal bile production.
2. Take supplements of stone root, an herb that helps to dissolve stones and is available in pills, tinctures, and tea form.
3. Eat some saturated fat, because it signals the liver to produce bile. Eggs, grass-fed meat, fatty fish, and coconut oil are good sources.
4. Eat 7 cups of vegetables daily, half in the form of greens and brightly colored veggies for the rest.
5. Avoid these foods because they are thought to aggravate gallbladder conditions:
- Nuts, nut butters, and peanuts
- Large, heavy, fatty meals
- Calcium carbonate, because it reduces stomach acid
6. If bile salts don’t resolve your symptoms, you are most likely deficient in stomach acid, says Berg, who explains that stomach acid tells the liver to produce bile—with or without a gallbladder. Restore stomach acid by taking betaine hydrochloride (abbreviated betaine HCI or HCL).
If Your Gallbladder Has Been Removed …
Follow the same steps above for those with gallbladders, but omit stone root and use bile salt this way: Take the supplement before breakfast and then again before lunch and dinner if you have bloating or other symptoms. Once symptoms resolve, you can cut back by taking bile salt only before breakfast.
Weight and Gallstones
“If you’re overweight and have gallstones, your doctor will typically tell you to lose weight,” says Berg, but this is faulty reasoning. Studies show that overweight people are more likely to have gallstones, but that doesn’t mean the excess weight causes the stones. More likely, says Berg, a lack of bile production contributes to weight gain, because it interferes with healthy digestion and nutrient absorption, and makes you crave fried or sugary foods.
If you have gallstones, weight loss can aggravate the condition, because excess fat comes out through the liver and bile ducts. Therefore, taking bile salts is especially important during weight loss and can help prevent gallstone problems.
Best Vegetable Choices for a Healthy Gallbladder
Whether you have a gallbladder or not, says Berg, greens improve the liver’s ability to make bile by enhancing detoxification—and a liver that is less burdened with toxins works more efficiently. Greens also help to make bile thinner, which allows bile to flow more easily and also lowers the risk of gallstones. (Although rare, stones can still form in the liver and lodge in ducts even when the gallbladder has been removed.) The following veggies are particularly good at enhancing your own bile production:
- Cruciferous vegetables such as broccoli, cabbage, and Brussels sprouts
- Raw in salads or cooked: beets, beet tops, and kale