After gallbladder surgery, digestion can be tricky for a while. Here's what to avoid.
When you have a problem with your gallbladder, like gallstones, your doctor may recommend that you have surgery to remove your gallbladder.
Your gallbladder is an organ that you can live without, but some people need to avoid certain foods after gallbladder removal.
The Gallbladder and Digestion
The gallbladder is a small organ that sits under your liver.
It stores, concentrates, and helps secrete bile, a liquid made by your liver that helps digest fatty foods.
If you need to have surgery to remove your gallbladder, your liver still makes enough bile for normal digestion.
Even so, it is not unusual for people to have some difficulty digesting certain foods in the days and weeks following gallbladder surgery, also called a cholecystectomy.
It's important to carefully follow your doctor's instructions about your diet after gallbladder surgery.
If you're hospitalized, your medical team will help you transition from a liquid to a solid diet almost immediately after your gallbladder surgery.
If you're recovering at home, you'll need to introduce foods slowly and consume mainly clear liquids, like broth and gelatin, at first.
If you feel ready and are not nauseated, you can slowly begin introducing solid foods back into your diet as you start feeling better.
But you may need to avoid certain types of foods for a while.
More than half of people who have recently had gallbladder surgery report problems with digesting fats following their surgery.
This is because your gallbladder is no longer there to control the release of bile into your intestines after you eat a meal.
Instead, a small amount of bile is now directly "leaked" from your liver into your small intestine at a slow, constant rate.
It can take a few weeks for your body to get used to this change, and you may experience bloating, diarrhea, and gas after eating fatty foods during this time.
Sometimes news of an alternative remedy will spread rapidly through websites and other media.
But just because you are reading about it everywhere does not mean that a remedy is effective or even safe.
One such alternative gallbladder treatment is the so-called gallbladder cleanse.
There are many different recipes for this so-called "cleanse," but most involve drinking large amounts of citrus juices, Epsom salts, and olive oil.
The advertised promises sound enticing, especially if you're facing the cost and hassle of a cholecystectomy.
But there are no gallbladder flushes or cleanses that have been proven to break up or eliminate gallstones, says Sanjay Jagannath, MD, a gastroenterologist at RMG Gastroenterology Group in Clayton, North Carolina.
"There's not any good evidence to suggest there's anything out there to reliably do that," Dr. Jagannath says.
One popular homemade gallbladder cleanse recipe prescribes a combination of apple juice, lemon juice, and olive oil to eliminate gallstones.
Others suggest using a Chinese herb called gold coin grass.
Jagannath says people who ingest these remedies often have subsequent bowel movements that include small round objects thought to be gallstones.
However, he adds, the objects are actually the result of the olive oil mixing with bile, the fluid in the gallbladder that digests fat.
I have personally supervised more than 200 people in clinical practice who have been through the gall bladder flush described below. I have never encountered problems more than the occassional nausea, assuming that the protocol is followed as mentioned below.
HUNDREDS OF STONES
It is estimated that 20% of the world’s population will develop gallstones in the gall bladder at some stage in their lives. This figure does not take account of the numerous stones that accumulate in the liver and its ducts, given that the liver produces them in the first place, and then travel down to the gall bladder. I have personally witnessed the removal of gallstones from hundreds of patients – some of them had gall-bladder symptoms but had no positive results from an ultra sound scan. Most, however, did not have any symptoms at all, yet would flush out literally hundreds of stones – no exaggeration! One woman in her 50’s had three scans and the radiologists found nothing. She had pains in the gall-bladder region for 20 years. When she did the gall bladder flush she removed 430 stones the first time around, and about 300 the second time!
About a week before I did my first gall bladder flush I went to see a friend who is an ultrasound specialist. He checked my gall bladder and found it as clean as a whistle. When I flushed a week later I removed 5 LARGE stones (about the size of a hazelnut), and about 150 smaller stones, including gravel.
It is believed by many naturopathic doctors that EVERYONE has gallstones, some less than others, and I have validated this many times in clinical practice.
The cleanse that I recommend below takes place within a period of less than 14 hours and can be done at home over the weekend. It is a painless and harmless natural way of removing stones, without requiring invasive procedures such as surgery, laser, etc.
If you are diagnosed with acute cholecystitis, you will probably need to be admitted to hospital for treatment.
Initial treatment will usually involve:
fasting (not eating or drinking) to take the strain off your gallbladder
receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
taking medication to relieve your pain
If you have a suspected infection, you will also be given antibiotics. These often need to be continued for up to a week, during which time you may need to stay in hospital or you may be able to go home.
With this initial treatment, any gallstones that may have caused the condition usually fall back into the gallbladder and the inflammation often settles down.
In order to prevent acute cholecystitis recurring, and reduce your risk of developing potentially serious complications, the removal of your gallbladder will often be recommended at some point after the initial treatment. This type of surgery is known as a cholecystectomy.
Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you are too unwell to have surgery. This is where a needle is inserted through your abdomen to drain away the fluid that has built up in the gallbladder.
If you are fit enough to have surgery, your doctors will need to decide when the best time to remove your gallbladder may be. In some cases, you may need to have surgery immediately or in the next day or 2, while in other cases you may be advised to wait for the inflammation to fully resolve over the next few weeks.
Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, > 6 h) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common.
In the elderly, the first or only symptoms may be systemic and nonspecific (eg, anorexia, vomiting, malaise, weakness, fever). Sometimes fever does not develop.
Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 wk in 85% of patients even without treatment.
Without treatment, 10% of patients develop localized perforation, and 1% develop free perforation and peritonitis. Increasing abdominal pain, high fever, and rigors with rebound tenderness or ileus suggest empyema (pus) in the gallbladder, gangrene, or perforation. When acute cholecystitis is accompanied by jaundice or cholestasis, partial common duct obstruction is likely, usually due to stones or inflammation.
Other complications include the following:
Mirizzi syndrome: Rarely, a gallstone becomes impacted in the cystic duct and compresses and obstructs the common bile duct, causing cholestasis.
Gallstone pancreatitis: Gallstones pass from the gallbladder into the biliary tract and block the pancreatic duct.
Cholecystoenteric fistula: Infrequently, a large stone erodes the gallbladder wall, creating a fistula into the small bowel (or elsewhere in the abdominal cavity); the stone may pass freely or obstruct the small bowel (gallstone ileus).
Supportive care (hydration, analgesics, antibiotics)
Management includes hospital admission, IV fluids, and analgesics, such as an NSAID (ketorolac) or opioid. Nothing is given orally, and nasogastric suction is instituted if vomiting or an ileus is present. Parenteral antibiotics are usually initiated to treat possible infection, but evidence of benefit is lacking. Empiric coverage, directed at gram-negative enteric organisms, involves IV regimens such as ceftriaxone 2 g q 24 h plus metronidazole 500 mg q 8 h, piperacillin/tazobactam 4 g q 6 h, or ticarcillin/clavulanate 4 g q 6 h.
Cholecystectomy cures acute cholecystitis and relieves biliary pain. Early cholecystectomy is generally preferred, best done during the first 24 to 48 h in the following situations:
The diagnosis is clear and patients are at low surgical risk.
Patients are elderly or have diabetes and are thus at higher risk of infectious complications.
Patients have empyema, gangrene, perforation, or acalculous cholecystitis.
Surgery may be delayed when patients have an underlying severe chronic disorder (eg, cardiopulmonary) that increases the surgical risks. In such patients, cholecystectomy is deferred until medical therapy stabilizes the comorbid disorders or until cholecystitis resolves. If cholecystitis resolves, cholecystectomy may be done ≥ 6 wk later. Delayed surgery carries the risk of recurrent biliary complications.
Percutaneous cholecystostomy is an alternative to cholecystectomy for patients at very high surgical risk, such as the elderly, those with acalculous cholecystitis, and those in an ICU because of burns, trauma, or respiratory failure.
Biliary colic and cholecystitis are in the spectrum of biliary tract disease. This spectrum ranges from asymptomatic gallstones to biliary colic, cholecystitis, choledocholithiasis, and cholangitis.
Gallstones can be divided into 2 categories: Cholesterol stones (80%) and pigment stones (20%). Most patients with gallstones are asymptomatic. Stones may temporarily obstruct the cystic duct or pass through into the common bile duct, leading to symptomatic biliary colic, which develops in 1-4% of patients with gallstones annually.
Cholecystitis occurs when obstruction at the cystic duct is prolonged (usually several hours) resulting in inflammation of the gallbladder wall. Acute cholecystitis develops in approximately 20% of patients with biliary colic if they are left untreated. However, the incidence of acute cholecystitis is falling, likely due to increased acceptance by patients of laparoscopic cholecystectomy as a treatment of symptomatic gallstones.
Choledocholithiasis occurs when the stone becomes lodged in the common bile duct, with the potential sequelae of cholangitis and ascending infections.
Biliary sludge is a reversible suspension of precipitated particulate matter in bile in a viscous mucous liquid phase. The most common precipitates are cholesterol monohydrate crystals and various calcium-based crystals, granules, and salts. A portion of biliary sludge contains comparatively large particles (1-3 mm) called microliths, the formation of which is an intermediate step in the formation of gallstones (about 12.5%).
For patient education information, see the Digestive Disorders Center and Gallstones.
The kidneys are our organs that filter out toxins and waste from the bloodstream. Because toxins can affect your entire body, there is no question that supporting your kidneys is crucial for keeping your overall health in check. Without a balanced diet, purified drinking water, and body cleansing, toxins can build up and affect the function of the kidneys, liver, and neighboring organs… and may even lead to kidney stones and other problems.
Cleansing the Kidneys With a Few Sips
Cleansing the kidneys is a simple process and most cleanses don’t require an exhaustive supply of tools or ingredients to work. In fact, just drinking plenty of purified water is the first step toward an effective flush. Water, however, only provides hydration. The following 5 kidney-cleansing drinks may provide that extra cleansing boost.
1. Cranberry Juice
Cranberry juice has been touted for years as support for the urinary tract. Research shows that cranberries can help fight against urinary tract infections, possibly by decreasing the adhesion of bacteria to the bladder and urethra. Cranberries may also be helpful for cleansing the kidneys of excess calcium oxalate, one of the main contributors to kidney stones. When purchasing cranberry juice, always choose varieties that are certified organic and free of added sugars, preservatives, or artificial flavors; or, get a juicer and make your own.
2. Beet Juice
Beets and beet juice contain betaine, a very beneficial phytochemical. It has antioxidant qualities and increases the acidity of urine. This can help clear calcium phosphate and struvite buildup from the kidneys. The removal of calcium in the kidneys not only promotes kidney function, but decreases the likelihood of kidney stones.
3. Lemon Juice
Naturally acidic, lemon juice has been shown to increase citrate levels in urine, a factor that discourages kidney stones from forming. For a quick lemon kidney cleanse, squeeze 4-5 lemons into a quart of cold water and drink up.
A gallbladder attack happens because of inflammation and irritation of the gallbladder. Called cholecystitis, gallbladder attacks occur because of the presence of an infection or gallstones in the gallbladder or from damage to the bile ducts that drain the gallbladdder. Cholecystitis may become an acute condition with a sudden onset or it can become a chronic health problem. Remedies for gallbladder attacks involve diet and lifestyle modifications, medications and surgery.
Low Fat Diet
According to the National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK, an important remedy for gallbladder attacks is a low fat diet. The consumption of fat causes an increase in the production of bile which, in a diseased gallbladder, increases biliary spasm and pain symptoms. Donna D. Ignatavicius, MS RN, and M. Linda Workman, PhD, authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care", emphasize the importance of sufficient protein intake along with adherence to a low fat diet. Adequate protein prevents the formation of certain gallstones. Gallstones are a frequent cause of gallbladder attacks. People with gallbladder disease should confer with a physician or nutritionist to establish an appropriate diet that meets individual needs.
The NIDDK report that a direct link exists between obesity and cholecystitis. One possible reason for this connection purports that in overweight people the amount of bile salts in bile is reduced, leading to elevated cholesterol levels. High cholesterol slows gallbladder emptying and increases gallstone formation. A low fat diet and regular exercise help control weight and cholesterol levels.
Donna D. Ignatavicius, MS RN, and M. Linda Workman, PhD, further explain why individuals with high cholesterol have an increased risk of gallbladder attacks. Often, people with high cholesterol take cholesterol lowering medications.
High cholesterol in the bile causes 80 percent of gallstones, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Gallstones cause cholecystitis or inflammation of the gallbladder, which can result in severe abdominal pain, nausea and vomiting. In order to digest fat, the liver makes bile, which is subsequently stored in the gallbladder. When bile hardens, gallstones are formed. Eating a proper diet can keep the gallbladder healthy and prevent gallbladder attacks.
While high doses of saturated fats can increase circulating cholesterol and the risk of gallstones, cutting fat completely from your diet is unnecessary. Choosing healthy fats can keep the body healthy and the gallbladder happy. Try to cut back on meats that are high in saturated fats such as red meat and organ meats. Eating salmon or other meat that is high in omega-3 fatty acids can not only keep your gallbladder healthy but decrease your cholesterol as well. Remember, some fat in the diet is necessary to help control cravings and to maintain your brain power and healthy skin.
Fruits and Vegetables
In a 2006 "American Journal of Medicine," article, researchers from the University of Kentucky Medical Center reported that after examining the diets of 77,000 women, they found that women who had higher intakes of fruits and vegetables were less likely to have gallbladder attacks and subsequent removal of their gallbladders. Green leafy vegetables, citrus fruits and cruciferous vegetables were associated with lower risk of cholecystectomy or gallbladder removal.
Whole grain foods have been shown to lower the risk of many chronic diseases, according to the Whole Grains Council. Eating foods such as whole wheat pasta, whole grain breads, quinoa and oats can reduce the risk of stroke and heart disease by lowering blood cholesterol. Lowering blood cholesterol reduces the risk of gallbladder stones. Eat 2 to 3 servings of whole grains daily.
Liver disease is any disturbance of liver function that causes illness. The liver is responsible for many critical functions within the body and should it become diseased or injured, the loss of those functions can cause significant damage to the body. Liver disease is also referred to as hepatic disease.
Liver disease is a broad term that covers all the potential problems that cause the liver to fail to perform its designated functions. Usually, more than 75% or three quarters of liver tissue needs to be affected before a decrease in function occurs.
The liver is the largest solid organ in the body; and is also considered a gland because among its many functions, it makes and secretes bile. The liver is located in the upper right portion of the abdomen protected by the rib cage. It has two main lobes that are made up of tiny lobules. The liver cells have two different sources of blood supply. The hepatic artery supplies oxygen rich blood that is pumped from the heart, while the portal vein supplies nutrients from the intestine and the spleen.
Normally, veins return blood from the body to the heart, but the portal vein allows nutrients and chemicals from the digestive tract to enter the liver for processing and filtering prior to entering the general circulation. The portal vein also efficiently delivers the chemicals and proteins that liver cells need to produce the proteins, cholesterol, and glycogen required for normal body activities.
As part of its function, the liver makes bile, a fluid that contains among other substances, water, chemicals, and bile acids (made from stored cholesterol in the liver). Bile is stored in the gallbladder and when food enters the duodenum (the first part of the small intestine), bile is secreted into the duodenum, to aid in the digestion of food.
The liver can be damaged in a variety of ways.
Cells can become inflamed, for example, hepatitis.
Bile flow can be obstructed, for example, cholestasis).
Cholesterol ortriglycerides can accumulate, for example, steatosis).
Blood flow to the liver may be compromised.
Liver tissue can be damaged by chemicals and minerals, or infiltrated by abnormal cells, like cancer cells.
Alcohol abuse is the most common cause of liver disease in North America. Alcohol is directly toxic to liver cells and can cause liver inflammation, referred to as alcoholic hepatitis. In chronic alcohol abuse, fat accumulation occurs in liver cells affecting their ability to function.
Cirrhosis is a late-stage of liver disease. Scarring of the liver and loss of functioning liver cells cause the liver to fail. Significant amounts of liver cells need to be damaged before the hole organ fails to function.