In the United States and around the world, gallstones and gallbladder disease is on the rise. About twenty million Americans, or fifteen percent of the population, have gallstones. Of those people, eighty-five percent of their gallstones are cholesterol stones, correlating with the rise in obesity and high cholesterol. Because of this, there are about 700,000 cholesystectomies, or gallbladder removal surgeries, done in America each year. (3) Cholesystectomies are not a small procedure, can have long recovery periods, and forever change your diet and lifestyle.
What are gallstones and why does the gallbladder need to be removed?
Your gallbladder is the small organ located underneath your liver that stores the bile responsible for breaking down fats in your digestive system. When you eat a meal containing fats, your gallbladder releases bile into the small intestine to break down those fats, depending on how much you have consumed. (1, 2)
Gallstones occur when hard deposits of substances in the bile get stuck in your gallbladder, causing abdominal pain and infections that can lead to bloating, gas, nausea, and vomiting. Gallstones can range from the size of a grain of sand to as large as a golf ball. If this becomes chronic, the gallbladder must be removed. People most likely to require gallbladder removal surgery are those of advancing age, typically over the age of 65. (1, 2, 3)
Risk Factors for Gallstones and Surgery
There are several factors that can increase your risk of developing gallstones and needing surgery down the road. Some of these are in your control, and others aren’t.
Uncontrollable risk factors: (3)
- Family history
- Ethnicity (Indigenous Americans and Mexican Americans are highest risk)
Controllable Risk Factors: (3)
- Type 2 Diabetes
- Metabolic Syndrome (obesity, high cholesterol, and insulin resistance)
- Non-Alcoholic fatty liver disease
- Dyslipidemia (low HDL-cholesterol and high serum triglyceride levels)
- Typical “Western” Diet
- Decreased physical activity
As you can see, much of what causes gallstones to develop in the first place is very much under our control.
Do Gallstones Always Mean Surgery?
Just because you have gallstones does not mean you will require surgery. If they are small, not blocking the ducts, and not causing you any pain or health issues, then surgery won’t be necessary. They do need to be treated, however, to avoid build up and surgery down the road. They can be treated by: (5)
- Medicines, such as oral bile acid pills which thin the bile to allow stones to dissolve (5)
- Shock wave lithotripsy (5)
- Contact dissolution therapy (5)
- Percutaneous cholecystostomy (5)
Some integrative practitioners will also recommend the use of herbs depending on an individuals medical history and severity of the situation such as: (6)
- Chicory root
- Dandelion leaf
- Dandelion root
- Milk thistle seed
- Peppermint leaf
- Yellow dock root
- Chanca piedra
Foods to avoid After Gallbladder Surgery
Without the gallbladder to store it, the liver continually leaks bile into the intestines, and not necessarily in the appropriate amount that is required. Not only does this mean your ability to digest fats decreases, but it also means that some bile can end up in the large intestine. If you consume too many fats in one sitting, you may experience diarrhea, abdominal pain, and other other intestinal problems. (1, 2, 3, 4)
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The list of foods below should be avoided up to one month post-surgery and ideally should be minimized moving forward to limit adverse reactions. While most patients are able to return to their regular diet, it is helpful to keep this list in mind. Furthermore, many people are also able to find relief by supplementing with digestive enzymes that include ox bile, as this helps with the digestion of fats.
1. Deep fried foods
Extremely fatty, deep fried foods are a challenge for even those with healthy, fully functioning digestive systems. Without a gallbladder to store enough bile to break down all of those fats, fried foods are out of the question. This includes:
- Fried chicken of any kind
- Fried fish
- Tempura anything
- French fries
- Onion rings
Essentially all deep fried foods are on the no-fly list, even those that sound potentially healthy like deep fried vegetables or falafel. Instead you’ll need to switch to low-fat, home baked or pan-seared versions. (4)
2. Greasy Foods
Any food that leaves grease on your hands after touching it contains too much fat for your digestive system to handle. This goes for most fast foods, like burgers and pizza, as well as bacon, most cheeses, heavy sauces and gravies, and fatty cuts of meat (dark meat and most sausages included). (4)
3. Vegetable Oils
As mentioned already, your limited ability to consume fats means that you have to stick to the healthy ones that your body actually needs. Vegetable oils are high in Omega-6 fatty acids, which are already higher than they should be in a typical western diet. If you consume too many of these, you won’t have room left to eat the ever important Omega-3 Fatty acids that your body needs to fight inflammation and disease. Oils you should avoid include:
- Soybean oil
- Sunflower oil
- Canola oil
- Safflower oil
- Grapeseed oil
- Corn oil
Also watch out for ingredients such as cooking oils and sprays, mayonnaise, and store bought salad dressings, as these are usually made with vegetable oils. You will have to either find products made from other oils, such as olive oil, coconut oil, or avocado oil, or you will have to learn how to make your own. (4)
4. Convenience Foods
Most store bought, prepackaged foods are high in omega-6 fatty acids, because most are made with soybean oil. Either look for products that don’t contain vegetable oils, or better yet, make your own! These products include:
- Cakes and cake mixes
- Potato Chips
- Tortilla chips
In reality, while there are some truly healthy snack food items out there, they are expensive and can be hard to find. You are better off avoiding these products, learning how to make healthy substitutions, and sticking to healthy snacks such as cut up veggies and fruits. (4)
5. Large Meals
Indulging at Thanksgiving, Christmas, All-You-Can-Eat Sushi, and other occasions will have to be a thing of the past for you. Large, heavy meals put too much strain on the digestive system, which causes more forceful contractions of the digestive and intestinal muscles, which can cause more pain and diarrhea. Offer to bring items to group dinners so you know there will be foods there that you can eat, eat a small snack or meal before going so you aren’t starving upon meal time, and keep your portions small. You can always save some leftovers to eat later, and it will be well worth not spending most of your holiday celebrations in the bathroom. (4)
6. Water before and during meals
Whether or not drinking water before or during a meal actually affects digestion is subject for debate, but it’s something you may want to experiment with. You may find that avoiding drinking water leading up to and during a meal helps minimize discomfort and symptoms, or you may not. (4)
7. Other Potential foods to avoid
Beyond just fatty foods, there may be other foods that you find trigger symptoms. These foods can be different for each person, and the best thing to do is use the elimination diet to determine which ones do and don’t affect you. The most common offenders are:
- High FODMAPs foods
- Excessive alcohol intake
- Excessive sugar consumption
- Soy products
- Corn and corn products
These may or may not effect you, so by taking them out one at a time you will be better able to figure out which ones you can keep and which you will have to do without. (4)
The Bottom Line
Having your gallbladder removed does not mean the end of eating delicious foods. It just means eating healthier and improving your label reading, healthy cooking, and ingredient swapping skills so that you can still enjoy food without having to run to the bathroom after every meal.
If you know someone who has or is about to undergo gallbladder removal surgery, share this article with them so they know what yo avoid and are prepared for the lifestyle changes that they are going to have to make.
(1) Krans, B., & Nall, R. (2015, October 13). What Is Open Gallbladder Removal? Retrieved August 28, 2017, from http://www.healthline.com/health/gallbladder-removal-open#1
(2) Cholecystectomy (gallbladder removal). (2017, May 09). Retrieved August 28, 2017, from http://www.mayoclinic.org/tests-procedures/cholecystectomy/home/ovc-20229995
(3) The Growing Global Burden of Gallstone Disease. (n.d.). Retrieved August 28, 2017, from http://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-growing-global-burden-of-gallstone-disease
(4) Barbara Bolen, PhD | Reviewed by a board-certified physician. (n.d.). Foods You Should Never Eat When You No Longer Have a Gallbladder. Retrieved August 28, 2017, from https://www.verywell.com/foods-to-avoid-after-gallbladder-removal-1945016
(5) Non-Surgical Treatments for Gallstones. (2010, January 26). Retrieved August 29, 2017, from https://www.everydayhealth.com/gallbladder/non-surgical-treatments-for-gallstones.aspx
(6) Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM. (2016, January 15). The Gallbladder and Gallstones. Retrieved August 29, 2017, from https://www.globalhealingcenter.com/natural-health/gallbladder-and-gallstones/
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