1. Bile Acid Malabsorption (BAM) / Chronic Diarrhea
What it is: Unregulated bile floods the colon, acting like a laxative
Symptoms: Frequent, urgent, watery diarrhea (often yellow or greasy), cramping, dehydration
Treatment: Bile acid sequestrants (like cholestyramine), low-fat diet, soluble fiber
2. Small Intestinal Bacterial Overgrowth (SIBO)
Why it happens: Bile normally keeps gut bacteria in check. Without proper bile flow regulation, bacteria can overgrow in the small intestine
Symptoms: Bloating, belching, constipation alternating with diarrhea, food intolerances
Note: SIBO is 5x more common in people without a gallbladder
Groceries
3. Increased Risk of Colon Cancer (Long-Term)
The link: Chronic exposure to unregulated bile acids in the colon may damage intestinal cells over decades
Research: Studies (including in Gut and The Lancet) suggest a modest but significant increase in colorectal cancer risk 10–20 years post-surgery
Prevention: High-fiber diet, regular colonoscopies, and bile-supportive nutrients (like calcium-D-glucarate)
Important: These risks don’t mean surgery is “bad”—but they highlight why preserving your gallbladder when possible is ideal.
When Surgery Is Necessary (And When It’s Not)
True emergencies that require immediate removal:
Acute cholecystitis (infected, inflamed gallbladder)
Gallstones blocking the bile duct (causing jaundice or pancreatitis)
Gangrenous or perforated gallbladder
Situations where surgery may be avoidable:
Asymptomatic gallstones (found incidentally on scans)—no treatment needed!
Mild, infrequent attacks that respond to diet changes
Sludge or small stones without complications
Key insight: Up to 80% of people with gallstones never have symptoms. Removing the gallbladder “just in case” is rarely recommended by gastroenterologists.
How to Support Gallbladder Health—And Possibly Avoid Surgery
If you’ve been diagnosed with gallstones or biliary sludge, lifestyle changes can often halt progression:Buy vitamins and supplements
1. Adopt a Gallbladder-Friendly Diet
Eat: Healthy fats (avocado, olive oil, fatty fish) to stimulate healthy bile flow
Avoid: Refined carbs, sugar, fried foods, and trans fats (they promote sludge)
Include: Beets, artichokes, dandelion greens, and turmeric—they support liver and bile function
2. Maintain a Healthy Weight—But Don’t Crash Diet
Rapid weight loss (especially >3 lbs/week) increases gallstone risk
Aim for gradual loss (1–2 lbs/week) with balanced protein and fiber
3. Consider Targeted Supplements (With Doctor Approval)
Ox bile or digestive enzymes with lipase: Help digest fats post-meals
Taurine or phosphatidylcholine: Support bile quality and prevent sludge
Magnesium: Helps relax bile ducts and prevent spasms
Note: Some functional medicine protocols (like the “gallbladder flush”) are not scientifically proven and can be dangerous. Always work with a qualified provider.