Woman I know at work had hers removed and we've been talking a lot about nutrition when this came up. I don't really know what to tell her.
In order to digest fats, you need bile (which is normally released by the gallbladder when needed). Without a gallbladder, bile just kind of drips non-stop into the digestive tract. She may or may not benefit from supplemental bile salts to help with fat digestion, but I'd have her ask her doc.
I think this is highly individual. CW says no. I prove that wisdom to not be so wise. In fact in the throws of my gallbladder disease all I could eat was fatty beef so go figure. I eat plenty of fat and have no signs that it is undigested. None.
You CAN do a paleo diet that is lower in fat so maybe you can just tell her that there certainly are people without gallbladders who can ingest large quantities of fat but she should try it, maybe start out at a more moderate level) and then listen to her body.
Just curious. Those of you who think the gallbladder-less should be taking salts, do you think it's just impossible that we are digesting the fats. Do you think it's possible that those of us who seem to have no apparent issue with fats just aren't aware, aren't getting the usual symptoms of fat malabsorption? I might like to try the salt therapy just to see the difference but honestly if I'm not digesting my fats at this point I'm not sure I want to start as I'll end up the size of barn I think.
SAVE THE GALL BLADDER!!! I swear, I want to start a petition. These things get removed left and right like some sort of irrelevant mass thats in your way....Seriously, there are ways to promote a healthy system were you dont have to just take this thing out. Surgeons jump on removing this way too quick in my opinion. Kinda like, hey while i'm in here fixin your hernia you want me to go ahead and take out that pesky appendix and gall bladder?
Find a Chiropractor that uses Standard Process Products in your area-- Cholacol are natural bile salts. We were given a gallbladder for a reason--whether or not you get "the rumblies" (Great word, by the way, Vern), the optimally functioning body would emulsify fats appropriately with bile stored in the gallbladder and digest them accordingly, including EPA/DHA, which are certainly longer chained fats. I guess what I'm saying is this--it's dangerous to base whether or not you are digesting fats based on presence or lack of symptoms...
This came up in my nutritional training, because another student had no gallbladder. The instructor suggested she take Biotics bile salts after muscle testing her, and she did really well eating more fats with the addition of the bile salts. I agree that we are all unique, and there is no one size fits all protocol, but you could definitely suggest she try bile salts, and gradually add more fat as long as it keeps feeling good in her body.
I had mine removed, and it was hard at first, but adapted. Dr. Kruse says that the biliary duct forms a sort of primitive gallbladder. I'm not sure that's enough.
However, when I went paleo last year, it was suggested that I take Now SuperEnzymes, which is a replacement for bile with Betaine HCL, and that I use these immediately before every meal that contains fats and proteins in the right amount.
I usually take one SuperEnzyme pill right before starting to eat meats, and the rest spaced out as I eat the meal.
The protocol Robb Wolf recommends to finding out the proper dose is to take these, upto 5 and no more, one at a time until you feel heat right at the top of your stomach with your hand. For me, it's about 2-3 per meal, but I also add in a betaine-HCL capsule as well as I previously had issues digesting proteins. (Not sure I need the extra Betaine-HCL anymore, but they don't seem to hurt.)
Robb says that if you don't have a gallbladder, you should always take these as you won't get proper digestion otherwise. So it's sadly for life.
I can say that they've made a huge difference, and I can tell via the shape of bowl movements when I've not had these - they come out lumpy, like clusters of grapes, instead of straight and smooth - from undigested fats.
The other thing to keep in mind is that since coconut oil is more than half MCTs and since MCTs don't require bile to process, eating relatively more coconut oil than other fats gets rid of the need for bile.
BUT there is one huge danger from the gall bladder removal surgery and that is that it increases the risk of colon cancer. I remember all sorts of issues with acid reflux (but it actually was bile reflux) after the surgery. If I didn't eat anything at night at all to avoid reflux, I'd throw or reflux up a bright yellow/green bitter liquid which of course was bile.
So I took to eating cheese at night since the fats in the cheese would counter the bile. This worked for a few years, until it didn't, then I found the dairy itself - almost any dairy, would cause acid reflux. So was in a catch-22.
I cleaned up my diet a couple of months after the surgery and found I could tolerate olive oil, so mostly ate paleo like salads, but also had pasta, beans, and whole wheat bread, as I found The Perricone Prescription PBS special and got his book, and that made my health a lot better, though I still had broken digestion when it came to fats. (I suppose EVOO was ok since it's mostly MUFAs and that didn't need bile to digest either.)
Over time, this stopped working, but luckily last year, I found Mark Sisson's site, and then Robb Wolf's site and Squatchy on that site recommended I take SuperEnzymes - with the same kind of advice at the top of this answer, and that made the entire difference.
So yes, you can digest fats even without a gallbladder, you can do it without the bile pills, but it's inefficient and certain types of fats work better than others.
Now, I don't have to care about the types of fats (obviously avoiding trans and n6-PUFAs, but not because of digestion issues), I can happily eat 4 rashers of bacon along with 4 eggs and have no issues at all.
Yes, but maybe not everybody, and it may take some time to adapt.
I can eat high-fat no problem. I think my gallbladder wasn't working well prior to the removal, so I think I adapted to less bile before my gallbladder even came out.
I believe certain fats require less bile and may be easier to digest as well (MCTs, emulsified fats like cream, etc...)
I had a Gastric Bypass, as well as had my gallbladder removed in 2001.. ten years later and I don't really have any problems with fats, but I ate terribly before my surgery and eat very well now, so I don't really have the best way to compare how my body would/should have behaved prior to my surgery.
I occasionally experience oily stools and I certainly don't absorb as much fat as I eat (due to the Gastric Bypass) but I don't eat a ton of fat. When it comes to my proteins, I eat a lot of fish. When I do eat foods higher in fat (heavy cream in coffee or bacon) I do sometimes get a few rumblies, but nothing that would otherwise keep me from eating it.... you know. cause it's bacon.
Including more sources of short and medium-chain fats can be beneficial for those who do have gall bladder issues or issues digesting fat.
Obviously things like Coconut Oil, MCT Oil, Ghee and even butter are good options. If you can tolerate them, raw milk, cream or other raw dairy sources are also good.
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