담낭 건강 및 식이 권장 사항 이해

### 담낭 건강의 이해: 기능, 문제 및 식이 지침
* 👨 ↪f_200D↩⚕️ 기능의학 전문의인 카를로스 아라밀로 박사가 담낭에 대한 일반적인 질문, 특히 **담낭의 기능과 문제 발생 후 식단 고려사항**에 대해 설명합니다.
* 📍 담낭은 복부에 위치하며 **간에서 생성된 담즙을 저장**하여 지방과 단백질의 동화를 돕는 등 소화에 중요한 역할을 합니다.
* 담즙은 음식물이 위에 들어가면 담낭에서 **산과 콜레시스토키닌(CCK)이라는 호르몬**에 의해 분비되어 소장에서 영양분을 흡수할 수 있도록 합니다.
* ⚖ 담석은 **콜레스테롤, 수분 및 담즙산과 관련된 불균형**으로 인해 형성되어 **담즙 생성 부족과 담도 산통**과 같은 고통스러운 증상을 유발할 수 있습니다.
* 🛑 담석이 있거나 담낭을 제거한 경우 담낭의 담즙 수축 및 방출 기능이 손상되므로 통증과 불편함을 예방하기 위해 처음에는 **지방 섭취를 피해야** 합니다.
* 🍏 수술 후에는 위산과 담즙 기능을 향상시키기 위해 **사과 사이다 식초와 잎이 많은 채소**와 같은 산성 및 쓴맛이 나는 음식을 섭취하여 식단을 통해 담즙 생산을 돕는 것이 필수적입니다.
* ⚠ 담석이 있는 사람은 증상이 해결될 때까지 **지방 섭취를 피해야** 하며, 담낭이 없는 사람은 **설사나 복부 팽만감과 같은 소화기 문제를 예방하기 위해 지방 섭취를 모니터링**해야 합니다.
* 💡 궁극적으로 담낭 건강을 이해하고 정보에 입각한 식단을 선택하는 것은 전반적인 웰빙에 큰 영향을 미칠 수 있으며, **"건강은 가정에서 시작된다"**고 강조합니다.

카를로스 아라밀로 박사는 담낭 문제와 수술 후 회복을 관리하는 데 있어 식단의 중요성을 강조합니다.

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

Dr. Carlos Jaramillo

담낭은 복부에 위치한 기관으로 간에서 담즙을 저장하고 배출하여 소화에 중요한 역할을 합니다.

적혈구가 분해되어 생성되는 담즙은 지방과 단백질의 동화를 돕습니다.

담낭은 음식물의 존재에 반응하여 수축하여 담즙을 음식물과 혼합하여 소장에서의 영양소 흡수를 돕습니다.

담낭의 결석 형성은 콜레스테롤, 수분 및 담즙산의 양 사이의 균형에 따라 달라집니다.

이 세 가지 변수의 불균형은 슬러지 형성과 결석으로 이어질 수 있습니다.

결석이 생기면 통증과 합병증을 유발하여 담낭을 제거하는 수술로 이어질 수 있습니다.

담낭 문제는 담낭의 기능 저하, 담석 또는 담낭 제거로 인해 발생할 수 있습니다.

담석이 있거나 담낭 기능이 느린 담낭 환자는 지방이 통증을 유발할 수 있으므로 지방을 피하는 것이 중요합니다.

담낭 제거 후에는 처음에는 지방을 피하는 것이 좋지만 담즙 분비가 불확실하기 때문에 지방 섭취량을 모니터링하는 것이 중요합니다.

담낭 제거 후에는 복부 울혈, 설사, 복부 팽만감을 예방하기 위해 초기에 지방 섭취를 피하는 것이 중요합니다.

담즙 생성은 위산에 의존하므로 식단 변화를 통해 위산을 개선하는 것이 중요합니다.

사과 사이다 식초, 시금치, 케일, 무와 같이 쓴맛이 나는 산성 식품을 섭취하면 담즙 기능과 생산을 개선하는 데 도움이 될 수 있습니다.

담석 증상이 나타나면 산성 및 쓴 음식을 피하고 문제를 해결하는 동안 지방을 피하세요.

담낭 제거의 필요성을 결정하려면 외과의와 상담하세요.

담낭을 제거한 후에는 처음에는 지방을 피하면서 위산으로 점차 기능을 강화하세요.