Post Gallbladder Surgery: What Can I Eat?

February 11, 2017

Post Gallbladder Surgery: What Can I Eat?

Are you confused about what to eat and what’s off limits after gallbladder surgery? Listen as our nutritionists tell you what is best to eat after surgery.

While gallbladder removal is one of the most common surgeries being performed people are confused about what they should eat and what’s off limits. Clients have asked – Do I have to stop eating butter?  Can I still use mayonnaise? Should I get rid of all fat from my diet? We are going to answer all of those questions, and more, listen in!

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KARA: Welcome to Dishing Up Nutrition. I'm Kara Carper, licensed nutritionist and certified nutrition specialist, and I'm the host of today's show. This show is brought to you by Nutritional Weight & Wellness. We’re a company specializing in life-changing nutrition education and counseling. Each week we bring you information on how eating real food in balance can help you to heal your body. So today we have a really great topic. This topic has not been addressed much on past shows and our topic today is what can I eat post gallbladder surgery.  , we've had a lot of requests for this show and gallbladder removal is one of the most common surgeries being performed in our country right now. 750,000 people are thought to be having gallbladder surgery each year in the United States. Are you confused what to eat if you've had your gallbladder out? Are you wondering, do I have to stop eating butter? Can I still use mayonnaise? Should I get all of the fat out of my diet and eat fat free? We're going to answer all of these questions today and more. First I'd like to introduce JoAnn Ridout. Joanne is a licensed and registered Dietitian. She sees clients that the Wayzata and Maple Grove offices. She's going to help today to dispel some of the common myths that people have about post-gallbladder surgery.

JOANN:  Yes, thank you. Good morning. I am excited to share information about this important topic and as Kara said, it's one of the most common surgeries being performed in our country. I've even heard of cases where it's kind of an exploratory thing. They're not even sure whether it needs to come out, which is really sad. So, do you have a family member, friend or coworker who has had gallbladder surgery? Be sure to tell them about this show.

KARA:  We also have Shelby Hummel in the studio with us today. Shelby is a licensed nutritionist and she sees clients one on one at our Wayzata office.

SHELBY: Great to be here with both of you. Good morning to our listeners. We actually have a lot of clients who have had their gallbladder removed and when working with clients I'm finding many are complaining of digestive problems after their surgery. So, today's show is going to be helpful for those people, especially if they're experiencing those uncomfortable symptoms after their surgery.

KARA: OK. So, this is a little off topic, but have you seen commercials where the message frequently is “I can eat whatever I want and still lose weight.” They've been on a lot lately. For the listeners, if you've seen these commercials, do you believe that? Do you think that you can eat anything you want and still lose weight?

SHELBY: Well, really, Kara, as nutritionists, we’re working with clients every day who want to lose weight, maybe stop aches and pains, and improve their health overall, but we know that message of “You can eat whatever you want” can be really detrimental. So, Joann, what comes to mind when you hear this?

JOANN: Right. I agree very detrimental and I always think about clients who might have an issue with binge eating or compulsively eating or clients who are addicted to certain foods. If they believe they can eat whatever they want and lose weight, they won't be able to get those cravings under control and they still would continue to be binge eating. Some foods really are not safe for certain people. So, what if you were to eat a candy bar for breakfast? How would that set you up for weight loss? I don’t think so.

KARA: Another thing that concerns me about the message is that not all foods are going to be OK for someone if they have food sensitivities. I mean, I'm someone that has a food sensitivity. I have several clients who are in the process of losing weight. They really have to be careful to avoid certain things like gluten or dairy or they're going to be very sick.

SHELBY: And it's interesting because some of those clients will come in with kind of that sneaking suspicion that cheese or bread doesn't really sit right with them, but they don't really accept it until we sit down and we put together that individualized plan for them that actually that's going to optimize their health and really start their metabolism. So, you're right. It's really not as easy as saying, “You can eat whatever you want and still lose weight.”

JOANN: I agree. I've had many clients, even just a couple this week that said the same thing, “I've had this sneaking suspicion about dairy or something.” And when you kind of sit down with them, they're like, “Oh yeah, OK, that makes a lot of sense.”

KARA: So, we look closely at a client's symptoms and medications before we recommend an eating plan, but now it's time to move on to our topic today of what to eat after gallbladder surgery. So, for those of you that don't know much about gallbladder issues, almost 2 million people go to the hospital each year because of gallbladder complications. Isn't that surprising? What do y'all think is causing this? Usually it's because of gallstones. Too many gallstones and also stones that have gotten too big can cause a very painful gallbladder attack.

SHELBY:  Yeah. And people describe that pain and pressure as being like really bad indigestion. And I actually had a gal come up to me at a health fair this week. She said it kind of feels like you're having a heart attack. And it's common for doctors to recommend surgery as kind of that that only option or the only solution for people. And what we often hear from clients is that their body doesn't even need a gallbladder and that their doctors told them that having their gallbladder removed won’t cause any symptoms.

JOANN: So, Shelby, you said a lot of people post-surgery experience digestive problems, what kind of complaints are you hearing specifically?

SHELBY:  Oftentimes people are nauseous or maybe they have that indigestion, but worse than even before the surgery. And sometimes they're the things we don't really want to talk about with family and friends; diarrhea, gas and bloating.

JOANN: So, but not everyone has digestive problems after surgery. So, if you're listening and you're someone who has to run to the bathroom every time you eat, we’ll help you figure out what foods are causing those issues. Kara, what are some of those foods that you hear about being problematic for people with gallbladder problems?

KARA: What I hear from people is they have problems when they eat and these are the terms that we hear in her office. Fatty foods, rich meals or fried foods. So, ask yourself, are these the foods that give you indigestion, diarrhea, pain, gas and bloating? The fatty foods, rich meals, and fried foods. We're going to kind of touch on those.

SHELBY:  Let's tackle fried foods first. What do you think about when you hear fried foods? I picture the State Fair because I want it to be warm and sunny and the end of August. But maybe you picture a fast food joint. Maybe your fried foods or French fries or cheese curds, onion rings, or even fried chicken.

JOANN:  Yep. And the oils they use in those fried foods are the damaged fats such as trans fats and refined oils. These are really bad fats. They're very hard to digest and break down. So, how do you feel when you eat these foods? They're hard for everyone to digest, even with a gallbladder, but after gallbladder surgery, those fried foods will cause even more problems because the refined and processed oils can’t be broken down by the body.

KARA: That's right. It's not all fats that need to be avoided. This is the big topic today. But definitely the oils in fried foods need to be avoided. Trans fats. Also, if you see on a label, soybean oil, corn oil, sunflower oil, canola oil, cottonseed or any kind of vegetable oil should be avoided.

JOANN: Right. And so, I often hear of clients talking about rich foods and you mentioned that earlier. So, for example, I was thinking about things like fettuccine alfredo, macaroni and cheese, maybe some kind of a cream soup. Many of our clients with no gallbladder tell us they can no longer eat rich foods. So, what foods do you think about when someone says “This is a rich meal?”

KARA:  I shared with you earlier that I have three aunts who have had their gallbladders removed and I kind of hear them talking about what the rich foods are that are causing them problems. It's usually something that has cheese in it or maybe a cream base. So, examples might be pizza, grilled cheese, lasagna. It could be that they went to a restaurant, got a bowl of cream-based soup, maybe a chicken alfredo. Without a gallbladder, most people are going to be just running to the bathroom after a meal like that.

SHELBY: Yeah, absolutely. And, Kara, I actually have one of your aunts in my nutrition class. We were talking about gallbladder health and diet is definitely one of the things she brought up. Those rich foods definitely don't agree with her. So, when I look at these foods and one of the big pieces of that is cheese or milk, that creamy richness. That's an important ingredient that we start to look at. So, dairy products are much harder to digest when that gallbladder is taken out. And it's common for people to suffer from chronic diarrhea after eating foods with cheese or even drinking milk. So, have you ever had problems after eating yogurt, cottage cheese and ice cream? Think about that, listeners. These foods may also trigger digestive complaints.

JOANN: Yep. And some of the foods, for example, pizza may create problems for multiple reasons. So, pizza’s got a lot of cheese, but it's not just the cheese. The pizza has those bad fats as well and is also high in sugar. So, again, think about how you feel after eating pizza. Does it send you to the bathroom quickly? We're going to talk more later in the show about how high sugar foods affect digestion. And I see that it's time for a break.

Maybe you've started to notice that you have indigestion, gas, or bloating after you eat. Do you have other digestive complaints? If so, we can help you. Whether you live in the twin cities or in Oregon or Michigan or Utah or even Australia. Did you know that we offer classes online at weightandwellness.com? We offer our online Gut Reaction class to help restore digestion with real food nutrition.

BREAK

SHELBY: Welcome back to Dishing Up Nutrition. Are you experiencing digestive issues like gas or bloating? Maybe diarrhea or even nausea? If you need help getting to the root cause of those tummy troubles, I would encourage you to make an appointment with a nutritionist at Nutritional Weight & Wellness. Are you still confused about what to eat after your gallbladder surgery? Our nutritionists can help you choose real foods. We sit down, we help you create a personalized eating plan to help you with weight loss, better digestion, improved moods, and even decreased joint pain. So, give our office a call at 651-699-3438 to set up an appointment.

KARA: I wanted to share some information about Patty. So, let me tell you a little bit about Patty. Cassie Weness, who is a colleague of ours, has a cousin, Patty, in North Dakota who really was struggling with digestive issues. She was having a lot of reflux. She did end up getting her gallbladder removed. That's what her physician recommended. It was kind of the only option that she was given. Looking back, she stated in a conversation, she kind of wishes she didn't have the gallbladder removal. She wished she would've known about our company and maybe tried some other things first. But she was really miserable post-surgery and shared that with Cassie and Cassie just suggested to make an appointment with Nutritional Weight & Wellness. So, she did. She made an appointment with Dar.

SHELBY: Yeah. And one of the favorite things with speaking with Patty is she said she thought she was eating pretty healthy, according to her physician and some other weight loss programs. She wasn't consuming saturated fat. And really there were days where she was eating no fat at all. She said she thought that was a good day. And so, looking back she's like, “Well, if I'm not able to digest fats without a gallbladder, why am I still so miserable?” She wasn't eating butter, she hadn't even heard of coconut oil, avocados or olives. Really what she was consuming and what was really recommended for her was canola oil, margarine. And really, she wasn't feeling that great.

KARA: After she got off the phone appointment with Dar, she says she got on track, eliminated processed carbohydrates. We’ll talk more about what that means, but it's pasta, crackers, bagels, things like that, cereal. She increased her protein. She really increased that good, healthy fat. She says she was eating one to two tablespoons each time she had a snack or a meal. She increased her vegetable intake, so she was eating two to three cups three times a day.

SHELBY:  Sounds like just like what we teach in our Nutrition 4 Weight Loss class.

JOANN: Exactly. And so, once Patty got on track with Nutritional Weight & Wellness, relief came within just a few weeks. And she said she remembers feeling better within a few days. I've found more difficult foods to digest or the actually the starchy vegetables. So, she does limit those. And she took digestzyme digestive enzymes with meals. She also took bifido powder and l-glutamine. She also attended the Nutritional Weight & Wellness weekend series that a couple times. So, I have loved working with Patty. I've worked with Patty and her son, as well. I know Patty sees Dar as a nutritionist, but I've talked to her to meet with her regarding her son, but she's also referred many people to this company because she feels so much better. So, Hello Patty!

KARA: If you're listening, thank you so much for having us share your testimony. I hope it helps other people. Before break we were talking about pizza and foods with bad fats that trigger a lot of issues, especially post-gallbladder removal. I think it would be helpful for our listeners if we went over the different kinds of fats.

SHELBY: Yeah, absolutely. So, if you have had your gallbladder taken out, we definitely don't want you to go on a low-fat or fat-free diet. That is not the answer.

KARA: That's right, but not all fats are the same and some fats are healthy, much easier to digest than others. Joanne, would you mind summarizing the different kinds of fats for us?

JOANN:  So, to sum up the fats that are going to be harder to break down and digest, they are the bad fats found in fried foods and fast food. Those things, canola oil we mentioned, vegetable oil, the fats found in your favorite crunchy, salty snack, the chips or crackers. They're also the fats that are found in those baked goods in your office break room like muffins, cake, brownies. I always call those the foods with no label.

SHELBY: I've talked about this a little bit before, but fats in those dairy products are going to be harder to digest. So, cheese, milk, ice cream, yogurt, and even cottage cheese. And I actually have a problem digesting some of those dairy products. So, I can only imagine how much worse that would be without the help of my gallbladder.

KARA:  Same with me, I'm in the same situation. Well, here's the good news. There are plenty of healthy fats that are easy to digest after gallbladder surgery. You heard me right. You don't have to go on a low-fat diet, so that's wonderful news. Small amounts of the right kind of fats are going to be an important part of the foods that you're eating. So, you can still eat butter and full-fat mayonnaise. A cold-pressed mayonnaise, such as the brand Hain or Spectrum would be a better option than regular mayonnaise made from soy bean oil.

SHELBY: And some other fats that are easy to digest, such as avocados and guacamole, or one of my personal favorites, olives and olive oil. Even those nuts and nut butters should be pretty easy to digest. So, you can get almond butter, you can get pecans, walnuts, pistachios, an even macadamia nuts, but sometimes peanuts and peanut butter can be harder to digest. So, switching from a peanut butter to an almond butter might be a good option for someone. I actually like to use something called sunflower seed butter. It's typically labeled “sunbutter” and there's the organic or natural sun butter at grocery stores. And sunflower and pumpkin seeds also would be a good choice for healthy fat.

JOANN: That's right. And the biggest thing about nuts and seeds is that you want to check and see if they're roasted in oil. Quite often it might be cotton seed oil that they're roasted in. That's a damaged fat as well, so that causes the nut to be damaged. They can cause diarrhea and other digestive problems, and so we're always looking for raw or just plain dry roasted.

SHELBY: Or, Joann, one of the other things that we talk about when we're teaching in classes or working with clients is the most important things to look at on the nutrition label. For those nut butters, we're just looking for the nut, or the seed in the case of the sunflower seeds, and salt. We don’t want any added sugar or any oils.

JOANN:  So, here's my favorite type of healthy fat for someone missing a gallbladder; any kind of coconut products. So, there's a lot of research showing that coconut oil is the easiest to digest and break down after gallbladder surgery.

KARA: Coconut oil, that's one of my favorites as well. It's something called a medium chain fat. It just means that the digestion is different from other fats and oils, so it doesn't require bile to be broken down and absorbed. If you have not tried coconut oil yet, it would be a great oil to add in. I like to cook with it. It's very stable, so can actually heat it a little bit higher than butter and definitely higher than olive oil.

SHELBY: Great for roasting vegetables.

JOANN: Exactly. I also cook my eggs in coconut oil. I use it for stir frying, pan-sautéing vegetables on the stovetop. Another way to incorporate coconut is with full-fat canned coconut milk. Thai Kitchen is a great brand and typically found in the Asian section. I always tell clients to maybe look on the bottom shelf for it. You can add it into a smoothie. Check out our smoothie recipe online.

SHELBY: And for any of you people out there who think that you have an issue digesting dairy, I would recommend making that non-dairy version of our protein shake on our website. It doesn't have any yogurt and the recipe will actually give you substitutions, which is canned coconut milk. It’s delicious and very easy to digest.

JOANN:  So, it's time for break again and you are listening to Dishing Up Nutrition. February is national heart disease prevention month. So, are you thinking about ways to keep your heart healthy now that you're taking a cholesterol lowering medication? We actually recommend taking CoQ10 for anyone on a cholesterol lowering medication. CoQ10 is one of the main nutrients for the heart. We may recommend CoQ10 for helping to lower blood pressure, maybe to help stabilize heart rhythm. Many clients experience less muscle cramps and muscle weaknesses when they start including this powerful antioxidant found in foods like sardines, grass fed beef, wild caught salmon.

BREAK

KARA: Welcome back to Dishing Up Nutrition. Now, who watched the Super Bowl? It was amazing. If so, did you notice the two big superstars? The ones I'm talking about are Tom Brady, New England Patriots’ quarterback and Lady Gaga, iconic singer. These talented individuals take their eating very, very seriously.

SHELBY:  Yeah, I think there was quite a bit of information about Tom Brady. Did you know he doesn't eat any gluten? His diet is dairy free. He doesn't eat any sugar. So, you could really tell that his brain was so in charge. He was very determined. And he even takes it one step further and tries to eat those grass-fed meats that we talk about and most of his carbohydrates are organic vegetables. And, no surprise, the main healthy fat that he consumes? Coconut oil. He also stays away from caffeine. So, he has lots of natural energy.

JOANN: That's right. So, most of you probably saw Lady Gaga as well, and she also has a clean diet. So, she has some protein, a lot of vegetables, and good, healthy fats. She eats five times a day just like our Nutritional Weight & Wellness program recommends. She avoids bread and sugar and you can see the results with her talent, her creative brain, and her healthy body. So, it's so refreshing and encouraging to see celebrities who take their health as seriously as their careers.

KARA: I agree. Good for them that they're that knowledgeable of exactly what's going into their bodies.

JOANN: So, you might be listening to our show and still wondering to yourself, “I had my gallbladder removed and I'm still confused about what to eat.” So, maybe your doctor or someone you know told you you had to stop eating fats such as butter or meat or eggs or all fat, or maybe they said it doesn't matter what you eat with no gallbladder, you can eat anything. I think a lot of times people go into those appointments and get very little nutrition information. No wonder people are confused. But we're going to put together some meal ideas for you.

KARA: That's right. We always hear that people want more examples. That's what they always say. So, let's get started. Shelby, could you give the first example?

SHELBY: Absolutely. So, we're definitely here to give you some good examples. So, if you're listening this morning and you've had your gallbladder removed, how would you feel about starting your day with eggs? Maybe cooked in coconut oil or butter? Those easy to digest fats. Maybe some nitrate-free bacon or sausage. To be quite honest there are so many people that come in and are so excited that I say, “You can eat high quality bacon.” And then of course we want some vegetables, so maybe some sautéed vegetables like spinach, maybe some sweet potatoes or some hash browns cooked in butter.

JOANN: Sounds like a really great start. That's a really good breakfast. People usually save those breakfasts for the weekends, but now we can eat them every day. A lunch option might be a bowl of chicken and wild rice soup. That's one of my favorites. But we don't want it to be a cream-based soup, though, because that would be a little harder to digest. Then with the chicken and wild rice soup, have some cut up raw vegetables on the side dipped in guacamole or hummus is a great option.

KARA: For a mid-afternoon snack, you listeners could be eating a couple of slices of nitrate-free deli meat, maybe some turkey or ham, a piece of fruit, and some raw nuts.

SHELBY: Yeah, absolutely. And people without a gallbladder may be surprised to hear what they can eat for dinner. So, you can have a hamburger or we had steak last night. That was really good. Definitely have steaks. So, contrary to what you've may have been told in the past, it's not the burger that's causing those digestive complaints, but it could be the bun if that's one of those processed carbohydrates. It could be that cheese. Remember we talked about those dairy fats are a little bit harder to digest. So, if I eat a burger I'll eat it with a knife and a fork and have some tomatoes and lettuce, something on the side, maybe like our sweet potato wedges with some butter. And last night we had roasted asparagus.

KARA: And they could have that, too, roasted in coconut oil. I bet listeners would also be shocked to hear that they don't have to be eating low fat foods to avoid things like diarrhea.

JOANN: That's right. And you might be wondering, “Well much how much fat can I eat?” And maybe people are thinking, “I've experimented with some fat and it didn't go so well.” So, Kara, why don't you talk about how much fat.

KARA:  Sure. I'd love to. So, I have a client. I'm going to use a client example. She had her gallbladder removed and she actually gave me some great feedback on the quantity of fat that was appropriate for her. She was eating extremely healthy, choosing all the right healthy kinds of fats and avoiding all the bad ones, but she was still having some diarrhea, so what we figured out is that she was eating more fat even though it was healthy, it was more than her system could handle. So, she figured out that she could eat about 10, maybe 12 grams of fat at one sitting, like at a meal. If she had more than that, like 15 or 20 grams, she would be running to the bathroom.

SHELBY:  That's great advice for our listeners. So, some people can tolerate a little bit more fat than others. It's going to be different for each person. So, if you guys want to know a little bit more direction on what 10 grams of healthy fat looks like, it would be two teaspoons of butter, two teaspoons of olive oil, or two teaspoons of that really delicious coconut oil you were talking about.

JOANN: And also a couple more examples. Ten grams of fat is about a half an avocado, so that's a pretty good sized serving. Two tablespoons of almond butter, 6 to 10 olives or a tablespoon of mayonnaise. So, those foods are, of course we're talking about the high-quality mayonnaise, like the safflower mayonnaise, but foods you might not have realized you could eat with no gallbladder.

KARA: There is a biochemical reason that after a gallbladder surgery, it's just more difficult to digest and break down fat. And it has to do with something called bile. So, I'll just explain briefly what happens when you do have a gallbladder. Your liver produces bile acids. The bile acids flow into the gallbladder. That's where they're stored until they're needed.

SHELBY: And that bile works to break down fat into tiny droplets, so it's easy to absorb and digest.

JOANN: So, that bile sounds like a pretty important ingredient. I read that eating fat and not having enough bile is like trying to wash greasy dishes without soap. Good visual. And the fat just doesn't get broken down then.

KARA: That's a good way to look at it. When you have a gallbladder, you need fat, so let's just say that half of an avocado, your body senses that there's fat in the small intestines. Then there's a signal for the gallbladder to release the stored bile into the intestinal tract. That's where the bile works to break down the fat so it can be absorbed. That's where we get to utilize all the great fatty acids from that avocado. That's right.

SHELBY:  So, once the gallbladder's removed, we don't have that storage unit for the bile, so instead, the liver sends a constant trickle of that bile right into the intestinal tract. So, this is where problems can arise because when people eat fat, they're missing that big burst of bile that they would normally get from their gallbladder. So, that constant small trickle of bile from the liver is sometimes not enough to break down the fat and the intestinal tract.

JOANN:That's right, and it's that shortage of bile that causes people to have diarrhea, some pain, some bloating, some nausea and indigestion after eating. And it looks like it's time for another break.

SHELBY: So, you are listening to Dishing Up Nutrition brought to you by Nutritional Weight & Wellness. So, have you been listening to our show the past 11 years and starting to think that real food is the answer to your weight loss goal. Maybe you live outside of Minnesota and are looking for real solutions for a better metabolism. Our online Nutrition 4 Weight Loss program is the new science of weight loss. You get access to 12 weeks of classes and two one-hour appointments with a nutritionist. You can come into one of our seven locations or we can connect by phone or Skype. So, call our office at 651-699-3438 to sign up right away or go on our website to learn more.

BREAK

JOANN: Welcome back to Dishing Up Nutrition. Are you still experiencing hot flashes, mood swings, and weight gain? Or maybe you're just starting to. Maybe you want help with sleep, osteoporosis, or other menopausal symptoms. I encourage you to join our Menopause Survival Seminar. This is a full-day seminar. It's always a great day. Lots of socializing among the clients. We have an organic lunch and snacks. It's a great way to get some questions answered and spend the day maybe with your sister, with one of your friends or one of your neighbors and get all these topics answered. And these are things that a lot of people are talking about but maybe don't have a lot of answers. Seats are filling up fast. This class is always full. So call our office today 651-699-3438.

So, before we went to break, we had a caller. So, I'm going to take the call now. Tim, you are calling about gravy. Did you have questions?

CALLER: Yes, I did have a question. I was just wondering when I'm making gravy, is it necessary to use a fat separator?

JOANN:  I have never used a fat separator actually, but one of the things we were thinking about in talking about this question is that if you're going to keep the fat in the gravy that you're making, we would encourage you to be using a high-quality meat such as a grass-fed meat or pasture-raised meat. We're going to be talking a little bit later in the script about the grass-fed meats that are free from hormones and antibiotics. So, you'd want to make sure you get the fat off and separate that if you are using that quality of meat, if you're using a conventional meat. But if you're using a high-quality meat, go ahead and leave it in there.

CALLER: We get chicken from the co-op. Or pork chops.

JOANN: OK, wonderful. That's great. And I would call that a higher-quality meat. I'm assuming it's probably pasture raised, grass fed organic, so you can go ahead and use that fat.

KARA: Good question. Thank you for asking. OK, so, just back-tracking, we were talking about bile and the purpose of that and that we just don't have that storage of the bile that is going to help break down and digest our fats after the gallbladder's removed. So, on that note, when I hear that my clients and literally every single client I've had without a gallbladder says this, that their doctor told them their gallbladder is not a necessary organ. I just kind of wonder why are people saying this? It does have a purpose. And I mean it's great if you had your gallbladder removed and don't have issues, but a lot of people do have issues.

SHELBY: Absolutely. So, if you're like many people who are struggling with diarrhea and other issues, you might need to look at something called a digestive enzyme. And we talked a little bit when we were giving Patty's testimonial, she was saying she takes the digestive enzyme with her meals and those enzymes actually contain that bile substance that helps break down fat so it can be absorbed and digested.

KARA:  And not all digestive enzymes that are sold are going to be the same. There's one in particular that seems to be the most helpful for post-gallbladder surgery. It's by Ortho molecular, it's called Ortho Digestzyme, and many of my clients who have had their gallbladders removed say that taking this with meals has really helped them to get rid of their digestive issues.

JOANN: Right. That's a great supplement. Another supplement that we often use, we were talking about before the show, that helps anyone who's having digestive issues is something called Bifido balance or Bifido powder. I pretty much recommend this bifido bacteria for all of my clients who are having intestinal issues. One to two capsules before meals.

SHELBY: Yeah, absolutely, and I want to talk a little bit more about bifido powder, but just to kind of solidify the point you to have been making. Oftentimes, when people come in and they're feeling gassy or bloated, one of the first places I'll look is a probiotic, like the bifido balance or the bifido powder, and then that digestive enzyme that can help break down those foods. It's really uncomfortable for a lot of people to be bloated after meals. So, about the bifido powder. It's actually really helpful for children or people who don't like to swallow pills. I recommend about a quarter of a teaspoon of that bifido powder before meals. It can work just as well as the bifido balance capsule. We know that bifido bacteria is that good gut bacteria that supports digestion and overall health.

KARA: For everyone listening so far, what we have talked about today is that even though you don't have a gallbladder, you can still eat healthy fat and really should be eating healthy fat with every meal and every snack every time you eat, but there is a little more to the picture as well in addition to the healthy fat.

JOANN: Right, and I know we've been talking today about several clients who've had their gallbladder removed, they've been told to eat low fat foods, and doesn't that just make everything worse?

KARA: It does. I'm kind of back to the client who was running to the bathroom. She had a little bit of excess healthy fat in her diet. When she had initially followed a low-fat diet after the surgery, she was following that advice from her physician. And terrible diarrhea all day long. Bloating, pain, diarrhea, especially after eating. So, we know what a low-fat diet looks like. What does a low-fat diet consist of though?

SHELBY: You've probably heard me say this a time or two, but when I'm working with people, I say, if we take that fat out, that low fat diet, we're removing fat. Oftentimes, people are eating lower amounts of protein because we know that there is some fat in those grass-fed steaks or eggs. Maybe they've been told to eat low fat so they're avoiding eggs. So, if we have low fat and low protein, what's the third thing that we’re eating a lot of? It’s going to be high carbohydrates, right? And when we have too many carbohydrates, we think of sugar.

KARA: Because those high carbohydrates are turning into a lot of sugar.

SHELBY:Those processed cards, especially.

JOANN: As nutritionists, we see the effects all the time from eating too much sugar, but with no gallbladder, that birthday cake at your grandchild's birthday party is much more likely to cause you some issues.

KARA: And if it's not a birthday cake, it may be that candy you have in your bottom desk drawer. Or maybe you're going to the vending machine to get that Coca Cola to keep you awake for your afternoon meeting. Whatever type of sugar you're having, sugar is going to cause a lot of problems, especially with no gallbladder.

SHELBY: Yeah, and Kara, I think of some of those coffee drinks like a Frappuccino with that caffeine, that sugar, and that milk. All three things that are going to be hard to break down.

KARA:  Definitely. We talked a lot about the dairy. And I hear that from clients, too, that coffee drinks and soda, they're going right through them, so it could be a combination. The caffeine is going to be more problematic after having a gallbladder removed and so is sugar and soda. And alcohol, too, could cause the same issue, especially an alcoholic drink with a lot of sugar in it.

JOANN: So, the sugar and the high fructose corn syrup, to me, sounds like the common denominator of all these processed, sugary foods you're talking about. Those are big culprits, post-surgery. And I haven't met anyone without a gallbladder who can handle desserts without diarrhea. So, I'm working right now with someone who's had his gallbladder removed, finally feeling great again once he stopped eating dairy, sugar, and gluten. And of course, no bad fats.

KARA:  Yes, I mean there seems to be different levels of tolerance to foods after surgery. Some really need to stop eating grains altogether in order to feel good. They might have to focus on a really clean diet of protein, healthy fats, vegetables, and even more limited fruits. So, we're talking like no rice, no quinoa, not even the gluten-free grains. So, it really just depends on the person. And we encourage you to make an appointment if you're trying to get this figured out and it feels overwhelming.

Our goal at Nutritional Weight & Wellness is to help each and every person experience better health through eating real food. It's a simple, but very powerful message. Eating real food is life-changing and we just want to leave you with three main points from our show today. We want to dispel the myth that you can no longer eat fat after you've had your gallbladder removed.

JOANN: And the good news is you can eat real healthy fats like butter, coconut milk, olive oil, avocados and almond butter.

SHELBY:  And don't eat those processed foods.

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