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What You Do Not Know About Gallbladder Removal

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These data are taken from the medical literature.

• More than 700,000 Americans have their gallbladder removed each year.

• After surgery to remove the gallbladder – cholecystectomy – about 10-15% of patients will eventually experience pain and digestive problems; it is known as postcholecystectomy syndrome.

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

• Currently, gallbladder surgery does not relieve gallbladder pain in 10% to 33% of people with established gallstones.

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

You lost the gallbladder. If you’ve been told that laparoscopic cholecystectomy is a simple, relatively safe, painless, and cosmetically beneficial procedure with no large scars, then that’s true. It is also true that the postoperative period and recovery would be quick. However, if you’ve been told that the gallbladder is just an unnecessary sac for bile storage or anyone can live without symptoms after gallbladder surgery, that’s not entirely true.

Many people are not aware of the important role of the gallbladder, especially when it comes to the digestion of fat and fat-soluble vitamins, cholesterol metabolism, acid-base balance, detoxification, the influence on the pancreas and the sphincter of Oddi function, the gut mobility etc.

The digestive system is a combination of digestive glands and chambers where digestion takes place. All organs such as the mouth, salivary glands, esophagus, stomach, liver, gallbladder, pancreas, duodenum, small and large intestine work like a well-organized orchestra. The nervous system and blood messengers – digestive hormones – regulate this orchestra. The gallbladder is a key player in the digestive system. Therefore, without a gallbladder, the digestive system will never function normally.

To understand this, let’s go to the basic anatomy and physiology of the gallbladder and biliary system. Bile is a medical term showing relation to bile or bile duct. Two digestive glands such as the liver and pancreas produce bile and pancreatic juice which are a key part of proper digestion. Liver constantly produces bile. It is a yellow-greenish liquid bitter alkaline solution composed of water, minerals and bicarbonate, cholesterol, bile acids, lecithin and bile pigments. Bile is concentrated in the gallbladder. When the fatty foods come out of the stomach, the gallbladder contracts and concentrated bile goes into the duodenum to aid in digestion.

Bile has a few functions.

First, bile helps pancreatic lipase break down fats, which promotes their absorption in the small intestine. Without concentrated bile, humans cannot normally absorb fat and fat-soluble substances and vitamins.

Second, there is the sophisticated mechanism that regulates the contraction of the gallbladder and the simultaneous opening of the sphincter of the Oddi muscular valve between the bile and pancreatic ducts and the first part of the small intestine, the duodenum. When Oddi’s sphincter is closed, the gallbladder is relaxed. I call it the pendulum effect.

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

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

Fifth, through bile, human removes fat-soluble toxins, alcohol, drugs, some medicines, bile pigments, heavy metals, etc. These toxins also irritate the gallbladder, bile ducts and sphincter of Oddi.

Sixth, in the normal state, bile does not enter the pancreatic duct. Even a tiny drop of bile in the pancreatic duct can activate the digestive enzymes and cause the pancreas to digest itself. This is how pancreatitis begins.

Seventh, bile is the natural regulator of gut motility. There is bile obstruction and bile acid diarrhea.

Eighth, bile and pancreatic juice normally play the essential role in promoting beneficial gut bacteria. Poor quality and quantity of these fluids can lead to overgrowth of small intestinal SIBO bacteria and Candida yeast.

Without the gallbladder, the pendulum effect breaks down and dysfunction of Oddi’s sphincter develops. This muscle valve closes, pressure in the common bile duct increases, causing pain and cramps. High pressure in the common bile duct can cause gallbladder pain and pancreatitis.

Without the gallbladder, the liver continuously produces liver bile, which is collected in the bile ducts. When Oddi’s sphincter cannot withstand the increasing pressure in the common bile duct, it opens and unconcentrated liver bile enters the duodenum, whether food is present there or not. It can cause indigestion, especially with fatty foods, and irritation of the duodenal walls from the acidic bile. Irritated duodenum contracts chaotically to cause backflow of bile into the stomach and esophagus, resulting in persistent heartburn, gastritis, ulcers, or Barrett’s esophagus. Conversely, precipitated bile acids enter the large intestine and lead to bile acid diarrhea.

I very briefly describe the problems that can cause postcholecystectomy syndrome. You don’t need an operation. Brilliant technology and experience, sophisticated equipment are not in most cases the reasons for pain and indigestion in people after gallbladder surgery, but the absence of the gallbladder is.

We can’t reset the gallbladder. Therefore, we need to focus on healthy diet and lifestyle, making bile and pancreatic juice alkaline, whole body cleansing with restoring beneficial gut bacteria, detoxification, etc.

Postcholecystectomy syndrome is the real problem affecting millions of Americans. There is no magic bullet or magic treatment for it. I have been working with patients without a gallbladder for 40 years and I am convinced that treatment must not only be symptomatic but also focus on the root of the problem. I’m sure a person without a gallbladder needs treatment if they’re feeling well. I’m sure the treatment must be less dangerous than the disease. I am sure that only the combination of conventional medicine with the various methods of alternative medicine, such as medicinal diet, herbs, nutritional supplements, drinking Karlovy Vary medicinal mineral water at home, acupuncture, colon hydrotherapy, abdominal massage are the key to keeping the person away from pain and digestive problems.

The information contained herein is for educational and 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 direction of a physician or qualified health practitioner.

Thanks to Peter Melamed Ph.D.

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