Gallbladders are being removed at an epic pace, and while I see many patients with gallbladder issues, a question I don’t get often enough is how to eat following a cholecystectomy. How to eat with gallbladder issues along with discussing some key labs that are being left out of routine physicals and supplements to use and avoid.

Many people tell me their doctors either gave them no diet information or they told them they could eat as they did before the surgery once they heal up. This is incorrect. Gallbladder issues are generally caused by a poor diet. Continuing to eat in the manner that caused your issues is  a bad idea. Even though you don’t need to worry about your gallbladder once it and the pain are gone you will eventually cause other health issues by ignoring the nutritional issues that caused your gallbladder attacks.

Gallbladder removal rates are skyrocketing!

In 1996 there were about 600,000 cholecystectomies done a year and in 2019 there are an estimated 1.2 million which reinforces my theory that surgery is being used instead of the far less invasive and health enhancing diet changes that should be the norm. Surgery is big business. Also we lack accurate nutrition guidelines to help people avoid gallbladder disease and the lack of correct nutrition information is a systemic problem that I talk about enough elsewhere so I spared you here.

We are told that having a sick gallbladder is just a luck of the draw. Some of us are just unlucky, or perhaps it’s genetics? Many tell me their parents or siblings had similar gallbladder issues. They are resigned to surgery and don’t even try to make diet changes to avoid surgery and heal their gallbladder.

Genetics don’t cause gallbladder issues! Diet does.

Genetics play a part in most health issues, but gallbladder issues are not caused by genetics. They are caused by diet and lifestyle. If your gallbladder is not functioning correctly then at least 80% of the time you have diet changes that need to happen in order to restore health.

Your gallbladder is an integral part of your digestive and elimination systems you will enhance your overall health and wellness by making diet changes instead of waiting for surgery to become the only solution. If more doctors recommended the correct diet changes, and more people were willing to change their diets we would have far less gallbladder removals and a healthier population. I think that the recent rise in non-alcoholic fatty liver disease (NALFD) is due to the extra stress put on the liver and the rest of the digestive and elimination system when the gallbladder is removed.

Digestion and elimination directly affect nutrient absorption and eating a healthy diet directly affects our health and ability to stave off disease. Improving our gallbladder function though cleaning up the diet should always be the first step whether you are facing surgery or not.

The symptoms of a “sick” gallbladder are pain in upper right portion of your abdomen area, pain between your shoulder blades, sweats, and nausea especially after over eating, or eating a rich meal with too many unhealthy fats and processed carbohydrates. As the condition gets worse flu like symptoms can arise including fever, chills and pain.

You should always get this clinical picture checked out and if you suspect a gallbladder problem be sure you ask your doctor to test your blood levels of an enzyme called GGTP also known as GTP or Gamma-glutamyl-transpeptidase, which is often part of a traditional liver panel but I have noticed it being left off of many conventional blood panels over the past 10 years.

I was taught over 20 years ago that GGTP is a good indicator for possible gallbladder issues when the other values for liver enzymes are ALT and AST are both low or normal and GGTP is above 50. Other good blood test indicators to test for along with your GGTP are Bilirubin, Aspartate transaminase (AST, formerly referred to as serum glutamic-oxaloacetic transaminase, SGOT), and Alanine transaminase (ALT, formerly called serum glutamic-pyruvic transaminase, SGPT), Alkaline phosphatase and Lactate dehydrogenase (LDH). Many panels will have the ALT and AST but they leave out the GGTP. I am not sure if this is a simple oversight but it’s a trend I see, and I wind up sending many people back to get a full liver panel including the GTP /GGTP specifically.

Many people have been able to change their trajectory, make the necessary diet changes and avoid gallbladder removal simply by getting this test done and restoring gallbladder function before surgery is needed. This is probably a $10 blood test so asking your doctor to add it to your yearly physical is a good idea. If you are experiencing digestive distress or symptoms it should be tested right away along with a complete blood panel.

If your labs and symptoms indicate gallstones or a dysfunctional gallbladder. Change your diet.

I am not saying diet is a cure for gallstones or a hot gallbladder but I have seen it get rid of symptoms almost every time when it’s caught early enough. With an issue like this where surgery is the number one treatment the only reason most people don’t try diet changes before losing an organ is lack of encouragement by doctors and lack of correct diet information. 

Here are some general diet strategies for gallbladder issues.

Don’t eat “bad fats” don’t eat fats that cause inflammation in the body. These bad fats include  high Omega 6 canola oil, safflower oil, soybean oil, corn oil, cottonseed oil and any oil that has the word hydrogenated in front of it. I know these oils have been called “heart healthy” by the American Heart Association and The Academy of Nutrition and Dietetics (formerly the ADA) for decades but it’s not true. I call these fake “vegetable oils” because these are not really vegetables. In fact, most of them are considered weeds. Some are grains. They are cheap oil, more like byproducts or left overs of over-subsidized crops and they go rancid easily.

The reason for hydrogenating these inflammatory, nutrient deplete oils, is to make processed foods last longer on the shelf. We can thank hydrogenated oils along with preservatives for making it possible to find a Twinkie after 5 years looking exactly like it did day one. The problem is those oils also stay in the body rather than get used for fuel. These oils should be avoiding contrary to the misinformation put out by the biased organizations mentioned. Don’t eat any fat that is hydrogenated. And try to avoid these inflammatory fake plant vegetable oils in general for good nutrition and with gallbladder issues for sure. These fats, along with a diet high in sugar and processed carbohydrates and grains, are what contribute to the issues that cause atherosclerosis and heart issues. Meats, and the healthy oils like coconut and avocado  are not the culprits but that is another article. I have seen it alleged that saturated fats are the cause of cholesterol and hence gallstones. This is patently wrong. But the gallbladder is involved in digesting fats so we don’t want to eat a lot of fat while trying to heal it up.

The healthy fruit and vegetable oils to eat are organic unrefined avocado oil, olive oil and coconut oil to name a few. Eat them in moderation with gallbladder issues and you may want to eat a diet of mainly vegetables and protein with low amounts of these fats for a few weeks to months while letting your gallbladder heal. It depends on your specifics and how early you caught your issues. Gallstones are typically made of cholesterol, bile, bilirubin and minerals like calcium. Fats do not cause gallstones but they can cause an attack.

Reduce your intake of sugary, processed carbohydrates and don’t overeat. Eating smaller meals of cooked vegetables at first is a good idea. You don’t need to eat flavorless steamed veggies you can very lightly sauté them in the healthy oils with some mild  spices for flavor. Sometimes spices irritate an already sick gallbladder so you may need to leave them out for awhile.

Making soups and broths with chicken, fish or turkey and vegetables and light spices is a good idea to give your digestive system a rest. Add bone broth if you tolerate it. If you want more carbohydrates use fresh fruits or things like sweet potato, potatoes and squash if you tolerate them. You may need to slowly add the healthy fats back into your diet after a few weeks or a month eating the soups, veggies and proteins. Eating as clean and lightly as possible with your focus on nutrient density is important for a few months if you want to heal your gallbladder. You can try adding some eggs for protein and eventually small amounts of grass- fed meats if you want to. Eating 60-75% vegetables at first with broths and protein for at least 30-60 days should give you some relief. From there you can start to add other foods in one at a time and notice how you feel or if you get symptoms back with any foods. Don’t just go back to overeating and junk foods when you feel better. It will come back. Use this reset as an opportunity to design a healthy diet for yourself. Get a Nutritionist to help if needed.

You can also use a high- quality, clean protein powder like a collagen or lower carb plant based one to help heal up your gut and digestive system while resting it from other protein sources or if you don’t eat animal protein. Yes, I know collagen is from animals but it’s not meat. You can see my page on recommendations for some specific protein supplements  to choose from.  LINK

Take Digestive Enzymes to Help Your Gallbladder

My other recommendation for someone after gallbladder removal or while trying to avoid one is to use digestive enzymes with each meal until your system is back into balance. A broad-spectrum enzyme like Digest Gold from Enzymedica is a good idea and I tend to recommend more specific products like Pancreatin and ox bile extract from Vital Nutrients. Because digestion and mineral absorption issues can lead to more gallstones supplements often must be more specific to each persons health issues and biochemistry.

I recommend other specific supplements for supporting gallbladder, liver and digestion but since each of us is different I don’t want to risk people using supplements that are not specifically for them and may not be safe. Many gallbladder supplements that I see online and recommended by under-educated coaches (or whatever) can make the whole issue worse. I have had patients who followed silly gallbladder “cleanses or detoxes” using products that caused stones to enter the common bile duct and emergency surgery or worse was the result. There are some specific products from trustworthy companies that get great results, but they should be used with supervision and for that reason they are not mentioned here. If you are already getting pain and attacks then your gallbladder is bad enough that you should be getting help.  Gallbladder issues are often not noticed until the problem is causing symptoms and are quite advanced by then. This is why that GGTP lab is so important to have done regularly.

If you are on a keto or higher fat diet and are seeing increases in your liver or gallbladder enzymes of feeling a rumbling pain in your right abdomen area after eating you may want to get your gallbladder checked. Weight gain and weight loss both mobilize fats and the gallbladder deals with them. I see many patients who either genetically can’t deal with cholesterol well or have bad digestion or both and in that case they may not be good candidates for a high fat diet of any kind. Eating the correct fats is a big factor but I suggest hiring a professional if you are in this group. Another lab you should have done before keto or high fat diets is the NMR cholesterol test which tells us how your body is equipped to deal with fats of all types. These included your deeper cholesterol values like your LDL particle number and size.

If you are having gallbladder attacks don’t rush right into surgery unless you do have an acute situation like a stone in the bile duct or your doctor can give you a good reason to. Short of that extremely painful issue of a stone in the duct, and if your doctor has agreed, try changing your diet and restoring function to your gallbladder before going under the (laparoscopic) knife. I think most of us should have a great clinical nutritionist for optimal health and to provide a balanced perspective, but I could be biased there. If your labs are generally normal except for the GTP /GGTP then I would try the diet I have here and maybe some mild liver and digestive support and maybe you can avoid the acute issues.

If your doctor is not open to or educated about restoring function with nutritional strategies and diet versus invasive surgeries, I suggest you find an integrative MD, Functional Medicine Doctor or a Naturopathic Medical Doctor. Here in CA many NDs can write prescriptions but often don’t need to because they were taught how to heal patients with diet and functional medicine as I was. If you start by working with a Nutritionist make sure they have real training in functional medicine and real college in a science as well. Hiring someone like a  nutrition, wellness or holistic coach with only an online certificate to manage a gallbladder issue is like hiring an operating room technician to do your surgery. They lack the foundation and real training. This and the unsupervised use of products are part of why some doctors are not as open to nutritional strategies for things like this. We find ourselves in a place where common sense is becoming more common and diet is being looked at as a solution to health issues finally. This is a great place to be and by hiring and taking advice from qualified professionals we can change the way gallbladder dysfunction is “treated” and hopefully see surgery rates stop rising so astronomically quickly.

Doing something just because this is the way something has always been done is not a reason to keep using an ineffective method.

When we know better, we do better.