What You Do Not Know About Gallbladder Removal

These data are taken from the medical literature.

• More than 700,000 Americans have removed their gallbladders annually.

• After gallbladder removal surgery-cholecystectomy about 10-15% of patients eventually will have pain and digestive problems; it is known as a postcholecystectomy syndrome.

• The common symptoms of the postcholecystectomy syndrome are pain, gas, bloating, indigestion of the fatty foods, gastritis, sphincter of Oddi dysfunction, chronic pancreatitis, bile reflux, bile acids diarrhea.

• Currently, gallbladder surgery does not ease the biliary pain in 10%-33% of people with detected gallstones.

• After the introduction of laparoscopic technique in 1989, cholecystectomy rate was increased by 60%.

You lost the gallbladder. If you were told that laparoscopic cholecystectomy would be a simple, relatively safe, painless, cosmetically beneficial procedure without big scars it is true. Also true is that post-op period and recovery would be fast. However, if you were told that the gallbladder is just an unnecessary sac for bile storage or everyone can live after gallbladder surgery without any symptoms, this is not entirely true.

Many people do not realize the significant role of the gallbladder, particularly when it comes to bile in the digestion of fat and fat-soluble vitamins, cholesterol metabolism, acid-alkaline balance, detoxification, influence on the pancreatic and sphincter of Oddi function, intestinal motility, etc.

The digestive system is a combination of the digestive glands and chambers where the digestion occurs. All organs such as a mouth, saliva glands, esophagus, stomach, liver, gallbladder, pancreas, duodenum, small and large intestines work as a well-organized orchestra. The nervous system and blood messengers-digestive hormones regulate this orchestra. The gallbladder is an essential player in the digestive system. Therefore, without gallbladder digestive system will never work normally.

To understand that, let us go to basic anatomy and physiology of the gallbladder and biliary system. Biliary is a medical term that shows the relation to bile or the bile duct. Two digestive glands such as liver and pancreas produce bile and pancreatic juice, which are a core of the proper digestion. Liver constantly produces bile. It is yellow-greenish, liquid, bitter, alkaline solution consists of water, minerals, and bicarbonate, cholesterol, bile acids, lecithin, and bile pigments. In the gallbladder, bile is concentrated. When the fatty foods come from the stomach, gallbladder contracted, and concentrated bile goes into the duodenum to promote the digestion.

Bile has a few functions.

First, bile helps the pancreatic lipase split up the fats promoting the absorption of them in the small intestine. Without concentrated bile, the human being cannot normally absorb fat and fat-soluble substances and vitamins.

Second, there is the sophisticated mechanism that regulates contraction of the gallbladder and simultaneous opening of the sphincter of Oddi-muscle valve between bile and pancreatic ducts and the first part of the small intestine that is called duodenum. If the sphincter of Oddi is closed, the gallbladder is relaxed. I call it as pendulum effect.

Third, the bile acids inside the bile can be in a soluble form or can be precipitated. The alkalinity of the bile keeps the bile acids in the soluble form. Contrary, acidity causes precipitation of them. Precipitated bile acids are very aggressive, corroded substances, which irritate bile ducts and sphincter of Oddi causing spasms and inflammation. In the gallbladder, bile is concentrated in 4-5 times, while a concentration of the aggressive bile acids also is increased. No wonder, the gallbladder is more prone to irritation and inflammation; therefore, it is a first target for the surgical knife.

Fourth, acidic changes in the bile can lead to creating of the gallstones.

Fifth, through the bile human being removes fat-soluble toxic matter, alcohol, drugs, some medications, bile pigments, heavy metals, etc. These toxins irritate the gallbladder, bile ducts, and sphincter of Oddi, as well.

Sixth, in the normal condition, bile does not go into the pancreatic duct. An even tiny drop of the bile in the pancreatic duct can cause activation of the digestive enzymes, self-digestion of the pancreas. Thus, pancreatitis begins.

Seventh, bile is the natural regulator of the intestinal motility. There are bile constipation and bile acid diarrhea.

Eighth, bile, and pancreatic juice normally play the essential role in promoting the beneficial intestinal bacteria. Low quality and amount of these fluids may lead to SIBO-small intestine bacterial overgrowth and Candida-yeast overgrowth.

Without the gallbladder, pendulum effect breaks, and the sphincter of Oddi dysfunction develops. This muscle valve closes, a pressure inside the common bile duct raises leading to pain and cramps. High pressure within the common bile duct may cause biliary pain and pancreatitis.

Without the gallbladder, liver continuously produces liver bile that is collected in the bile ducts. When the sphincter of Oddi cannot stand the increasing pressure within the common bile duct, it opens, and not concentrated liver bile goes into the duodenum regardless is food there or not. It may lead to indigestion, especially fatty foods and irritation of the duodenum walls by the acidic bile. Irritated duodenum chaotically contracts to cause bile reflux into the stomach and esophagus creating persistent heartburn, gastritis, ulcers, or Barrett’s esophagus. On the other way around, precipitated bile acids enter the large intestine leading to bile acids diarrhea.

I describe very briefly the problems, which may cause the postcholecystectomy syndrome. They do not depend upon surgery. Brilliant technique and experience, sophisticated equipment in the majority of cases are not the reasons for pain and indigestion in the individuals after gallbladder surgery, but absent of the gallbladder is.

We cannot put gallbladder back. Thus, we have to focus on the healthy eating habits and lifestyle, making bile and pancreatic juice alkaline, whole body cleansing with the restoration of the beneficial intestinal bacteria, detoxification, etc.

The postcholecystectomy syndrome is the real issue involving millions of the Americans. There is no silver bullet or magic treatment for it. Working 40 years with the patients without the gallbladder, I am sure that treatment has to be not only symptomatic but also focusing on the root of the problems. I am sure that person without gallbladder has to be treated when he/she feels good. I am sure that treatment has to be less dangerous than the disease. I am sure that only combination of the conventional medicine with the various methods of the alternative medicine, such as healing diet, herbs, nutritional supplements, drinking Karlovy Vary healing mineral water at home, acupuncture, colon hydrotherapy, abdominal manipulation are the key to keeping the person off from pain and digestive problems.

The information contained here is presented for educational, informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. This information is not to be used to replace the services or instructions of a physician or qualified health care practitioner.

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