The removal of the gallbladder is a pretty common thing these days. It can be surgically removed for various reasons, most commonly for an acute gallbladder attack. A gallbladder attack creates severe pain in the upper right abdomen which can radiate to other regions.

The gallbladder can also be removed because of the long-term symptoms of aching or spasming there. Occasionally, a person may have had their gallbladder unexpectedly removed as a result of another surgery in the same region, when the doctor either justly or unjustly removed the gallbladder while they were there.

Unjust removal is when a doctor does not find any problem with the gallbladder but removes it anyway for no explainable reason. Here is a picture of the gallbladder so you can visualize it as we go through this discussion.

Gallbladder diagram
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The purpose of the gallbladder is to suck up bile that the liver makes via the duct system and to store and concentrate that bile for use at mealtimes.

Upon eating fatty or oily foods, the bile is released. Bile release is stimulated by a hormone called cholecystokinin which is produced in the first part of the small intestine.

What does bile do? It aids in fat digestion. The bile decreases the surface tension of the fats so that enzymes can have more access to surface area in order to release the nutrients in the fats. Useful facts are in vegetables like avocados, nuts, seeds, and coconuts.

Lean meat with no skin is actually still 20% fat. Fatty foods provide our “fat-soluble vitamins” (vitamins A, D, E, and K), as well as our omega fatty acids (omegas 3, 6, and 9). If we don’t have enough bile, we do not get full absorption of these healthy nutrients. Period. For more about how fats or “lipids” are digested by enzymes, scroll to The Role of Bile, here.


The liver will produce bile with no gallbladder present, but it is thin, unconcentrated, and less powerful.

For those people who get immediate symptoms from not having enough concentrated bile, the symptom tends to be gas or bloating soon after digestion (although there are other causes for that same symptom). For a discussion on some of the far-reaching effects of not enough fat assimilation, see Michael McEvoy, Certified Nutritional Consultant’s article Here.

Another symptom of poor fat assimilation is either “camel-colored stool,” or normal darker colored stool that has unclean wipes.

People with chronic unclean wipes may have a chronic low bile production which changes the flora in the bowel. The bacterial flora colony in the gut does not thrive in a high oil or fat environment. The fats should be assimilated as the stool goes down. All that being said, not everybody with no gallbladder (or those who have low bile production) gets overt symptoms.

After years of insufficient bile and insufficient fat digestion, the body could show signs of nutrient deficiency, especially if no nutritional supplementation has been added to compensate. Here is a summary of your fat-soluble vitamins and what they do for you:


Vitamin A, D, and E all help to decrease inflammation and all help with cancer prevention.

They also can help to calm autoimmunity symptoms, for those people who have those conditions.

Other healthful fatty nutrients are the “essential fatty acids.” Essential fatty acids are “essential” because we must assimilate them from food. Our body does not make them. Omega 3 fatty acids are found in fatty fish species. These oils are anti-inflammatory and benefit the joints and the heart. They help with memory and cognition and are thought to be helpful in Alzheimer’s prevention.


Omega 6’s are also “essential,” and you get them from walnuts, sunflower seeds, and vegetable oils.

They are healthful to a certain degree, but they reach a tipping point if you get too much of them and then they become pro-inflammatory.

Omega 9’s are not essential–the body making some of it on its own. They are useful in reversing inflammation and can help with insulin sensitivity and therefore with keeping good blood sugar levels. Omega 9’s are found in olive oil, cashews, walnuts, and other oils.

For those who really want to get into the nitty-gritty of the benefits of fat in the diet, and how fats support us, you can access the “Designs for Health” Primer on Dietary Fats, Here.


One thing you can do to get full assimilation of your food is to have good chewing hygiene.

Did you know that we have antibodies that come out of our saliva, and that they do the work of tagging bad things in the food (like allergens and pathogens) for the immune system to recognize and destroy? Chewing also makes the surface area of the food larger for all our enzymes and secretions to come into contact with that food. Plus the saliva is the first front of enzymatic action, helping to digest carbs. One source says 30% of digestion happens in the mouth.

Although most doctors do not tell a person with no gallbladder to take the enzyme “lipase” to help to digest fats, one could say that it is a disservice of omission or ignorance. People with no gallbladders should take either lipase or bile salts with each meal that contains fat in order to get their nutrients.


Which product should you take to help with no gallbladder?

There is no “pat” rule. Try both options below (lipase enzyme or bile salts) and see which your body likes. You can also alternate by taking lipase on one day, and bile salts on the next day. Or you could go through a whole bottle of one type, then on the next purchase, get the other type of support and compare how you feel after eating and upon eliminating.

For the lipase enzyme, and we recommend the Integrative Therapeutics brand.

Find their product bulletin Here. Take one with each meal that contains any fat, and two for any meal that contains significant fat. “Significant” fat may comprise a steak meal, or perhaps chips and guacamole or hummus.

Lipase Concentrate • by Integrative Therapeutics


For the bile salts, and we recommend Standard Process brand Cholacol.

Use one or two tabs per meal, depending on fat content. You can find the product bulletin Here.

Cholacol • by Standard Process

Fat digestion support is a long-term, life-long protocol that can be discouraging to think about in terms of “always being on supplements. However, think of it as needed support. It is not natural to have no gallbladder, but that deficit can be compensated for with the use of supplementation.

If your problem is low gallbladder power and sluggish bile production, there is a good chance that you can change that with the help of integrative medicine or an alternative health provider that has expertise in diet and liver cleansing.

This bulletin is not an attempt to diagnose or treat any condition but is intended to support the systems of the body in regard to fat-soluble nutrient assimilation.

© Sylvia Skefich, D.C. 2019, revised in 2020