Gallbladder Problems Explained: Diseases, Gallstones, and Polyps

Today we’re talking about gallbladder health, including issues like gallstones and polyps. I think you all understand that the connection between the intestines and all other organs of the gastrointestinal tract is enormous. Therefore, the gallbladder plays one of the important roles in our digestion, and problems like gallstones or polyps can significantly impact this process. We’ll discuss why and how this happens, exploring various gallbladder conditions and their effects on overall digestive health.

Interesting Statistics

Let’s start with statistics. In the picture, you can see statistics showing that diseases of the gallbladder and biliary tract are in second place among gastrointestinal diseases.

Notice that children and adolescents occupy a larger percentage than adults. This is due to modern dietary trends, the abundance of trans fats and sugars in children’s diets. This includes not only things bought in supermarkets or stores (we all see teenagers walking around with chips, cola, and other unhealthy products), but also the food organized in schools and kindergartens. Of course, this needs to be addressed at home, trying to ensure that the child has as many meals as possible at home. It’s also due to a large number of genetic pathologies associated with the gallbladder. Many children are now diagnosed with gallbladder bends and kinks, some of which pass with age, while others remain with children forever. As a rule, this pathology is passed from mother to child. And the more such pathologies parents have, the more children have.

Gallbladder in the Digestive System

Before we start talking about diseases, let’s discuss the place of the gallbladder in our digestive system.

The gallbladder doesn’t perform its functions alone, but together with the liver and bile duct, we call this the biliary system. It consists of the liver, where liver cells produce bile, then this bile flows through the bile duct directly into the duodenum and into the gallbladder. That is, in some quantity there, in some quantity there.

There’s different work of sphincters, ducts, and so on, we won’t go into details, we discuss this in depth in the Healthy Digestion course. Our task is to understand that the liver produces bile and then it enters the duodenum and gallbladder. The liver can produce a lot of bile, the liver can produce little bile, this will also be the beginning of peculiar pathological processes.

Functions of Bile

It’s necessary to understand that the functions of bile are quite extensive. If you know and understand why bile is needed in the body, then, of course, the desire to improve gallbladder health or prevent gallbladder diseases comes to the forefront when we talk about the health of the gastrointestinal tract.

1. Lipase activation.

An important function, emulsification of fats and absorption of fat-soluble vitamins. Without bile, we cannot absorb fats from food. Consequently, we cannot get the necessary vitamins contained in fats: vitamins A, E, D, and K. These vitamins are essential for us, they are irreplaceable and we must get them from food. Very often we see when a person takes, for example, vitamin D for quite a long time, but its level does not increase. First of all, this may be due to some problems and diseases of the gallbladder that interfere with the absorption of vitamins.

2. Antibacterial functions.

One of the most important functions of bile, which allows destroying bacteria, viruses, fungi, and other antigens that have penetrated the organs of the gastrointestinal tract. Bile itself is quite an aggressive environment, so it can indeed deactivate some parasite eggs, the parasites themselves. If enough bile is secreted, if it works actively, then we say that bile and the gallbladder are active participants in our immunity. Bile is one of the important protective properties of the body.

3. Enhancing intestinal peristalsis.

Also one of the most important functions, because if food absorption and fecal excretion are disturbed, we will face the fact that this will affect our microbiota and, in the future, this will entail changes in human immunity.

This can be associated with both loosening of the stool, for example, chronic diarrhea, when bile is produced in sufficient quantities or it does not flow in the usual rhythm in which it should. Or, conversely, its insufficient amount, when we say that this affects intestinal peristalsis and forms constipation. A person tries to eat more and more fiber, drinks more water, but, unfortunately, this does not affect bile outflow, suppose there are some stone formations, there may be some inflammatory diseases. In this case, constipation will still form despite efforts. Therefore, the first thing to check when we talk about some loosening or constipation in a person, we look, among other things, at the state of the gallbladder and, accordingly, the liver.

Interesting Fact About Bile

In the morning on an empty stomach, the concentration of bile in the gastrointestinal tract reaches a maximum, up to 30 ml. The gallbladder is full in the morning. This can form morning nausea, morning bitterness in the mouth in some people when there are some gallbladder diseases.
Increased amounts of bile are usually found in people who are overweight, obese, pregnant, especially in the second and third trimesters, and when taking oral contraceptives. Here, an increased amount of bile will be formed, 30 ml is the norm for a person weighing 75 kg, everything else is already an increased amount.

Accordingly, the more bile (if there are no ways to excrete it), it can thicken: first sand is formed, then some polyps can form, then stones are formed, well, then a number of pathologies follow. Therefore, warm drink on an empty stomach, when you wake up and drink a glass of water, starts natural processes, that is, bile begins to separate, then this bile stimulates intestinal peristalsis and facilitates morning toilet.

Ideally, morning toilet should occur before you have breakfast, everything after is already not considered a variant of the norm. The variant of the norm is – got up, brushed your teeth, went to the toilet before breakfast, but this doesn’t always happen, but it’s necessary to strive for this.

Gallbladder Diseases

The most common gallbladder diseases:

1. Biliary dyskinesia (disruption of their motility)
2. Cholelithiasis (stone formation)
3. Chronic cholecystitis (inflammation of the gallbladder itself)
4. Postcholecystectomy syndrome (removal of the gallbladder when there is some pathology, a stone that can close the duct, polyps that the surgeon doesn’t like, which can develop into oncological diseases, surgical treatment in the form of gallbladder removal is used)
5. Genetic disorders (Gilbert’s syndrome)
6. Formation of polyps.

It’s necessary to understand that gallbladder diseases are associated with such conditions as sluggish intestinal peristalsis, changes in the qualitative and quantitative composition of our intestinal microbiota. Therefore, it never happens that all other organs of the gastrointestinal tract are healthy and normal, but the gallbladder is sick or has some chronic pathology. As a rule, this is a complex of some diseases, and the reason for this begins, of course, with nutrition.

Let’s briefly consider all those pathologies that occur

Biliary Dyskinesia

Biliary dyskinesia (movement disorder) of the bile ducts is a functional disease in which there are no organic, structural changes in the gallbladder and ducts, but only their motor function is impaired. This involves excessive or insufficient contraction of the gallbladder or uncoordinated actions in opening or closing the ducts. Such a diagnosis can be seen quite often in ultrasound results or gastroenterologist’s conclusions.

It’s important to understand that treating this pathology should always begin with compensating for stress, addressing psychosomatic issues, and normalizing a person’s psychological health, because in addition to acute chronic psychotraumatic situations, there may also be deep intrapersonal conflicts. Food sensitivity, allergic reactions, and food intolerances also play a role here. But balancing rest and sleep patterns, anxiety, and increased stress states can be attributed to the causes of biliary dyskinesia.

Cholelithiasis

Cholelithiasis is a disease in which stones form in the gallbladder or bile ducts. Bile first thickens, then forms, most often, cholesterol stones, which can be located in different areas of the gallbladder and block ducts, or they can just lie motionless in the gallbladder. Depending on how they behave, a decision is made to remove the gallbladder or dissolve the stone. Most often, stone formation leads to gallbladder removal, very small stones are sometimes tried to be dissolved, but here a diagnosis is already made about what kind of stone it is, and a gastroenterologist conducts the treatment.

In the formation of cholesterol stones, the key role belongs to insulin resistance, hyperglycemia, diabetes, dyslipidemia, obesity, and overweight. If we look at the statistics of this disease, we will see people who are overweight, see nutritional disorders, and an excess of trans fats.

I had a case, I didn’t lead it, but it was a client’s child who came to me. The girl was, I think, four years old and she had stones in her gallbladder. Her complementary feeding started with ice cream, that is, there was a complete lack of eating behavior and this formed stones in the child’s gallbladder. This is a quite serious pathology.

Gallstones are crystalline structures that occur in abnormal bile. Stones are formed from cholesterol and calcium salts bound to the bile pigment bilirubin, they can be large or small.

Signs of cholelithiasis largely depend on the number of stones, their location and size, as well as on which part of the biliary system where the stone “gets stuck”. When a stone gets stuck, it forms an anxious acute condition when urgent surgical intervention is necessary.

In a fairly large number of people with stones in the gallbladder, there are no manifestations of the disease, usually these are single, large stones. Typical manifestations of cholelithiasis are considered to be attacks of hepatic colic caused by stones leaving the bladder or moving through the ducts. At the same time, severe pain suddenly occurs in the right hypochondrium, which radiates to the right arm, right shoulder blade, accompanied by nausea and repeated vomiting. Often an inflammatory process in the bladder joins, the temperature rises. The condition is quite serious for a person, this pain is very strong.

If a stone blocks the common bile duct even for a short time, the patient notices darkening of urine. In general, if we talk about diagnosing gallbladder diseases, dark urine and light-colored stools are one of the signs of gallbladder diseases. Here you can independently make a primary diagnosis of some pathologies.

Cholecystitis

Most often, the chronic form is an inflammatory disease of the gallbladder. The most common cause of chronic cholecystitis is bacterial infection – various types of E. coli, Proteus, enterococci, staphylococci, streptococci, the role of viruses is also discussed. Giardiasis of the bile ducts is of certain importance, parasitosis occurs, but here it is already the task of a competent gastroenterologist to determine and see the causes.

Cholecystitis contributes to the long-term course of the inflammatory process: changes in bile properties, stone formation, and impaired bile outflow. In fact, everything starts with biliary dyskinesia, then cholecystitis can join, especially when our immunity is weakened, and then this can lead to the formation of stones, polyps, there may be some suspensions first, then we will already see the presence of stones and so on.

Symptoms of Gallbladder Dysfunction

The most common interesting findings are:

• Non-localized skin itching, which is characteristic of both children and adults. This is when the head, arm, leg itches today, and tomorrow it’s the back, stomach, arm. As a rule, it passes quite quickly, no inflammatory or any special manifestations on the skin occur, these can be just dry migrating spots;
• Dark urine;
• Light-colored stool or diarrhea. Also, if we talk about stool, if it floats, doesn’t sink – this can also be a symptom that fats are poorly absorbed, and stool that sticks to the toilet walls (excuse the details) can also indicate gallbladder disease;
• Foul-smelling stool, I won’t describe the smell, I think it’s understandable;
• In acute form – pain in the right hypochondrium;
• Undigested food in the stool;
• Weight loss or decrease in body mass can also be a symptom. If we’re talking about an overweight person, this point may be absent or unnoticeable. For a person who, for example, had a body mass deficit and has gallbladder disease, it will simply be more difficult to gain weight.

Gallbladder Polyps

Polyps are excessive growth of the epithelium of the gallbladder mucosa. It’s more common in females over 30 years old.

Causes of polyps:

• As a rule, heredity and predisposition (but this doesn’t play a key role);
• Irregular and irrational nutrition, especially abuse of food containing cholesterol. This means trans fats, excess sodium, especially dietary table salt, and excess, of course, simple carbohydrates and sugars;
• Chronic cholecystitis, hepatitis, and biliary dyskinesia.

As soon as there are any disturbances in the gallbladder function, it’s necessary to take immediate measures to compensate for them, so that all those diseases we discussed don’t develop.

Clinical manifestations, if we talk about polyps, there are none, no symptoms, even pain may not occur. But, as a rule, those non-specific symptoms that we discussed do occur.

Polyps can be single or multiple, they can be cholesterol or parenchymal. Polyps are never left alone, they always require removal. If the polyp cannot be removed, then, most often, the gallbladder is removed.

Indications for surgery:

• When the number of polyps is more than two;
• Polyps located on a wide base;
• Polyp sizes more than 10 mm;
• Located at the neck of the gallbladder and in its duct;
• Polyp growth (increase of at least 2 mm per year);
• Diffuse nature of polyp formation involving all organ walls;
• Presence of clinical manifestations of the disease that worsen the quality of life of patients, when it affects digestion, vitamin absorption;
• It’s impossible to exclude the malignant nature of the process.

Causes of Gallbladder Diseases

Globally, there are several causes that lead to gallbladder diseases. These causes can be eliminated by the person themselves and this will be an excellent prevention.

Causes:

1. Lack of fluid. When we talk about a person being dehydrated, a person doesn’t consume the necessary amount of fluid. I remind you that the water norm is when we multiply the desired weight by 30 ml (average formula, without individualization, but at least it will be clear what to focus on).
2. Excess carbohydrates in the diet. We’ve already talked about excess trans fats, carbohydrates, and sodium. When we say that a person consumes products rich in sodium – these are any products associated with processed meat, sausages, ham, and so on, any semi-finished products, minced meat, cutlets. Junk food: hot dogs, McDonald’s, chips, and so on. All this junk inevitably leads to gallbladder diseases sooner or later.
3. Lack of fats and proteins. If a person has an excess of carbohydrates, it forms a lack of fats and proteins.
4. Insufficient calories. That is, a person may not eat enough standardly, bile is not secreted in response to food intake, stagnates and forms some pathologies.
5. Low physical activity. I would also include stress here, as we’ve already discussed, because the opening and closing of all sphincters is related to our vagus nerve and our psycho-emotional state.
6. Allergic reactions and food intolerance.
7. Infections and inflammations can also be a cause of gallbladder diseases.

Diagnosis of Gallbladder Diseases

The minimum diagnostics that can be done, which you can already do and come to the doctor with these results:

• Ultrasound of the biliary tract in dynamics. That is, an ultrasound of the abdominal organs, sometimes a CT scan may be prescribed to see how the stones are located if they are found. And with these analyses, you go to the doctor.
• Complete blood count, biochemical blood test is mandatory. Most often, bilirubin and its fractions are needed there, to look at cholesterol levels, liver condition.
• Coprogram, to see how various food components are absorbed.
• Urine analysis, which can also show us gallbladder diseases.

I’ll say right away that the competence of a nutritionist includes the initial stages of the disease, when we talk about a person having dyskinesia, cholecystitis – here we need to adjust the diet, you can take supplements. If it’s about surgical intervention, then only a surgeon can help, and after removal, there may be support from a nutritionist: the doctor gives a conclusion and the nutritionist implements it.

Useful Habits for Bile Outflow

What useful habits can there be for bile outflow?

• Sufficient fluid, especially warm fluid. Drinking warm water has an important therapeutic property. Of course, this habit should be introduced, and it doesn’t matter what condition your gallbladder is in.
• Magnesium waters, taking magnesium, will also help normalize the gallbladder function.
• The amount of fat in the diet. It should not be limited, we limit trans fats, but healthy fats, especially egg yolk, are very desirable for the gallbladder. It stimulates the production of a certain hormone that is responsible for the motility of the gallbladder itself, contracts the walls of the gallbladder.

Nutrition Strategies

What can and should be done?

Balance proteins-fats-carbohydrates. The most important thing to do here is to reduce the amount of carbohydrates you consume, especially from junk food, especially their sugars, fructose, instead add proteins and fats to your diet, this will be useful. I’m not saying to remove them completely, but it’s important to adjust the balance between them.

I’ll say right away that the balance of proteins-fats-carbohydrates is different for everyone: it depends on the goal, body constitution, adipose tissue, hormone levels, and so on, so there’s simply no average formula. If individualization is not needed, just try to look at your plate: what are proteins-fats-carbohydrates for you. I have many posts on this topic, you can look at my Instagram.

Sufficient calories. The norm is neither overeating nor undereating. Sufficient fluid, avoid sodium, smoked foods, preservatives, flavor enhancers, sauces. In general, if in one sentence to name the nutrition strategy of the entire gastrointestinal tract – it’s a complete restriction of semi-finished products.

There are a huge number of semi-finished products in your life! Look at your cart that you collect in the supermarket, how many natural products are there from which you can already cook a dish?

As a rule, very few, we take something ready-made that can be easily made. It’s clear that we won’t make cheese and butter, here semi-finished products remain for them, but we can make minced meat ourselves. Red fish doesn’t need to be bought in a package that’s salted with unknown salt, it’s better to buy a whole fish, properly cut it, make soup from part of it, send part for baking, salt part with good sea salt and make a good product out of it, rather than buying ready-made, salted by someone with preservatives. Various sauces, even seemingly harmless soy sauce, are not the healthiest product, especially cheap ones in the store for 1 euro or dollar.

Limiting semi-finished products will be the first and most important strategy.