What is the gallbladder’s function?
Your gall bladder’s main function is to collect and concentrate bile produced by the liver that the body uses to digest fats. Think of bile a bit like you would dishwashing liquid. Have you ever tried to wash dishes with fat or grease on them in water without dishwashing liquid? Not really effective is it? Not at least until you squirt a little dishwashing liquid into the warm water then they are clean in no time. Your gallbladder makes plenty of its own type of “”degreasing liquid”” called bile. Bile becomes up to twelve times more concentrated in the gallbladder (and hence much more effective) than it was in your liver. Think about this, with your gallbladder gone, your liver now has to produce, store and secrete bile. It can do this but not as effectively as it can without that little purse called the gallbladder hanging by its side.
The liver makes between 600 – 900 mls of bile each day, and what is not sent during meals to the duodenum (beginning of your small bowel) directly via the liver’s main duct to emulsify fat, it is diverted through a smaller duct (branching off the main liver duct) to the gallbladder for storage until required. When fat in a meal reaches the duodenum (where most of the food you eat is digested and absorbed), hormones enter the circulation and along with nerve signals, stimulate the gallbladder to contract.
This contraction, assisted by the small intestine’s contractions, induces the gallbladder’s small round muscle and the stored bile is propelled into the duodenum where it mixes with food from your stomach and pancreatic juices from the pancreas by way of the pancreatic duct. If you eat a fairly fatty meal (fish and chips for example) your gallbladder can empty completely within one hour. It is this combination of bile and fats that can make one feel “”queasy”” at times after a fatty meal.
Bile itself is made up of water, salts, fatty acids, lecithin, cholesterol, bilirubin, and mucus and has two main functions. The first function is to help in the absorption and digestion of fats, and the second to eliminate certain waste products from the body, especially excess cholesterol and the haemoglobin from worn out red blood cells, which have an average lifespan of 3 months.
In particular, the bile
(1) increases the solubility of fat-soluble vitamins, fats and cholesterol to assist in their absorption,
(2) stimulates secretion of water by the colon to help move its contents along,
(3) is a medium for excretion of bilirubin (the chief bile pigment) as a waste product of destroyed red blood cells, other waste products, medical drugs and their degradation products, and other toxins.
Bile salts are in fact re-absorbed into the small intestine, and re-secreted into the bile after extraction by the liver. All bile salts in the body re-circulate some 10 to 12 times a day by means of this so- called enterohepatic circulation. In each circulation small amounts of bile salts enter the colon where bacteria break them down for excretion with the feces.
Who is the greatest at risk of gallstones?
o Female gender: women outnumber men at least 2:1.
o Family history
o Forty or more years of age
o 3 children or more
o Diet: low calorie, low cholesterol, low fat. (especially a diet like this after a diet high in fat)
o Diet: previously high in refined carbs, alcohol, chocolate, chips, etc.
o High cholesterol history
o Constipation history
o Rapid weight loss
o Food allergy history
o Dehydration due to not enough water
o Liver problems like cirrhosis or past hepatitis infection
o Sensitive to penicillin antibiotics
Signs and symptoms of gallbladder problems
I have seen many women in the clinic who have for years on and off never felt quite well in terms of their digestion. Many have experienced a low grade ill feeling, a digestive discomfort which was put down to indigestion, constipation or diarrhoea or even a “”grumbling appendix””. They go on for years and years with digestive symptoms and never realise that they may be related to a gallbladder problem. That’s because they are so inter-related with other digestive symptoms and too easy for their doctor to say: “”You are fine; there is nothing to worry about””.
Constipation is one of the most commonly missed complaints, and so is farting. Don’t be embarrassed here, we all fart, some men (and plenty of smallish children) enjoy boasting about it but women do it too and are generally totally embarrassed. Flatus is most common in bed when you first lie down, during the night or when you get up. This is because your bowel changes its position and gas more easily escapes through the anus with the large intestine in a horizontal rather than in a vertical position. Don’t laugh, but do you sometimes feel fat, frumpy and farty and at times “”sicky”” after eating a fatty meal like fish and chips or chocolate? Does your partner joke about how much you “”let off””? Then you may very well have a gallbladder issue.
The Four F’s
Have you heard about the four f’s? We learn when we study medicine that women who are “”fat, fertile, forty and flatulent”” are often the gallbladder girls. They are much more prone to having gallstones or a sluggish liver and gallbladder. The following list provided here may be related to gallbladder but please bear in mind that it could also be something else. The first four symptoms mentioned are the most indicative of gallbladder issues. It is not necessary to have all or many symptoms to have gallbladder problems but the more you have from this list, the more confirmation you have that your gallbladder is involved. Please note that it is still advisable to consult your GP for an accurate diagnosis.
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