Gallstones diet

The gallbladder sits underneath your liver and stores bile, a liquid produced by your liver to help break down fat. Your gallbladder also helps you absorb certain vitamins and nutrients that dissolve in fat. 

When there is a chemical imbalance in your bile, gallstones can form in your gallbladder. Gallstones are usually lumps of fatty substances that have hardened. However, gallstones can also be formed from bile pigments or calcium. You can have anywhere from one to many gallstones, varying in size from small to large. 

Gallstones don’t usually cause symptoms. However, in a minority of people, a gallstone can block the bile duct that connects your gallbladder to your small intestine, causing severe abdominal pain, bloating, nausea and vomiting. If you experience these symptoms often, you may need surgery to remove your gallbladder.

Eating a healthy, nutrient-rich diet can help keep your gallbladder healthy and reduce the risk of gallstones and other problems, such as inflammation of your gallbladder. 

Causes of gallstones

Gallstones are fairly common, affecting around one in three women and one in six men at some point in their lives. Gallstones are more likely as you get older but your risk also increases if you:

• Are overweight or obese
• Eat an unhealthy diet, particularly a high-fat diet
• Have a family history of gallstones
• Have certain health conditions — this includes: 
• A food allergy (eg coeliac disease) that you do not treat ie you do not avoid eating the foods that trigger your allergy
• Coronary artery disease 
• Diabetes
• Lactose-intolerance
• Lose weight rapidly 
• Smoke

If you are a woman, your risk of gallstones increases if you:

• Are pregnant
• Take the contraceptive pill
• Take hormone replacement therapy (HRT)

Digestion and the gallbladder

Your gallbladder collects and stores bile produced by your liver. When food passes from your stomach to your small intestine, your gallbladder releases bile into your small intestine to help digest fats in your food — bile contains bile salts and other substances that break down fat.

Your gallbladder connects to your small intestine via the bile duct, which can become blocked by a gallstone. When this happens, it is called biliary colic; symptoms include severe abdominal pain, bloating, nausea and vomiting.

Gallstones and diet risk

Your risk of developing gallstones increases if you are overweight and if your diet is high in fat and cholesterol and low in fibre. Losing excess weight can help but make sure you do this gradually as sudden weight loss also increases your risk of gallstones. This is because crash diets prompt your liver to release more cholesterol into your bile, causing an imbalance that leads to the formation of crystals and subsequently gallstones.

Foods to eat with gallstones

Managing gallstones with your diet involves following a healthy, balanced diet. This includes:

Lots of fruits and vegetables

Try to eat at least five portions of fruit and vegetables every day, such as beans, citrus fruits, dark, leafy greens, peppers and tomatoes. These foods contain vitamins, minerals, fibre and antioxidants which can help maintain a healthy gallbladder. Vitamin C, magnesium and folate, in particular, may promote good gallbladder health.

Lots of fibre

A diet rich in fibre supports your digestive system and the movement of food through your bowels. It also helps keep your gallbladder healthy. Foods high in fibre include fruits, vegetables, beans, pulses, oats and whole grains.

Lots of fluids

It is important to stay hydrated, so make sure you drink at least two litres of fluids every day, such as water and/or herbal tea.

Starchy carbohydrates

Where possible choose high-fibre carbohydrates such as whole grains, brown rice and brown bread.

Dairy

Try to eat two to three portions of dairy every day and opt for low-fat dairy products whenever possible. This will help you maintain a healthy level of calcium which is important for gallbladder health.

Lean protein

Although red meat is a good source of protein, it can often be high in fat, which is not good for your gallbladder. Instead, try eating lean meat, sardines or eggs. You can also try plant-based sources of protein, such as beans, lentils, nuts, pulses, tempeh and tofu.

Healthy fats

Healthy fats include unsaturated fats that come from plant sources, rather than animals eg fats found in avocados, nuts and seeds, as well as olive, rapeseed and sunflower oil. Try to replace the animal and saturated fats in your diet with unsaturated, plant-based fats.

Foods to avoid to prevent gallstones

Eating a diet that promotes good gallbladder health can reduce your risk of developing gallstones and if you already have gallstones, can ease your symptoms.

Try to avoid or reduce your intake of:

Saturated and trans fats

Your gallbladder releases bile to help your body digest fats. Following a diet high in fat, particularly saturated fats and trans fats can put too much strain on your gallbladder.

Try to reduce the amount of fat in your diet by avoiding whole milk, meat, butter, ghee, cheese, cakes, biscuits and pastries. Where possible, replace saturated and trans fats with unsaturated fats. You can also try to eat smaller, more frequent meals to spread out the amount of fat you eat through the day and avoid eating large, fatty meals.

Deep-fried and processed foods

Deep-fried foods are high in fat, while highly processed foods (eg ready-made meals, doughnuts, biscuits etc) are often high in fat and sugar — both are not good for your gallbladder.

Foods deep-fried in vegetable and peanut oil are particularly hard to digest. Although these oils are plant-based and often largely unsaturated, at high temperatures, polyunsaturated fats become very unstable and can produce toxins.

Refined white flour

Refined white flour can be found in pasta and white bread and contains little to no fibre. It may increase your risk of gallbladder problems so try to replace white flour products with whole-grain alternatives as these are higher in fibre.

Sugar

Sugar is linked to increased gallstone formation so try to avoid high-sugar foods, such as cakes, biscuits and other sweet baked goods.

Low-calorie diets

Low-calorie diets can cause sudden weight loss, which can worsen your symptoms and trigger more gallstones to form. If you need to lose excess weight, do so gradually by following a healthy, balanced diet and exercising. Aim to lose no more than 400-900g per week.

Other triggers

Try to avoid drinking alcohol and smoking tobacco. Keep a food diary to see if any other specific foods trigger your gallstone symptoms. If you suspect a specific food is triggering your symptoms, exclude it from your diet for two weeks and see if your symptoms improve. However, make sure you do not exclude an entire food group as you need to maintain a balanced diet. You can speak to your GP or a nutritionist about how to make changes to your diet.

Cutting down on fat

It can be challenging to follow a gallstones low-fat diet. However, there are some simple changes you can make which may help:

Avoid processed foods

Whenever possible, try to avoid processed foods, particularly ready-made meals. Instead, cook your meals using fresh ingredients. This gives you more control over how much fat goes into your meals. For example you can:

• Choose leaner cuts of meat
• Make your own dressing by mixing low-fat yoghurt, lemon juice and herbs 
• Reduce the amount of meat in a meal and bulk it out with vegetables and pulses 
• Remove fat from the top of casseroles and stews
• Remove visible fat and skin from any meat 

Limit the amount of oil

Try to use as little oil or fat as possible when cooking. Instead of frying, try baking, boiling, grilling, roasting or steaming.

If you need to cook food in a pan, try using an oil spray or use a spoon to add oil to your pan, instead of pouring oil from the bottle — one teaspoon of oil per person is a healthy measure. You can also wipe off excess oil with a paper towel before you heat up the pan.

If while cooking food in a pan, you notice it is sticking, try adding a little water instead of oil.

Check food labels

Processed foods can be deceptively high in fat, so make sure you check the food labels. High-fat foods contain 17.5g or more of fat per 100g. At a glance, avoid foods with red colour coding on the fat label. Instead, choose foods with 3g or less of fat per 100g.

Your diet after gallbladder surgery

If your gallstone symptoms occur often and/or are severe, you may need to have your gallbladder removed. When recovering from gallbladder removal surgery, expect to have diarrhoea and loose stools for about a week after your surgery. This is because, without your gallbladder to store your bile, bile will be released more regularly, as and when your liver produces it, directly into your small intestines. 

You can reduce these post-surgery symptoms by changing your diet. Try to avoid: 

• Caffeine
• Creams, sauces and gravies
• Foods containing more than 3g of fat per 100g
• Fried, greasy or highly processed foods
• Full-fat dairy products
• Spicy foods

Instead, try to eat high-fibre, low-fat foods. Gradually increase the amount of fibre in your diet, starting with foods that contain more soluble fibre, as opposed to insoluble fibre, such as black beans, broccoli, Brussel sprouts, carrots, oats, apples, pears and apricots. You can also try eating smaller, more frequent meals. 

How to keep your gallbladder healthy

To help keep your gallbladder healthy, try to gradually lose any excess weight and maintain a healthy weight. Do not try rapid weight loss programmes or fasting as this can increase your risk of gallstones.

If you smoke, consider quitting as smoking tobacco is a risk factor for gallbladder problems as well as several different types of cancer, including gallbladder cancer.

In some people, allergic reactions can cause gallbladder symptoms. If you have a food allergy, try to avoid the foods that trigger your allergy. You may find it helpful to speak to your doctor about getting an allergy test or trying an elimination diet, where you exclude a particular food.