gallbladder hormones

The Gallbladder: An Essential Organ Influenced by Hormones

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I was told I did not need my gallbladder – that it was a nonessential organ. Hearing that from a surgeon convinced me to have it removed to rid me of abdominal discomfort and nausea. An ultrasound showed some gallstones, but no other reason for removing the organ was presented to me. I was 29 years old and not a savvy patient like I am today. I didn’t ask questions or seek alternative treatments or a second opinion. I was a working mom with no time to be sick. “Just take it out,” I said.

That “non-essential” organ proved to be very essential for my body. Immediately following the procedure and for the next 14 years, I suffered from severe pain in my right side, nausea, and a multitude of other disabling symptoms. I was eventually diagnosed with Sphincter of Oddi Dysfunction (SOD), a condition where estimates of 75-98% of sufferers are women. The majority become afflicted after their gallbladder has been removed.  As such, many of us with SOD regret having had this operation.

What Does the Gallbladder Do?

The gallbladder is a small organ that stores the bile produced by the liver. After a fatty meal, the body releases a hormone known as CCK that signals the gallbladder to release bile. Then the bile flows down the bile duct into the small intestine to emulsify and digest fats. The liver, where the bile is produced, also uses bile and the gallbladder to remove toxins from the environment, food, and other wastes. The bile stored and delivered by the gallbladder is different from the bile created and secreted by the liver. Bile in the gallbladder is more concentrated due to its removal of some water and electrolytes.

Gallbladder Removal (aka Cholecystectomy)

Over half a million people in the United States have their gallbladders removed every year. Clearly, it is a booming business. The common reasons for cholecystectomy are:

  • Gallstones (cholelithiasis)
  • Infected or inflamed gallbladder (cholecystitis)
  • Non-functioning or under-functioning gallbladder
  • Blocked bile ducts (ex. sludge or scarring)
  • Cancer and congenital defects (less common)

As you can see in some cases it is in the best interest of the patient to undergo cholecystectomy. However, some develop secondary symptoms that are worse than their original gallbladder symptoms.

Postcholecystectomy Syndrome—Symptoms to Consider

New symptoms may arise following a cholecystectomy. This is known as a postcholecystectomy syndrome (PCS). It is estimated that 10-20% of cholecystectomy patients develop PCS.  Without the function of the gallbladder in place, some of the problems patients experience range from annoying to life-threatening, ex. abdominal pain, bile diarrhea, bile reflux, gastritis, IBS, pancreatitis, liver disease, and what I have–SOD—where the pancreatic and biliary valves do not open and close properly. At the time of this writing, an excellent overview of the various PCS complications and more information about PCS can be found in the Medscape article, “Postcholecystectomy Syndrome.”

The Gallbladder and Hormone Connection

According to Johns Hopkins Medicine, the prevalence of gallstones is higher in women than men. Female sex hormones adversely influence bile secretion from the liver and gallbladder function. Estrogens increase biliary cholesterol saturation (the main ingredient for gallstones) and diminish bile salt secretion, while increased progesterone may lead to inhibition of the contraction of the gallbladder, reducing bile salt secretion and impairing gallbladder emptying. Due to fluctuating hormones women experience during pregnancy, it is not uncommon for women to develop gallstones during this time or shortly thereafter.

Alternatives to Cholecystectomy or “I Wish I Knew Then What I Know Now”

You can prevent gallbladder problems in many ways. Eat a diet low in saturated fats and sugars. Avoid crash diets. Try to eat whole foods rather than processed products with multiple ingredients (especially those with ingredients you can’t pronounce). Exercise. If you are on birth control or hormone replacement therapy, talk with your doctor about the effects they may have on your gallbladder. If they are unsure, your neighborhood pharmacist may be helpful or ask for a referral to someone who may be able to help answer your questions.

If you already have gallbladder issues, here are some alternatives to cholecystectomy to consider:

  • Endoscopic Retrograde Cholangiopancreatography (ERCP): a non-surgical procedure used to remove stones, sludge, treat SOD, place stents or apply balloon dilatation to widen the bile duct, and use special X-rays for diagnostic purposes.
  • Extracorporeal Shock Wave Lithotripsy (ESWL): uses high-frequency sound waves to shatter cholesterol gallstones into pieces small enough to pass through the bile ducts into the intestines.
  • Ursodiol: a medication that suppresses cholesterol production in the liver, reducing the amount of cholesterol in bile.
  • For women: seek out a functional MD or naturopath to get your hormones in check naturally.
  • Supplements and Herbs: I recommend only taking these under the care of a naturopath, herbalist, traditional Chinese medicine practitioner, or other alternative healthcare providers knowledgeable in the benefits and side effects of such medicinals.

Be leery of Internet claims to cure your gallbladder issues. For example, I did not list gallbladder flushes as for some people, these can be very dangerous.

Gallbladder symptoms can be quite disabling and prompt anyone to run to an operating room table for relief.  If your symptoms are tolerable, try alternative therapies and talk with your doctor about ERCP, ESWL, and Ursodiol as alternatives. However, if your well-being and life depend on having your gallbladder removed, take what your doctor says very seriously.

Image: Laboratoires Servier, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons

This article was published previously on Hormones Matter in March of 2015.

Brooke Keefer is a mom to three sons ages 30, 20, and 6 and has a 4-year-old granddaughter. Brooke has a BA in Mathematics from the State University of New York at Albany. For over 15 years she worked as a not-for-profit director, lobbyist, advocate, and a grant writer, manager, and reviewer in the field of children’s mental health and juvenile justice. Brooke suffers from several conditions—sphincter of Oddi dysfunction (SOD), chronic pancreatitis, and fluoroquinolone toxicity syndrome. Today, she writes health articles, advocates for patient rights, runs the Sphincter of Oddi Dysfunction Awareness and Education Network website, www.sodae.org and authored The Sphincter of Oddi Dysfunction Survival Guide. Her latest book, Living Well Without a Gallbladder: A Guide to Postcholecystectomy Syndrome was published in July 2017 and is available through most online booksellers.

8 Comments

  1. First disappointment thus far on this site but only because of the recommendation to avoid saturated fat. If this was the case then I’m not quite sure how we evolved over millions of years unless of course the author thought we sat around cracking nuts all day and eating plants which I doubt were very abundant during multiple ice ages.

  2. I am sorry but liver/gallbladder flushes are not dangerous when the protocol is followed. It removes hepatic stones and gallstones safe and efficiently.
    There are many sites which spread false information about it such as they are bit real stones and are soap stones as a result of the oil. Completely false.
    Also that stones will get stuck in the duct. False. I will outline thw protocol i do and explain the mechanics behind it so that people.can understand why it works and is safe.

    Between 1-2pm east four apples. No food, no coffe before this, only water.

    5pm 1 tbsp of epsom salts
    6pm 1 tbsp of epsom salts
    6:10pm eat a fatty meal. The fattier the meal the better the result.

    Why does this work?
    Firstly the apples contain malic acid which softens the stones so they do not get stuck in the common bile duct. (Optional:you can also take chanca piedra which also softens the stones)

    Why epsom salts?
    Because epsoms salts dilates the common bile duct so that stones will not get stuck. It is
    Is also a laxative and you will inderstand why thats important in just a moment.

    Why a fatty meal?
    Until now we have built up the bile since we have not had any fat yet. Then we softened the stones with malic acid in the apples, then we dilate the common bile duct with epsom salts.

    Now we eat a fatty meal because the goal is to force the gallbladder to contract powerfully and push out bile and along with it come stones. Either gallstones or hepatic stones.
    This is essential for your health as the liver performs over 500 functions in the body.

    Common myths- stones arent real and are soap stones caused, a byproduct of the oil.
    – I dont use oil so this is false (also when i did use the oil they were the same types of stones)
    Also common sense suggests if it were in fact soap stones you would produce the same amount of stones each time and feel no difference.
    When i perform this protocol i see less each time and eventually none once i remove them all.
    I also have eliminated my liver/gallbladder symptoms such as burning right shoulder blade pain, pain behind right eye.

    It is dangerous. Haha sorry but are you kidding me?!
    This is from the doctors that rip an organ out of your body telling you its useless.
    I feel so sorry for people that follow this ridiculous advice and most of the time the pain remains, terrible diarrhoea if you eat anything fatty as you cant breakdown efficiently anymore, people tend to put on lots of weight as you cant break down fat properly anymore. Many other after effects i have read from people that git this operation.

    I have explained why its safe above. The stones will not get stuck, thats why you eat apples.for malic acid and take epsom salts to dilate the common bile duct.
    If still worried about stones getting stuck take 2 chanca piedra capsules while eating the apples.

    Lastly to the author. Did your doctor tell you, you need to take ox bile? If not that is gross impotetence on dr behalf as you need to take it now to help digest your food since the gallbladder can no longer play its role.

    One last point- i still recommend to do a liver gallbladder flush even to people without gallbladders. Since it can still remove hepatic stones and hopefully provide you with some relief.

    Good luck all

  3. My sister had her gallbladder removed and is having pain in her liver whenever she eats late at night. Do yiu have any advice or know of any supplements she can take to help?

    • I had my gallbladder out because one day after eating pizza I thought I had food poisoning and begin getting every bit of what I ate out of my body vomiting continuously it let up overnight but started right back up in the morning I couldn’t even drink water I threw up buckets and buckets of bile and I thought I was gonna pass out after hours of pain… I called 911 because I couldn’t even get dressed went to the hospital to find out my gallbladder had to come out.
      It basically died inside of me and become Gengras the doctor said it was one of the worst he’s ever seen!
      I’ve not had a problem since having it removed, actually I feel better & have lost weight.
      I didn’t have any pain issues until that day when I had pizza.
      I could sleep for a week straight if I didn’t have anything to do, this was a issue for more than a year before the pizza attack.
      I looked back at some photos and I looked unhealthy, circles under my eyes and a yellowish color to my skin tone.
      My body let me know something had to go after that pizza!
      That’s the only surgery I’ve ever had, I had both my children naturally, I believe if it’s not broke then don’t fix it!
      No pills, no vaccines, and no problems!

  4. my granddaughter had her gallbladder taken out at 13 . She has stomach issues all the time and her hormones are off the chart emotionally. Do you have any suggestions. Thank you

  5. Brooke-I have replied here before and appreciate your responses. I will be going in for my 5th ERCP in 7 days here at the U of MN with Dr. Freeman. He is not exactly sure what he will do until he gets inside. I have had both a single plastic stent placed in the pancreatic duct and also multiple stents placed in the biliary duct to stretch this open. My last ERCP was 13 months ago when 3 stents were placed and then taken out 4 weeks later. I was having marginal success with this up until about 3 months ago when things started to turn worse again more consistently. The single stent always did well for the month it was in so I am hoping we will try that on this next procedure. If the plastic stent works well, would that mean I would be a good candidate for the by pass surgery? Just thinking if that works when in, but I revert backwards when not it. Obvoiusly I have a chronic problem here and would like to consider something more permanent if possible. Thank you!

    • I can’t tell you the bypass (biliary roux en y) would definitely help you. But I do know most of the people who have success with biliary stents often have success with this surgery. I know several people firsthand who have benefited from this surgery. It’s a major surgery but some doctors are doing it laprascopically.

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