Dietary advice for patients with gallstones or inflammation of the gallbladder
Information for patients from General Surgery
This leaflet is for:
patients who are having their gallbladder removed and need to follow a special diet before surgery; and
patients where surgery is not appropriate, but they have to manage their symptoms with a low fat diet.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
What does the gallbladder do?
The gallbladder is a small, pear-shaped organ located under your liver. It stores, concentrates and releases bile. Bile is a digestive liquid made by the liver.
When we eat, bile is released from the gallbladder into the small intestine. Bile helps to digest and absorb the fat and fat-soluble vitamins that we eat and drink.
What are gallstones?
Gallstones are small hard stones that can sometimes form in the gallbladder. Most gallstones are composed of cholesterol, but they can also be formed of bile pigments or calcium deposits.
Cholesterol precipitates or hardens into stones when;
the gallbladder empties less often than it should; or
bile becomes supersaturated with cholesterol.
Gallstones are more common as you get older. Obesity, rapid weight loss, and pregnancy also increase the risk of developing gallstones.
Complications of gallstones
Gallstones can block the flow of bile and cause complications, including inflammation or infection in the:
gallbladder
bile ducts
pancreas, or
liver.
Gallstones often do not cause symptoms. However, if a gallstone blocks one of the bile ducts, it can cause:
acute (short-term) abdominal pain
discomfort
nausea (feeling sick) and vomiting
Do I need to follow a special diet?
Your doctor may have advised you to follow a low-fat diet to help manage your symptoms and / or prepare for surgery. However, this is not the case for all patients, and there is little evidence to support this.
Removing fats from your diet lead to rapid weight loss and / or nutritional deficiencies. We recommend that you follow a healthy varied diet in line with the ‘Eatwell Guide’. This includes moderate amount(s) of fats, as it is an essential component of a balanced diet.
Eatwell Guide
We would advise you to follow the Eatwell Guide and follow a healthy varied diet. The Eatwell Guide provides a balanced framework for a healthy diet. It will help manage symptoms and reduce / prevent complications in gallbladder disease / gallstones.
The Eatwell Guide is divided into five main food groups. It shows you how much of each section you should eat to achieve a healthy and balanced diet.
Aim to achieve this balance over a whole day or a week
Eat at least five portions of fruit and vegetables a day.
Base your meals around starchy carbohydrates, choosing wholegrains whenever you can. Starchy carbohydrates include bread, rice, potatoes, pasta, and other starchy foods.
Include a variety of sources of protein. Protein is found in beans, pulses, tofu, fish, eggs, lean meats, and other plant-based sources.
Have some dairy or dairy alternatives. Choose lower fat and lower sugar versions where possible.
Choose unsaturated oils and spreads, such as vegetable oils and spreads. Use sparingly / eat in small amounts.
Limit your intake of foods and drinks high in fat and / or sugar and salt. This includes deep-fried foods, pastries and pies, and fried snacks.
Drink plenty of non-alcoholic fluids. The government recommends six to eight cups / glasses a day.
Eat a minimal amount of foods that are high in trans fatty acids. These include pastries and pies, deep-fried foods, and fried snacks (such as crisps).
Additional tips to help manage symptoms
Try to eat regular meals. Missing meals and fasting reduces gallbladder emptying, which increases the risk of stones forming or enlarging.
Some people find that eating large meals causes discomfort. If so, try reducing your food portions and eat more frequently, this may reduce your symptoms.
Eat breakfast soon after you wake up, as cholesterol concentrations are highest in bile produced overnight.
If you find there is a link between your fat intake and your symptoms, trial reducing your fat intake to see if this helps. Tips for eating less fat:
Try buying low fat versions of foods, such as foods labelled as ‘low fat’, ‘light’, or ‘diet’.
Check food labels and choose foods that contain less than 3 grams of total fat per 100 grams. These foods are labelled as green in the ‘traffic light’ system on the labels.
Try micro-waving, steaming, poaching, boiling, or grilling instead of roasting or frying.
Use oil and butter sparingly. Try using small amounts of oil sprays and low-fat spreads instead.
Take the skin and visible fat off meat / poultry before cooking.
If you find there are other certain foods that trigger your symptoms, trial not eating these to see if this helps.
Steatorrhoea is pale, yellow, orange or oily stools (poo), which may float or be foul smelling. If you have steatorrhoea, speak with your doctor or dietitian. You may need more advice to help you make further changes to your diet.
How can I reduce my risk of developing further gallstones?
Follow a balanced diet as outlined above.
Have regular meals including breakfast.
If you are overweight, gradual weight loss can reduce the risk of developing gallstones. However, rapid weight loss (greater than two pounds or one kilogram per week) or yoyo dieting is not recommended, as it may increase the risk of gallstone formation.
Physical activity and reducing the amount of time sitting are also important to reduce the risk of gallstones. Current UK guidelines recommend 150 minutes a week of moderate intensity exercise. For example, fast-paced walking, dancing or jogging. You should do physical and muscle-strengthening activities at least twice a week. These include weight-lifting, swimming, or hill walking.
What happens if I have my gallbladder removed (cholecystectomy)?
After a gallbladder removal, most people do not have any problems with their digestion as the gallbladder is not essential. The liver will produce the same level of bile. This will just pass continuously into the bowel rather than being stored between meals.
There is no evidence to show that you need to follow a low-fat diet after gallbladder removal. We advise you to just follow a healthy well-balanced diet.
If you develop symptoms of diarrhoea after gallbladder removal, please speak to your doctor. They will need to investigate your symptoms.
Additional support
Please speak to your dietitian or ask your doctor to refer you to one, if you are:
underweight
losing weight unintentionally
you feel that you need more tailored dietary advice
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