Many times people come to ask us about problems with the gallbladder. When we have issues with the gallbladder, we don’t quite understand where it is located or what its function is because we only hear that people have it removed. The second issue is that we don’t know what to eat in these cases. So, let’s see how we can solve this.

Hello everyone, I am Dr. Carlos Aramillo, a functional medicine doctor and the author of the book The Metabolic Miracle. Today, I want to talk about a topic that many people ask about, which is the gallbladder. Often, we hear about someone having gallstones or someone having their gallbladder removed, and after it is removed, we don’t know what to do. So, we will clarify some interesting points about the gallbladder in very simple terms, and I hope it will be helpful.

First, what is the gallbladder? The gallbladder is an organ located here within the abdomen, along this upper line. I have marked the muscle that divides the abdomen from the thorax. Above, there are the lungs; here would be one lung, and here is the heart. But inside the abdomen, I have marked the esophagus, which is where food goes down to the stomach, which is this initial pouch here. And here is the liver, which is the large organ I have marked here. Let's remember that...

The liver has functions for detoxifying, producing proteins, and transforming part of the thyroid hormone. It has many functions, but the liver also expels some of its waste products; it releases bile. Bile comes from the breakdown of red blood cells in the body, but it is not just waste; it also has many functions in digestion. It is interesting to see how a process of waste from red blood cells ultimately serves the body, allowing it to take advantage of its own functions for digestion. This is quite fascinating. 

Bile is expelled through these ducts. Bile helps me assimilate mainly fats and also assists in protein assimilation. When food enters, it reaches the stomach, which produces acids. These acids trigger a response that causes the gallbladder to fill with bile. When the gallbladder senses that there is fat present, it contracts to mix the bile with the food as it moves into the intestine. From there, the small intestine is where one absorbs all the nutrients. This process allows for what is called absorption or assimilation; when the bile mixes with the food, I can properly assimilate the fats. So what happens next? One might say, Well, until....

La función está clara: cuando la comida entra en el estómago, se activa el sensor. La comida pasa del estómago al intestino delgado y la vesícula se contrae, lo cual ocurre a través de una hormona llamada colecistoquinina o CCK, que permite que los componentes se mezclen y, más adelante, yo pueda asimilarlo porque ya está mezclado. Hasta aquí todo bien. 

Ahora, hemos oído de personas que de pronto tienen cálculos en la vesícula, que son piedras que se forman en la vesícula. La mayoría de las veces nos dicen que los cálculos en la vesícula aparecen porque las personas tienen mucho colesterol. Sin embargo, cuando les analizan el colesterol en sangre, no siempre está elevado. Entonces uno se pregunta: ¿qué puede hacer que una persona forme un cálculo? 

Vamos a ver. Hay una triada que determina cuándo una persona tiene cálculos en la vesícula. ¿De qué depende esa triada? La formación de cálculos depende efectivamente del colesterol, pero eso no quiere decir que sea colesterol malo. Recordemos que el cuerpo produce colesterol porque lo necesita. 

Lo otro es la cantidad de agua y, además, la cantidad de ácidos biliares, es decir, de todo lo que compone en parte la formación de la bilis. Debo tener un equilibrio entre estas tres cosas. Cuando mi triángulo empieza a estar desequilibrado, ya sea porque

A triangle that is completely balanced is when the gallbladder starts to produce bile that is concentrated inside. When it is not well balanced, it begins to form a sludge, and then gallstones develop. That is when the stones appear. So, when I have stones in the gallbladder, I do not have much bile available, which makes it difficult for my gallbladder to contract because it is full inside. When fat comes through, and the gallbladder is supposed to contract, it releases very little bile, and this can cause inflammation, leading to pain. That is why some people experience pain when they eat fatty foods and have gallstones; they feel a pain on the right side, similar to colic, which is referred to as biliary colic. We should remember that the gallbladder is located on the right side, beneath the ribs. This is what happens: there is insufficient bile production. 

Now, there is another condition that is also very common. A person may have gallstones, and if they have many stones, experience significant pain, or are at risk of a stone causing a blockage or pancreatitis, they are taken to surgery, and the gallbladder is removed. After the gallbladder is removed, the anatomy will remain as such, and the drainage of bile will be constant or not, because there is no longer a manager. Previously, we should remember that when the signal reached the stomach, it was the gallbladder that

It used to administer when bile was released, and now what remains is only what the liver produces, whether a lot or a little, which will determine how much bile will reach the intestine. So, what can we do? Let's see if someone has problems with the gallbladder, whether due to a slow gallbladder, which is called biliary dyskinesia, or because they have gallstones, or because they have had their gallbladder removed. What can we do? We will look at both scenarios. If I have gallstones and it hurts because the gallbladder is contracting and cannot contract, causing biliary colic, I should avoid fats while resolving this issue. This is because fat will cause the gallbladder to contract, and it will hurt. Other things I can do are temporary measures. For people who have a slow gallbladder or those who have had their gallbladder removed, it is advisable to avoid fats at first because, without a gallbladder, fat will not cause pain. Since there is nothing to contract, bile will be released constantly, and there will be nothing to hurt them. However, we do not know how much bile is being released. We don't know if a lot or a little is coming out. Therefore, since we don't know how much bile is being released, if a person has very little bile coming out after their gallbladder is removed, eating fat will be terrible for them.

It will generate a lot of congestion; diarrhea will occur, and there will be bloating, which will produce a lot of gas. So, it will produce that. Therefore, we should avoid fats at the beginning after gallbladder surgery. Now, what can I do after my gallbladder has been removed? What I need to ensure after the gallbladder has been removed is to remember that bile production mainly depends on stomach acid; it is not an independent signal. Since I no longer have a gallbladder, I have to ensure that the production is adequate, and adequate production depends on stomach acid. How can I improve my stomach acid? By including acids in my diet, such as apple cider vinegar. If it doesn't sit well, you can dilute it in a bit of water, or you can consume bitter foods like spinach, kale, coffee, seaweed, and many other bitter foods like radishes. These bitter foods have been shown to improve bile function, even in people who still have a gallbladder but have a sluggish gallbladder. Bitter and acidic foods help because bitter foods aid in contraction, and acidic foods help signal the production of more bile. So, if you have issues with a sluggish gallbladder, there is no problem with fats; what you need to do is include foods.

Acids and bitter foods should be avoided if you still have gallstones and are experiencing symptoms. It's important to avoid fats and work on resolving the issue. Consult with your surgeon to determine if removal is necessary. If your gallbladder has already been removed, while we work on improving function, it's best to avoid fats at first as we begin to enhance function with acids in the stomach. Remember that the stomach should be an acidic organ, and bitter foods can help improve function. So, there you have an explanation of how this works and how we can rehabilitate it properly. Remember, the most important thing is that with knowledge, we can achieve health, and health starts at home. A big hug, goodbye!

Vesícula Enferma? Dieta para la Vesícula u operados? - Dr Carlos Jaramillo

Scripts