Life Without a Gallbladder

It seems more common than not these days to have gallbladder removal surgery. While it is certainly necessary when the gallbladder has become so diseased it can no longer function properly, however, there may be more risks than meet the eye when it comes to simply having it removed.

What does the gall bladder do anyway?

The gallbladder is a small balloon like organ that resides in the upper right abdomen, tucked just beneath the liver. The primary responsibility of the gallbladder is to store a green digestive liquid mixture called bile. Bile is made in the liver and continually fills the gallbladder, similar to filling a balloon with water.

When food-containing fat enters the stomach, the gallbladder will begin to contract and slowly squeezes this bile solution into the first part of the small intestine, the duodenum. Bile acts like and emulsifier when it mixes with fat from food, assisting in the digestive process.

No Need for a Gallbladder?

It may seem like such a simple job the gallbladder has in releasing bile for digestion. And yes it is true, we can live without one. But when the gallbladder ceases to exist, there is no longer a catch all, storage pouch where manufactured bile can be stored.
Instead, when the gallbladder is removed, there is a direct connection between the liver and duodenum, allowing a continual slow release of bile.

While this slow trickle of fat digesting bile can be sufficient for some fat digestion, fats entering the small intestine from the stomach need more than just a trickle to sufficiently be broken down and absorbed. This can lead to chronic diarrhea and other symptoms due to fat malabsorption.

When fats from diet can not be adequately broken down with the digestive bile salts from the gallbladder they are sent through the small intestine whole and are not able to be absorbed and utilized. This leads to fat being sent to the colon and eventually in the stool which can result in diarrhea, oily or greasy stools.

Why is Fat Digestion so Important?

When the body does not appropriately break down fats, there is an increased risk of fatty acid deficiency. Fatty acids are what make up the structure of our cells, produce fuel for the heart, kidney and brain, and reduce inflammation in the body.

Reduced cell wall integrity due to decreased fatty acid breakdown and absorption creates fragility in the cell making it easier to succumb to cell lysing, aka cell death.

Beta-oxidation is the process in which fatty acids are used to make ATP or energy for various cells of the body. This is very important when it comes to the heart, brain and kidneys to name a few.

Chronic inflammation is no good for many reasons, mainly due to its ability to increase the progression of several disease processes like heart disease, liver disease and even cancer.

Symptoms of Fatty Acid Deficiency

Minor symptoms of fatty acid deficiency include dry and rough cracked skin, brittle fingernails, dry hair, chronic eczema, dandruff and a skin condition called follicular keratosis which results from a build up of skin and debris around hair follicles.

More concerning symptoms and diseases associated with fatty acid deficiency include increased thirst and urination, ADHD, dyslexia, autistic symptoms, memory problems, fibromyalgia, chronic fatigue and brain fog.

What can be done to ensure fat digestion and absorption?

Blood tests can be run to know if your body is actually absorbing and incorporating fatty acids in the body. Specifically, testing for essential fatty acids, the fatty acids that must be obtained through diet and digestion, is helpful not only to ensure adequate intake, but fatty acid ratios can also be obtained which is helpful to ensure an anti-inflammatory environment.

Stool testing can be done to make sure fats are not being lost via stool. When the body does not absorb fatty acids in the small intestine, they are sent through the stool for evacuation and can be found in a stool sample.

What Happens If I Have Already Had A Cholecystectomy?

Not to fret, just because you have already had your gallbladder out does not mean you are destined to be fatty acid deficient. It is important, however, to be aware of your digestion and note any abnormalities. It is also important to report any changes in your health including skin texture changes, energy level and cognitive changes to name a few.

Watch your stool- If you note changes in color, texture or see oil or greasy like stools you should alert your health care provider. Stool changes not only can indicate fatty acid maldigestion but can clue your physician into other health issues that may be going on.

If you suspect you may be at risk for fatty acid deficiency, consider speaking with your doctor about your concerns to determine ways to mitigate further or future deficiencies.

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