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A family member had her gall bladder removed quite a few years ago and is going full paleo. She has had issues with (ahem) diarrhea when using cream or half and half. But here's the cool part: coconut oil doesn't have the same affect!

I'm wondering if anyone else has had experience with paleo diet hacks for those with NO gall bladder. Generally, these people struggle with food and have a hard time eating the amount of fat required on paleo.

If you have knowledge about gall bladder and paleo, please comment!

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I think this has been asked here before so you might do a search. Offhand, you might want to look at other MCTs, emulsified fats, choleretics (like curcumin), and bile salt tablets. My gallbladder stopped working too well for a while before it was taken out, and by the time they removed it I had become pretty adapted and have had almost no problems with fats since. A lot of people can adapt over time, but some can't. – Paleo2.0 Apr 12 2012 at 22:38

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"Medium-chain triglycerides are processed differently. When we eat a fat containing MCTs, such as coconut oil, it travels through the stomach and into the small intestine. But since MCTs digest quickly, by the time they leave the stomach and enter the intestinal tract they are already broken down into individual fatty acids (MCFAs). Therefore, they do not need pancreatic enzymes or bile for digestion...Because coconut oil digests without the need of bile, those people who have had gallbladder surgery can consume this fat without fear. I have had people tell me they could only handle a very small amount of fat without it causing them discomfort, but they could eat a couple of tablespoons of coconut oil at one time without problem."

from http://www.ofspirit.com/brucefife1.htm

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It sounds more like a lactose issue than a fat issue. But you are correct that coconut oil is easier to digest. Coconut oil is MOSTLY made up of medium chain fatty acids (MCFA) which do not require bile for digestion. Your liver still produces bile when you don't have a gallbladder. In fact I've heard of cases where the body tries to "make" a new gallbladder in the bile duct where it attempts to store concentrated bile. The problem with not having a ball bladder is you don't have concentrated bile for digesting fats. But you still have the less concentrated fat from the liver. It's not the most efficient way of digesting fats. Its best to supplement with bile salts and to only eat healthy fats. But I still think your friend is having lactose issues. That's my best guess.

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I think you meant "you still have the less concentrated BILE" :) – Kamal Apr 13 2012 at 3:47
Yes, sorry that was a typo. I meant to say less concentrated bile. – Primo Health Coach Apr 13 2012 at 15:55
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I've been minus a gall bladder for about 10 years now and the only gastro problems I've ever had were before I went paleo. I have no problems eating any types of fat and I use cream in my coffee with no issues too. I think this may be a very individual issue though I know other people without gall bladders who do not have any issues eating a paleo/primal diet.

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The high MCT (medium chain triglyceride) content of coconut oil makes it a lot easier to tolerate for people without a gallbladder... go for it!

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