Every year in the United States, over 700,000 people get an important part of their digestive system removed. Cholecystectomy, or gallbladder removal, is often billed as a permanent (if invasive) solution for gallstones. Technically it does solve the problem of gallstones, and it is possible to stay alive without a gallbladder, but that solution comes at a high cost. The gallbladder is an essential part of the digestive system: without it, things just don’t work quite right.
Is Fat Bad for your Gallbladder?
Bile produced in the gallbladder is especially important for breaking down fat, so the typical solution from doctors who think fat is unhealthy has been an ultra low-fat diet. After all, why try to fix an important organ when you could just surgically remove it and then eliminate an entire macronutrient from your diet? Going by this approach, Paleo would be the last diet to try for anyone dealing with gallbladder issues.
But there’s just one problem with this: high fat diets don’t cause gallstones or any other gallbladder problems, and low-fat diets are not a solution.
- In this study, researchers found that higher-fat diets actually prevented gallstone formation during weight loss.
- This study found that a low-fat diet had no significant effect on symptoms after surgical gallbladder removal.
So what is the problem then, if fat isn’t to blame? For starters, sugar probably has something to do with it: in this study, obesity and a high-carb diet both independently contributed to gallstones. Genetics also play a role, and various groups of people are more likely to suffer from stones (for example, they’re more common in women than in men). And in fact, a low-fat diet can even contribute to forming gallstones (more on this below). Knowing this, it starts to seem a little more reasonable that Paleo might be a good diet for people with gallstones or people who have had their gallbladder removed.
Paleo and Gallbladder Health
Avoiding Gallbladder Problems with Paleo
To understand how Paleo can help you avoid gallbladder issues, it's useful to know what the gallbladder does and why it’s so important. Your gallbladder is an organ that stores bile, a fluid that helps you digest fat. When you eat a nice, fatty meal, your gallbladder releases the stored bile, which breaks down the fat so that your other fat-digesting enzymes can do their job.
Unfortunately, if you never eat a nice fatty meal, the bile just sits around in the gallbladder getting more and more concentrated. Eventually, cholesterol and other substances start to collect and form painful gallstones. That’s why a very low-fat diet can actually make gallstones worse – and why a Paleo diet rich in healthy fat can help prevent them.
Another reason why Paleo may help prevent gallbladder issues is the autoimmune connection. Specifically, gallstones are associated with Celiac Disease and other autoimmune digestive tract diseases. Since so many people are gluten sensitive without having true Celiac Disease, it’s reasonable to guess that Paleo might be helpful just because it eliminates gluten from the diet.
So far, we have two reasons why Paleo is a great diet for gallbladder function. That’s fine for healthy people who just want to prevent problems in the future, but if you've already had your gallbladder removed, it’s important to be careful. Diving headfirst into the coconut oil is not necessarily the way to go.
Most people without gallbladders already know this very well. Eating too much fat at a time can cause cramping, diarrhea, bloating, constipation, and a whole slew of other symptoms. Often this improves on its own (and a few lucky folks never have problems to begin with), but other times it’s a little trickier to handle. So what to do?
Tips for Going Paleo Without a Gallbladder
Most people can still make Paleo work for them without a gallbladder, but sometimes it takes a little tweaking.
- Don’t assume that you’ll react badly to Paleo because you reacted badly to a high-fat meal while on a grain-based diet. It’s amazing what our bodies can do when we take out the foods that make them sick!
- Medium-chain fats like coconut oil are often easier to break down and digest than long-chain fats. Some people who want to eat Paleo with gallbladder issues go for lean cuts of meat and then add coconut oil to them; this seems to be easier on the digestion.
- Remember that “Paleo” can encompass all different macronutrient ratios. Don’t try to go full-on ketogenic all at once. Try smaller servings of fatty foods and experiment with eating more protein and carbs until you find something that works for you.
- Ox bile supplements or digestive enzymes may help. Ox bile is exactly what it sounds like: bile from an ox. Taken with a meal, it provides a highly concentrated source of bile – exactly what your own gallbladder would have given you, if you had one.
- There’s also some evidence that the bile duct (the pathway from the gallbladder to the intestine) can actually enlarge into a kind of pseudo-gallbladder in time. Basically your body is making do with what it has and growing a new gallbladder from the duct. So even if you've had your gallbladder completely removed, you may find your fat tolerance increasing as your body recovers from the surgery.
Diet vs. Surgery
A word on gallbladder removal surgery: many people come to dietary cure because they’re looking for a way to avoid painful and stressful surgery. This is a worthy goal – but on the other hand, there is a time and a place for medical intervention. And what’s more, it doesn’t have to be an either-or choice between diet management and going under the knife.
If you’re interested in non-surgical treatments for gallstones, Dr. Eades has some pointers here. But for some people, surgery followed by a recovery diet might be the best option – and that’s fine too. Gallbladder removal isn’t the end of the world, and it’s much better to plan for it than to take an unscheduled trip to the ER. So don’t try to manage everything yourself; talk to a real doctor about what makes the most sense in your particular case.
Summing it Up
Will a high-fat Paleo diet give you gallstones? As far as we know, it won’t do anything of the sort; in fact, it seems to be protective. Can you go Paleo with a sick gallbladder or even after having the organ removed? Definitely. It just takes some time and a little tinkering.
With all that said, remember that gallstones are serious – if they’re left untreated, they can even be fatal! Don’t try to cure yourself by chasing down a jar of coconut oil with a whole bottle of ox bile pills. Talk to your doctor first and foremost, and figure out a plan that’s safe for you.