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Is It Possible to Be on Keto Without a Gallbladder?

The gallbladder is vital for breaking down fat by keeping and concentrating extra bile and distributing it when it is necessary.

You may feel concerned whether it is feasible to do the ketogenic diet without a gallbladder if you are suffering from gallbladder problems that require its removal. It is attainable, but it will take some hard work on your part to make it happen.

What is a Gallbladder?

The gallbladder is part of the biliary system encompassing the organ with its great blood discharge, the liver and liver tubes, bile tubing, and the organ responsible for storing bile. It is referred to as “biliary” because it involves the organs which produce and keep bile, then release it into the small intestine when needed.

The gallbladder can be found in the upper right part of the abdomen just below the liver, and is approximately the size of a pear. The extrahepatic biliary system houses it, and it acquires bile from the liver via cystic ducts.

Gallbladder Functions

It is essential to grasp the concept of what bile is and what it does, as the gallbladder deals mainly with preserving and dispensing bile.

Bile, a liquid produced by the liver, is essential for ensuring that the body functions properly. It has many important roles to play. The composition of 95% water contains various components that are dissolved, like bile salts, bilirubin, phospholipid, cholesterol, amino acids and others.

When someone eats food, especially meals high in fats, bile is typically produced in the body, however when one is fasting, the production of bile is reduced.

The two primary roles of bile are:

Fat absorption and digestion

Bile is essential to breaking down fats and making them easier to process during digestion. This procedure increases the effectiveness of digestion enzymes by dividing the large lipid droplets into smaller units, thus providing a bigger surface for the enzymes to act on. The typical bile production in humans is estimated to be around 600 mL/day.

If no bile is present, it will be more difficult for your body to process fats and a great deal of them will end up being eliminated through feces. The outcome will be a large, greasy bowel movement that appears to be either white or gray in color. Steatorrhea is a condition characterized by the lack of bile, which can bring about deficiencies in fatty acids and fat-soluble vitamins.

In addition, steatorrhea could potentially cause difficulties in the large intestine due to the gastrointestinal tract and gut flora not being suited to processing fats.

Getting rid of waste products

Bile flushes away unwanted cholesterol in your body through the means of changing it into bile salts, thus keeping your cholesterol level constant.

The two primary functions of the gallbladder are:

Storing bile

The liver puts out an excessive quantity of bile which is sent to the gallbladder to be kept until digestion takes place again. Eating activates the endocrine cells to deliver cholecystokinin (CCK), a hormone. This hormone regulates the smooth muscle in the gallbladder to spasm and the Oddi’s sphincter to relax, therefore allowing the gallbladder to expel the bile into the small intestine.

Concentrating bile

When you are not consuming food, the Oddi sphincter tightens, hindering bile from flowing into the small intestine. The squeezing of the bile duct causes a rise in pressure, which in turn causes bile to move into the gallbladder. The gallbladder increases the potency of the bile by absorbing water and electrolytes from the epithelial cells.

Gallbladder and Liver: How They Work Together

The gallbladder serves as a backup plan for the liver in order to monitor the release of bile into the small intestine. The liver creates bile which is then taken to the gallbladder via the hepatic and cystic ducts.

When you eat, cholecystokinin triggers the gallbladder to release bile into the initial segment of the small intestine. When you’re not consuming anything, bile is kept in the gallbladder to be concentrated and prepared to come out in response to the next meal.

What Happens If My Gallbladder is Removed?

If the gallbladder has been taken away because of situations like those brought up earlier, it suggests the liver has lost a crucial part of the biliary process. The bile created by the liver lacks a location to save it when food has not been eaten.

The liver will still generate bile further on, but it will send it out in diminutive amounts into the small intestine since the gallbladder is no longer present. The issue is that your liver may not be aware of when it should be secreting larger quantities of bile and when it is better off releasing less of it.

It will take a while for the liver to adapt to working without the aid of the gallbladder, and you may experience certain manifestations of poor absorption if your liver is not releasing the correct quantity of bile to process your meal. Some of the potential negative reactions to this could be feeling bloated, producing gas, and having loose bowel movements.

In brief: After removing the gallbladder, one may go back to their usual food regimen but it’ll take at least a month, and the change should be phased in gradually.

Keto Diet Without Gallbladder

It was previously mentioned that if the gallbladder is absent, the bile has no place to be contained and will flow directly into the small bowel. At times the liver will secrete an excessive amount of bile and at other times it will produce too little.

Bile is necessary for the digestion of fats, so individuals who have had their gallbladder removed are usually encouraged to follow a low-fat diet until the body adapts to no longer having the organ.

The liver’s secretion of bile can sometimes be inaccurate, which can lead to malabsorption of fat-soluble vitamins like Vitamin K and E if high-fat meals are consumed. This means that the fat in food will not be fully digested.

Does That Mean You Cannot Be on Keto Without a Gallbladder?

Fortunately, you can. Nevertheless, it’s important to start small and be careful until your body is accustomed to consuming a lot of fat. If you begin the diet abruptly, you may be vulnerable to symptoms that are associated with not assimilating fats properly.

One potential sign of an illness is having stools that are pale, fluffy, and large in size, accompanied with a bad smell. They can also produce oily smears on the toilet bowl and/or cling to its sides. Other significant symptoms include bloating, gas, and diarrhea.

In order to avert any difficulties, you must gradually introduce the ketogenic diet into your lifestyle and thereby achieve a seamless transformation.

Six Ways to Follow a Keto Diet If Your Gallbladder Was Removed

If you want to successfully partake in the ketogenic diet, it is recommended that you strive to implement these six approaches on a regular basis, but only with the endorsement of your doctor.

1. Ease Into Keto and Reduce Your Carbs Slowly

It makes no difference if you had your gallbladder taken out recently or a long time ago; it is essential that you take a more gradual approach to adopting a keto diet than what is usually recommended. Attempting to gain hurried progress by introducing an excess of fats or reducing too many carbs in one go could lead to malabsorption due to the strain it puts on your body. Instead of switching to the keto diet in one go, it is better to start by changing one meal a day.

For instance, on the first day, you could have more fat at breakfast or lunch and substitute some carbs, such as ditching the honey or syrup you use to sweeten your coffee or not having the bread on top of your sandwich at lunch. Check to see how your body responds before including any more fats in another meal. If your bowel movements remain unaltered, you can attempt to incorporate a small quantity of additional fat into your meals the day after. If you have a stomachache, it’s probably best to halve the amount of fat you take in before you increase your consumption of fat in other dishes.

Snacking on foods like beets and apples that boost the creation of bile may also be beneficial when increasing your fat intake.

2. Pair Your Fats with Soluble Fiber

If you see that your bowel movements are slick or greasy after consuming more fatty foods, then it is probable that your body cannot process all the fats you are ingesting. You should consider consuming fats that include soluble fiber before determining to not stick to a keto diet. This type of fiber, found in nuts, seeds, and veggies, acts to draw water into digestion and creates a jelly-like material which assists your body to absorb food and fat correctly. By combining meals with a higher fat content with soluble fiber, you may aid your body in entering and maintaining Ketosis.

Here’s a list of keto-friendly foods packed with fiber:

  • Brussel sprouts
  • Broccoli
  • Cabbage
  • Asparagus
  • Artichokes
  • Apples (for the transition period only)
  • Pumpkin seeds
  • Sunflower seeds
  • Flax Seeds
  • Chia seeds

You can also take some more steps to ensure your digestion is functioning optimally.

3. Help Your Body Digest Foods Properly

In addition to eating foods high in soluble fiber, the following foods can also send a signal to your liver to secrete more bile:

  • Lemon
  • Lime
  • Celery
  • Sauerkraut
  • Apple cider vinegar
  • Ginger

The higher the level of bile that your liver produces, the easier it will become for your body to process the additional fat you have eaten. Two alternative techniques to aid digestion are to take digestive enzymes and ox bile.

These supplements prompt your body’s own stomach enzymes and bile to start breaking down the foods consumed. This implies that the food is properly broken down and all of the nutrition from the meals is taken in.

4. Stay Hydrated, With One Exception

It has often been said that consuming water is essential, yet it is not a wise idea to drink water shortly before or after having a meal. When you have beverages alongside or close to your meals, you are actually washing out the digestive enzymes that are produced by your body. People consuming food have their digestion aided by enzymes, although when they drink water with their meal, the enzymes get flushed away too quickly and don’t have enough time to help break down the food. Be sure that you don’t drink any beverages while eating or within a half hour time frame before or after the meal.

5. Opt for Medium Chain Fatty Acids Over Long Chain Ones

The majority of individuals don’t have to concern themselves with what particular fatty acids they should include in their diet, so long as they are achieving a nutritious equilibrium of both medium-length and extended chain fatty acids. When it comes to individuals who do not possess their gallbladder, the situation is different. It is more difficult to break down long-chain fatty acids present in things like milk, beef and egg yolks, and they require more bile in order to be processed. This task is demanding for a person who does not have a gallbladder, and if it is not done correctly it could lead to difficulty in absorbing fats.

A way of obtaining necessary fats with less strain on the body is to consume medium-chain fatty acids found in grass-fed butter and coconut fats. With a shorter chain of digestion, your digestive system doesn’t require as much bile, allowing your body to efficiently absorb the vitamins and minerals contained in these foods.

Taking MCT oil derived from coconuts is an effectual way to help the body process dietary fats while lifting ketone levels. MCT oil does not necessitate bile for digestion and absorption, therefore it is simpler for the body to digest.

During your initial period on the keto diet, refrain from consuming food items like nuts, seeds, avocados, olives and meat that contain long chain fatty acids until your body adjusts. Try to obtain foods containing medium-chain fatty acids like the kind found in butter made from pasture-fed cows and MCT oil.


Even though the ketogenic diet may seem like a challenge for those who have had their gallbladder removed, it is possible to follow it by taking the right steps as talked about here.

The trick is to begin slowly and not go all-in on the diet right away. It will take some time for your body to become accustomed to eating fewer carbohydrates and more fats, allowing it to safely switch to a ketogenic state.

Make sure you check in with your physician before you begin the diet in order to make sure you’re taking proper safety precautions. If you feel any negative outcomes, you may want to decrease the activity and increase the amount of carbohydrates you eat to test if the circumstance will improve.

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