Gallbladder Dysfunction

Gallbladder dysfunction is a common cause of digestive symptoms.  These symptoms can range from stomach related dyspepsia, abdominal pain and bloating, to IBS with diarrhea.

The gallbladder has dual tasks helping with detoxification and also with fat digestion.  The liver processes many toxins which are drained into the gallbladder as bile.  Bile also contains the cholesterol residue the liver generates when breaking down old hormone remnants and that is returned to the liver by HDL or “good cholesterol” as well as bile acids which are needed to digest fats.

The liver stores bile as it is produced by draining it into the gallbladder. The stimulus of eating causes the gallbladder to contract emptying bile into the top of the small intestine.  The bile acids help to breakdown the fats entering the small intestine so the fat splitting enzymes can properly finish that task.

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The bile also contains toxin residues and the recycled cholesterol.  If the diet contains adequate soluble fiber, much of the cholesterol will attach to it and be eliminated.  The portion that is not is typically absorbed back into the system as the food passes through the small intestine.

The function of the gallbladder may become sluggish causing the bile to not empty completely.  This may cause poor fat tolerance with symptoms of pain after a higher fat meal, indigestion, bloating and occasionally diarrhea from the fat malabsorption.

Several factors may contribute to gallbladder dysfunction including:

 

•Excessive cholesterol recycling related to hormone imbalance and/or diet

•Dysfunction of the autonomic nervous system termed sympathetic dominance

•Inadequate intake of certain B vitamin family components

 

Excessive cholesterol cycling from hormonal imbalance is more common in overweight persons particularly females.  Steps to improve gallbladder dysfunction should include dietary management targeting body composition.

Gallbladder dysfunction contributing to dyspepsia and reflux symptoms can often be diagnosed with the Heidelberg Gastric Testing.  When the stomach contents are passed into the small intestine a muscular valve called the pyloric valve prevents these contents including the added bile from refluxing back into the stomach.  If this valve is not functioning well, this reflux can occur as the small intestine contracts to move the food.

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This plate from the gastric pH test shows pyloric reflux.  At point 3 on the test the patient was given sodium bicarbonate which takes the pH seen on the left scale back up to 7 as sodium bicarbonate neutralizes stomach acid.  As the stomach acidity recovers by new acid production the pH begins to fall towards the normal stomach level of 2.  The three spikes in gastric pH are caused by leakage of contents of the small intestine including bile back into the stomach as the small intestine contracts.  This poor closing may be caused by sympathetic dominance which can be helped by a number to autonomic training techniques.

It is ideal to diagnose and treat gallbladder dysfunction early by identifying all of the contributing factors and appropriately managing them.  Chronic poor emptying of the gallbladder can allow the stored cholesterol to precipitate forming gallstones which often require surgical removal.

 

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