Gallbladder does impact fat digestion

[Andrea_Johns]

There is a distinction that is never made in the case of a surgically removed gall bladder. It is true that without a gall bladder the liver still makes bile. The gall bladder is a storage organ. It slowly releases bile into the intestine when fat is ingested. Without the gall bladder more bile than is needed for the ingested amount of fat is dumped in all at once. Because more bile than is needed is released into the intestine that means a large amount of undigested bile is still present in the large intestine as digestion progresses. Bile is an irritant to the large intestine. The large intestine pulls fluid from your cells to dilute the bile (remember your biology…cells in the body absorb or release fluid to keep the salt concentration inside and outside the cells in equilibrium). This influx of fluid causes watery diarrhea. I am not a doctor but I am a person who has suffered from problems with too much bile. It got so bad I was afraid to leave the house. I went to my gastroenterologist. After testing for C Diff (test was negative) and another test for overgrowth of bacteria in my small intestine (also negative) she prescribed a medicine that binds excess bile. Like a miracle, within a week, no more racing to the bathroom. This is the description of the bile process that was causing my “issues” given to me by my gastroenterologist. The drug prescribed is Colestipol HCL. I can take 2 per day but have never needed more than 1.

I have to say that it seems that the problem with a missing gallbladder is glossed over by the Keto experts. As Dr Phinney et al explain I can technically eat fatty food because my body does make bile. Bile is necessary to digest fat. But there’s too damn much of the stuff released every time I eat fat in any amount. The question about eating a ketogenic diet when you are missing your gall bladder is often asked (in the various forums and You Tube channels I frequent). It seems to me that others must be having the same significant, life altering side affects of eating fat as I have had.

I am not challenging the experts in any way. I believe I can (and I do) eat a ketogenic diet. I am in ketosis. I have had weight loss success and my blood sugars now run in the 80’s because of eating a ketogenic diet. I am pointing out that if you have had your gall bladder removed, and keto is causing you physical distress there is a reason and there is a solution.

I’d like to ask how others deal with this problem. How did you overcome this issue without drugs? At this time I am stable but if there is an effective non-drug method to deal with this I’d be obliged if you could share it. Keto On!

[ryancrawcour]

Yes, the gallbladder is just the storage organ for bile. My understanding is that your body will produce bile at a constant rate and this leaks constantly in to your gut (because there is no where for this to go and be stored). Also, when you eat a large fatty meal all at once, the body usually draws on this reserve and now you have an influx to deal with the influx of fat. Without a gallbladder you don’t have that reserve to draw upon and hence some keto people without gallbladders report a problem with digesting fat.

I have no gallbladder too and do often experience the same very watery “issues”.

I have been taking bile supplement to assist with fat digestion. Seems to be helping. But I might need to go consult a gastroenterologist too. The last time I consulted one, when I had my gallbladder removed, they advised me not to eat fat. The doctor even said “your cardiologist will thank me one day!” Eeeeek!

[gatita]

I have no gallbladder too and do often experience the same very watery “issues”.

Same here… I don’t really worry about it much as, in my doctor’s words, I have always had a “rapid transit system.” You would think it would help me lose weight, but no…

Thanks @Andrea_Johns for the info about that drug. If it ever gets worse, I might try it, but for now things are livable. Also, thanks for that explanation! I never understood the mechanism.

@ryancrawcour, what kind of bile supplement do you take?

[lfb1]

I had my gallbladder removed 25 years ago. I have not had any fat digesting problems.

[Dany]

My n=1:
My gallbladder was surgically removed many years before I went Keto.

Straight out of the hospital, I resumed my high fat / high carbs diet and never had a problem.
The same holds true on Keto.

For full disclosure, I did go through an adaptation period of about 2 weeks when first starting Keto during which I had more diarrhea.
And the same thing occurs when I fast for more than 36 hours.
But I believe this occurs regularly for people with the gallbladder.

[ryancrawcour]

I take these - https://www.vitaminshoppe.com/p/allergy-research-nutricology-ox-bile-500-mg-100-capsules/ar-1258A

haven’t done the science in to whether or not taking bile supplements work, all I can say is that for me, I can digest normal amounts of fat ok (I put this down to having enough bile in my gut normally as my liver continually produces it) but when I eat a particularly fatty meal then I cannot digest the fat properly and it passes (noticed by oily and very loose, sometimes liquid, “stools” — sorry for the TMI —) taking a bile supplement like this with meals helps me digest the fat better.

so for me, it appears I have the opposite problem to @Andrea_Johns who complains about having too much bile. I appear to not have enough (when eating very fatty meals).

[ryancrawcour]

Straight out of the hospital, I resumed my high fat / high carbs diet and never had a problem.

that’s interesting. when I had mine removed I was explicitly told by the surgeon and post op care team to avoid eating fat of any form for digestive reasons (but for all the other reasons too).

[KetoCowboy]

My wife fears keto because of her missing gall bladder. If she ever decides to give keto a try, we hope ox bile salts will do the trick for her.

[Dany]

My surgeon said i could eat whatever doesn’t make me feel bad. My wife was at wit’s end trying to convince the doc to tell mw to stay away frim fat…but he said “though i might benefit from losing some weight, as far as the surgery was concerned there are no dietary restrictions”.

I had the surgery in Austria… if that matters

[Lenc]

My gallbladder was removed three years ago. I was told not to eat fatty foods, in the beginning. But after a while it would be okay.
Remember having a lot of pain and feeling nauseated after eating a pizza… Non-keto. The thing came out as quickly as it went in😬.

Now I sometimes feel all little discomfort when I eat a large fatty meal, and only one day of rushing to the toilet when getting adapted… Otherwise I don’t have any problems not having a gallbladder.

[tdsm]

I’ve had my gallbladder out for 3 years now and have been keto since June 1st this year. Before Keto, for breakfast meals, when dining out predominately, eating eggs, high fat meats and fried potato’s, I’d be in the bathroom with water stool and cramp feelings in about 30 minutes. It has to be some connection with the starch’s and fats combined as now being fat adapted, I don’t ever have these problems. I never really had a problem for the other meals, but I wouldn’t really eat large volumes of carbs for the other meals with high fat volumes. I don’t know, it’s weird.

[tdsm]

*watery stool

[ryancrawcour]

, eating eggs, high fat meats and fried potato’s, I’d be in the bathroom with water stool and cramp feelings in about 30 minutes. It has to be some connection with the starch’s and fats combined as now being fat adapted, I don’t ever have these problems

I can say the same. Always had watery stools since having my gallbladder out, before keto. Once keto this went away and I have what I remember as normal stools and regular bathroom schedule.

On those occasions when i slip up and have carbs, within 30 mins I am in the loo regretting it!

My body clear can deal with fat without a gallbladder, it’s the carbs it can’t deal with!

[Alicia_Jimenez]

Just wondering if anyone has had a bloody stool while on keto. My gallbladder was removed in 2014 and I adapted to it. But with keto, my intestines are having an issue. I was intermittent fasting for a week.

[PaulL]

You should not have blood in your stool, no matter what. Get to a doctor and get that checked out.

[Capnbob]

My mother had a Whipple procedure which removes gallbladder, part of the pancreas, some of the bile duct and duodenum and ties it all together differently so that bile takes longer to reach digesting food.

She takes creon pills (lipase) to digest the fat but can sometimes get the symptoms described. I haven’t related it to high carb or high fat meals but it is worth tracking.

I have also seen many reports of effective gallbladder regrowth… not that it just regrows like magic but the billiary duct from the liver distends over time to form a new de facto bladder for your bile which may renew normal function for bile eventually. Of course it can also just enable a reappearance of the gallbladder issues that required its removal in the first place (stones, etc.)

[Alicia_Jimenez]

Thank you. I’m thinking it’s the fasting. The bile is sitting in my gut alone and it’s irritating it.
I will go get it checked out today.
Just a little sad I can’t fast haha. I hope my body is okay with keto.

[Lesley_Hutton]

I have been on the Keto diet since May 15, 2017. I’ve lost 23 pounds, and am currently in a holding pattern on losing weight. I stopped losing about 3-4 months ago, but am very happy that I am maintaining my weight loss. In February, I started having loose watery stools after eating high-fat meals. At first, I thought it was a stomach bug. Then I actually got an antibiotic from the doctor because it lasted longer than 10 days. He thought maybe I had a bacterial infection or a parasite. It went away for a while but is now back. I had my gallbladder removed 3 years ago, and I am wondering if this is an issue because I don’t have a gallbladder. I’m wondering why I was on the diet for 9 months and then the issue began. Anyone have any insight?

[atomicspacebunny]

Resources:

Multifarious Effect of Butyrate on Intestinal Function Source: Pauline Paap - Orffa Additives

Butyric Acid: an Ancient Controller of Metabolism, Inflammation and Stress Resistance?

…"Factors affecting the transit rate of food through our gastrointestinal tract will have significant influence on stool form."

BRAT Diet: How to Stop Diarrhea in Its Tracks Beyond BRAT

[Laura_Cole]

I’ve been experiencing the same thing! I started about the same time you did and have had similar progress. I actually was diagnosed as IBS-constipation a couple of years ago. Water stool is NOT normal for me. Everything was fine until a few days ago with the watery stool began ,and it’s a weird beige color. Not okay. I had my gall bladder out 12 years ago. I’m getting a stool test done and seeing my GI doc later this week. We’ll see what she says. I’m a bit concerned about my liver and pancreas. My blood sugars are also elevated, even though I’m not eating carbs.