NetWellness receives many questions about specific diets for those with gall bladder problems. Whether you have questions about cholecystitis (inflammation of the gallbladder) or a diet after a cholecystectomy (gall bladder removal), NetWellness experts have some helpful tips.

If You Have Cholecystitis

Cholecystitis occurs more often in women than men and is commonly experienced by pregnant women. Although obesity is linked with gallstones, losing weight too quickly increases your risk of cholecystitis. This condition is more often seen with very low calorie/high protein liquid fasts or other quick fix types of weight loss diets.

If you experience pain from cholecystitis, be sure to see your physician as soon as possible (ASAP)!  Untreated cholecystitis can be life threatening. If you have bouts of untreated cholecystitis, you may eventually require surgery to have your gallbladder removed (cholecystectomy).

The best way to prevent cholecystitis is to maintain a normal/ideal weight and eat a diet that is moderate in calories and low in fat. Your diet should include:

• High fiber foods (fresh fruits and vegetables)
• Whole grains (such as whole wheat bread, oats, brown rice, bran cereal, etc)
• Beans (pinto, navy, black, etc.) and lentils
• Lean meat, such as chicken, turkey or fish (make sure that your poultry is skinless and the fish should not be packed in oil).

Dairy products should be low fat (non-fat or 1% milk, reduced fat cheese and cottage cheese). If possible, try to avoid whole milk products (butter, regular cheese, ice cream, etc.), fried foods, and highly processed foods (high fat crackers, donuts, processed cake, pie, cookies, etc). A diet high in refined sugar (from soft drinks and sugary desserts mentioned above) also increases the risk of gallstones.

Regular exercise will aid in maintaining your weight loss and appears to be protective in preventing gallstones in both men and women. There are some studies that suggest regular caffeinated coffee consumption and moderate alcohol aid in preventing gallstones. If you are pregnant or have had issues with alcohol in the past, you should obviously avoid alcohol. Coffee consumption may also need to be limited during pregnancy as some studies suggest excess caffeine may cause miscarriages.

After Gall Bladder Removal (Cholecystectomy)

After a gall bladder removal, it is important to follow a low-fat diet for several weeks or months. Fat tolerance varies from person to person, and therefore the diet needs to be tailored to your needs. This is why speaking to a Registered Dietitian (RD) is recommended. Eventually, you may be able to return to an unrestricted diet.

The main reason for a change in diet is because the body has difficulty in handling fats after a cholecystectomy. Fat and certain fat-soluble vitamins require bile in order to be absorbed. When the gallbladder is present, it stores bile that the liver makes. During a meal, the gallbladder contracts, releasing a pool of bile into the intestine that is used for fat absorption. After the gall bladder is removed, bile is still produced by the liver, but it is released in a continuous, slow trickle into the intestine. Thus, when eating a meal that is high in fat, there may not be enough bile in the intestine to properly handle the normal absorption process.

The change in intestinal bile concentration during high-fat intake may cause diarrhea or bloating, because excess fat in the intestine will draw more water into the intestine, and because bacteria digest the fat and produce gas.

People who have had their gall bladder removed have varying tolerances to the very foods that previous to their surgery may have caused gall bladder attacks. These foods may have been high fat or fried foods in addition to whole grain breads and cereals, nuts, seeds or gas producing vegetables (baked beans) from the cabbage family (broccoli, brussel sprouts, cabbage or cauliflower). Spicy food seasoned with red or black pepper may cause some discomfort for persons with gall bladder disease but not necessarily. Symptoms may range from burping (heartburn) and gas to a feeling of fullness (feeling as if the food is not going in the right direction).

Things you can do to reduce your symptoms:

• Choose leaner meats, skinless chicken and fish and remove visible fat before cooking
• Be careful with foods containing hidden fats such as fast foods, full fat dairy products, convenience meals, toasted sandwiches, pastries, nuts and nut butters.
• Use low-fat dairy products such as non-fat (skim) or low fat milk (1%), reduced fat cheeses, low fat yogurt and reduced-fat spreads
• Be mindful when eating out, choose foods such as vegetable soups, dressing-free salads, grilled fish (with no lemon butter), grilled chicken with no skin and rice or baked potatoes. Eat small portions ( plan on taking some home)
• Limit the fat and oil intake to no more than 2 to 3 servings per day (1 serving = 1 tsp. oil/butter/margarine).

Keep in Mind

Note that all of these suggestions are good for weight loss too! Go to ChooseMyPlate and enter your age, gender, weight, height and activity level to determine how many calories you should be eating. Then subtract 500 calories per day to create a 3500 calorie deficit over the course of a week. You will lose about one pound for each 3500 calorie reduction.

If you are currently eating fewer calories than the above calculation suggests, you may have inadvertently put your body in starvation mode. When this happens your body reduces its basal metabolic rate (BMR) so that you can live on fewer calories. Keep your body from going into this mode by spacing food intake no more than four to five hours apart (except overnight). Eat five to six small meals in place of three large meals. However, stay within your calorie limit! Eating small frequent meals spreads out your fat consumption so that more of it can be digested properly when it reaches your intestines as well as keeping your basal metabolic rate higher.

For more help, it is highly recommended that you see a Registered Dietitian (RD) / Registered Dietititan Nutritionist (RDN) in your area for more individualized help. You can visit the Academy of Nutrtion and Dietetics website to locate a nutrition professional your area and get a good start on improving your health. Good luck!

For more information:

Go to the Diet and Nutrition health topic.