The gallbladder is a small organ connected to the liver and small intestine that stores and releases bile. Bile is a digestive fluid produced by the liver that removes waste products, helps digest fats and absorbs vitamins A, D, E and K. Gallstones can occur when hardened deposits of bile form in the gallbladder or bile ducts, which carry bile to the small intestine. These deposits can cause painful and significant symptoms, or none at all, depending on their size and location. Understanding the causes, risk factors, possible symptoms and how diet changes may play a role, can all help you prevent and manage gallstones.

Causes of Gallstones

The exact causes of gallstones are not fully understood, but there are some factors that can contribute to their formation. Gallstones may occur when there is an imbalance in the substances that make up bile. High levels of cholesterol or bilirubin—a compound found in bile that increases with liver disease or some blood disorders—have been shown to cause gallstones. Similarly, if the gallbladder isn’t emptying properly or efficiently, bile can also become concentrated leading to stones.

Risk Factors

While anyone can develop gallstones, some people may be at a higher risk than others. For example, women are two times more likely than men to experience gallstones. Other risk factors include:

• Age (over 40)
• Family history
• Obesity
• Rapid weight loss
• A diet high in fat and cholesterol
• Certain health conditions (e.g., diabetes, liver disease, and inflammatory bowel disease)
• Pregnancy
• Birth control pills
• Hormone replacement therapy
• Smoking
• Certain ethnicities have been shown to have a higher risk of experiencing gallstones, including Indigenous and Hispanic populations.

Symptoms of Gallstones

Gallstones may not cause any symptoms and may only be discovered during a routine x-ray, abdominal surgery or other medical procedure. However, if a stone slows or blocks the flow of bile, it can cause significant discomfort and complications. The most common symptoms of gallstones include:

• Abdominal pain: Sudden and intense pain in the upper right or mid-abdomen which can radiate into the right shoulder blade. This pain usually occurs after meals, particularly if foods high in fat are consumed.
• Gastrointestinal Issues: An extreme feeling of fullness, bloating or indigestion even after small meals or snacks. Nausea or vomiting may occur after eating fatty or greasy food. These symptoms can exist alongside pain or independently.
• Jaundice: Yellowing of the skin and whites of the eyes due to a build-up of bilirubin in the bloodstream. Jaundice may also cause dark urine or pale stools.
• Fever and Chills: In more acute cases, abdominal pain may occur with fever and chills. This indicates an infection and requires immediate medical attention.

Untreated gallstones can lead to gallbladder inflammation (cholecystitis), bile duct obstruction or pancreatitis. Gallstones that are causing pain and symptoms are typically treated by removing the gallbladder through surgery. In some cases, medication, lifestyle changes and endoscopic procedures may be recommended. If you are experiencing any of the symptoms of gallstones you should speak to a health professional immediately for an appropriate diagnosis and to discuss the right treatment options for your situation.

Dietary Changes

‘Silent’ gallstones that are small and asymptomatic often do not require treatment. However, a balanced, nutrient-rich diet can help keep your gallbladder healthy and reduce the risk of future complications. This can also be beneficial if you have several existing risk factors and want to improve your overall health. Always speak to a doctor or dietitian before making any changes to your diet, but here are some general dietary recommendations to prevent gallstones:

• Limit Trans and Saturated Fat: Saturated and trans-fat, found in red meat and processed or fried food, can increase cholesterol levels in bile. Choose lean proteins, including poultry, fish and legumes and opt for baking, grilling or steaming over frying. Try to also incorporate more healthy, unsaturated fats found in avocados, fatty fish, nuts, seeds and plant-based oils.
• Eat More Fibre: A diet rich in fibre supports the digestive system and movement of food through the bowels, while increasing bile production. This includes fruits, vegetables, legumes, oats and whole grains. High-fibre foods, like beans, dark, leafy greens and citrus fruits also contain vitamins, minerals and antioxidants to help maintain a healthy gallbladder.
• Reduce Sugar and Refined Carbohydrates: Baked goods, white bread, cereal, sweetened beverages and other refined carbohydrates can lead to weight gain and insulin resistance—which are risk factors for gallstones. Choose more nutrient-dense snacks that will help maintain stable blood sugar levels.
• Stay Hydrated: Drinking lots of water throughout the day will encourage the flow of bile and prevent it from getting too concentrated. Consider adding lemon or lime to your water for added flavour and to aid in digestion. Avoid caffeine and alcohol, which can affect gallbladder function and bile production.
• Watch Portion Sizes: Large meals and excess portion sizes can put additional strain on the gallbladder. Eating regular, balanced meals throughout the day can prevent fluctuations in bile production and reduce your gallstone risk.

By better understanding the causes and symptoms of gallstones, and the impact of diet on your gallbladder function, you can take proactive steps to support your overall health and wellbeing. A dietitian at VHA Home HealthCare (VHA) may be able to help you make changes to your diet based on your lifestyle, culture and preferences to reduce your risk of gallstones.

Contact VHA’s Enterprise Health Solutions team at (416) 489-2500 ext. 4649 or by email at ehs@vha.ca for more information about our services. You may even have coverage for these services through an extended health benefit plan.

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