Are Oats OK for celiac patients to eat?

Oats do contain their own form of gluten, knows as avenin. However, a definitive study has been done to show that oats and the avenin they contain do not cause problems in most adults with celiac disease.

So they are safe to eat in a gluten-free diet, provided that they are processed with machinery that is not also used to process wheat– this can cause cross-contamination. And this information can usually be found on the product packaging.

Now, then, oats still contain phytic acid, which is present in the hull or outer portions of most seeds, nuts and grains.  When phytic acid is ingested, it can cause lots of problems in the digestive tract; this is because its chemical structure hits us with a one-two punch: it attracts and binds up valuable minerals like calcium, iron, magnesium, phosphorous, and zinc; it also inhibits the function of digestive enzymes like amylase, pepsin, and trypsin. Diets high in phytic acid, as a result, can cause mineral deficiencies.

While humans do produce phytase, the enzyme which breaks down phytic acid, we do not produce it in enough quantity to avoid digestive unpleasantries.

Fortunately, phytase is also present alongside the phytic acid in these same foods, but it must be activated by being soaked in an acidic environment.

BUT– phytase is fragile, is easily destroyed by heat or freezing, and even the simple processing to turn oats into oatmeal is enough to render it inert.

AND– phytase is not present in a high enough contentration even within raw oats to render all the phytic acid inert by soaking or cooking.

So should you stop eating oatmeal? Probably.

But then why bother saying that it’s OK to eat oats?

There is a solution: Lactobacilli. Or, in layman’s terms: Yogurt Bacteria. Lactobacilli produce phytase in quantities enough to neutralize the phytic acid in oats. So, by simply soaking your oats overnight in probiotic (still alive, not pasteurized) yogurt, you can let your bacterial friends do the hard work for you, and then you have delicious Muesli to eat in the morning.

Excellent article on phytic acid and phytase at the Weston A Price foundation

Gluten-Free Chicken Olympics

I love me some fried chicken. So I decided to do a food experiment to see which one of the locally available gluten-free chicken-nugget varieties tasted best and was the best value. I found the following products at Target.

In the arena, we have:

• Tyson gluten-free chicken strips, 14 oz, $5.99
• Tyson gluten-free chicken nuggets, 18 oz, $5.99
• Applegate gluten-free chicken nuggets, 16 oz, $8.99
• Nature Raised Farm gluten-free chicken nuggets, 12 oz, 2 for $10 ($5.00/bag)

Opening the bags, we note that we receive:

• 5 Tyson strips, $1.19ea, $0.42/oz
• 24 Tyson nuggets, $0.24ea, $0.33/oz
• 45 Applegate nuggets, $0.18ea, $0.35/oz
• 16 Nature Raised nuggets, $0.31ea, $0.41/oz

I should also note that each of these products are packaged in resealable bags, but also contain a separate internal heatsealed plastic bag inside which contains the food. Double packaging. And, in the case of the Tyson strips, all 5 of them, why even have a resealable bag? You’re going to use them all in one cooking session.

I baked them all in a glass dish according to the manufacturer’s recommendations. All came out fully cooked (they are pre-cooked anyways). I served them with a small variety of condiments (mustard, ranch dressing, sriracha, and Cholula hot sauce) taking the time to try them all with each sauce. Seen in the following photo, beginning in upper right, going clockwise: Tyson GF strips, Tyson GF nuggets, Applegate GF nuggets, Nature Raised GF nuggets.

GF Chicken Olympics

Regarding value for weight, it’s easy to figure. Gold Medal goes to Tyson nuggets, Silver to Applegate nuggets, Bronze to Nature Raised nuggets, and Tyson strips goes home crying.

At first impression, they all have appealing smell. So all receive Gold Medals for that.

Appearance-wise, the color on the Applegate nuggets wasn’t as vibrant as the others, which colorwise were all equal. So Gold Medal for appearance goes to both Tyson products and NatureRaised. Silver goes to Applegate.

Now taste-wise, all three had that deepfried umami to them, and all were good, however the flavor of the Applegate nuggets fell short, probably because due to their smaller size they have a higher breading-to-chicken ratio, and the chicken got lost under the taste of all the breading. That’s not to say they tasted bad, quite the opposite. Just not as chicken-y as the others. The nuggets from both Tyson and Nature Raised tasted nearly identical, maybe a tiny bit more pepper in the Tyson breading. The taste of the Tyson strips was good but they were heavily breaded, and, like the Applegate nuggets, the taste of the chicken started to get lost under the deepfried flavor of the breading. So… Taste Gold Medal goes to nuggets by Tyson and Nature Raised, Silver to Tyson strips, and Bronze to Applegate.

Texture is where they differentiated themselves and a winner for the whole lot came out. By far the best texture of all is the Nature Raised nuggets, which, defying all history of chicken nuggets in the oven, actually retained a crispy component to the breading. The breading on the Tyson nuggets was a close second but it felt more oily and saturated than the Nature Raised. The overdone breading on the Tyson Strips made them not so enticing after a while, which brought them in worse place than the Applegate nuggets, whose heavy breading wasn’t quite so bad after all compared to the Tyson ones. So… Texture Gold Medal goes to Nature Raised, Silver to Tyson nuggets, Bronze to Applegate, and Tyson strips goes home crying.

And, for overall performance and foodie joy brought to me by these gluten-free chicken products…

Gold Medal: Nature Raised Farms gluten-free chicken nuggets.
Slightly more expensive than the cheapest option, but worth it for the better texture and experience.

Nature Raised Farms gluten-free chicken nuggets

 

Silver Medal: Tyson gluten-free chicken nuggets
Better value but not as good texture.

Tyson gluten-free chicken nuggets

 

Bronze Medal: Applegate Naturals gluten-free chicken nuggets
Good value, decent product.

Applegate Naturals gluten-free chicken nuggets

Product review: Tinkyada gluten-free pasta

Pasta is one of those easy meals that I had fully given up on with my gluten-free diet, and one that I missed. Boil for 10 minutes, throw in the sauce, and eat. Cheap, filling, fast, easy. But the gluten in the pasta would cause me problems, and so the pasta had to go. At the time I started gluten-free eating, there wasn’t much on the market that was any good, so I just cut pasta completely from my pantry and did without.

I went to the store yesterday to see if there was any gluten-free bread-like product I could use to make BLT sandwiches with, but finding none, I saw the pasta instead. So I decided to give it a try.

I found several varieties of Tinkyada’s gluten-free pasta at Publix supermarket in their “green” section. I tried the rotini/spirals first. The label’s statement of “not mushy” and “perfect al dente texture” had me skeptical, but the claims turned out to be honest. It came out with excellent texture and consistency, it tasted like pasta, held together like pasta, chewed like pasta, and worked nicely with the sauce actually better than pasta (it was slightly more absorbent). It did tend to stick together more than wheat pasta once it cooled off in the colander; future tests with butter or olive oil will need to be done, to see if I can get it to stick less. It wasn’t a problem, though, as the stuck-together portions came apart again once I mixed in the sauce.

The instructions to boil for 14-15 minutes I found to be a bit excessive; I found 13 minutes to be more than adequate for my preferences.

Ultimately, it is an excellent product and I am overjoyed that I can eat pasta again.

Tinkyada pasta’s website is here, at www.ricepasta.com

Working on a new supplement that actually works

I have begun paving the trail to have a new supplement manufactured for those of us who no longer have gall bladders (or have lost the function of one that is still there). Since all of the bile supplements on the market are uncoated, they are mostly ineffective. I have tested lots of them and not had any results other than indigestion. The reasoning, so far as I can figure, is this:

In a perfect world, bile enters your system in your small intestine for a reason. 1 to emulsify fats, and 2 to reduce the acidity of your incoming stomach contents. Bile is a base. If the bile enters your stomach, it will increase the pH (reduce the acidity) of your stomach contents, leading to reduced digestion or outright negation of the pill you took.

In order to get the bile to the right place, it needs to be coated with something that will make it last through the acid environment of the stomach, and then break down in a more base environment like the intestine. Such coatings do exist, but none are presently used on bile tablets.

I believe that one of the greatest contributing factors to the side effects we gallbladderless people suffer is from pH imbalances in the digestive tract: food is too acidic as it travels through your intestine due to reduced bile output, and then the whole tract is too base the rest of the time because the bile is just constantly leaking into your system.

With a coated tablet, I hope to be able to, in effect, replicate the environment we once had when our gall bladders worked. Or get it reasonably close. We shall see. And you can help.

I am still in the formulation stage, but once I have the first test batch made, I will be looking for some volunteers to test it out for me and provide feedback. If you are interested, please contact me here or via email (media@evlmedia.com) and I’ll let you know as soon as it’s available.

Cutting back on diet coke

I have been shamelessly addicted to Diet Coke for years. I quit it once after reading up on the potential horrors of aspartame toxicity, and replaced it with Coke Classic, but I gained so much weight with the extra calories that I had to go back to Diet.

Freaking out after another onset of new “aspartame is horrible for you” propaganda, I’ve been off Diet Coke for a week now, and there are some notable changes in the consistency of my toilet trips. First of all, when I am drinking Diet Coke, I am drinking it all day. Sipping constantly. While working, while resting, it became a sort of habit, similar to smoking, that I had to constantly have a drink with me. Even when I am not drinking Diet Coke, and I am not thirsty, I still yearn for the physical sensation of constantly sipping a beverage. I wake up every morning craving Diet Coke. When I say it’s an addiction I’m not kidding.

The first reaction I notice to lack of Diet Coke is that I am not hungry between meals. I have read that aspartame is so sweet that it can trick your brain into thinking it is sugar-crashing, causing you to be hungry. This may be the case. I have not been hungry for snacks between meals the whole time since I quit drinking Diet Coke last week. I am also less thirsty to a significant extent. I have been drinking water and occasional ginger ale (made with sugar, not corn syrup). With the ginger ale, I maybe drink a glass, and I feel no need to drink more.

The second thing I notice is that my trips to the toilet result in firmer stools. Perhaps a consequence of not being overhydrated? I have also read some things about food allergies to caffeine. There are many potential variables, and I did not do a real scientific-method study, but the end results are that I feel much better and have more normal bowel habits as a result of my stopping drinking so much soda.

 

Treating gallstones without surgery or gall bladder removal

Don’t throw the baby out with the bath water. Try to keep your gall bladder if at all possible. While it is not technically necessary to digest food, it is very helpful in proper digestion and nutrient absorption. Chances are that you WILL miss it (as the symptoms of not having one pile up), and once it is gone, it is gone forever.

The following is a chapter from my book, on gallstone treatments:

Gallstone treatments

If you are fortunate enough to have caught your gallstone problem before your gall bladder was ruined, you have a few options for treatment.

ERCP:

If this sounds familiar from the diagnostic list that’s because it is the same procedure involving the same equipment, only this refers to using it to treat the stones after they are found. ERCP or “Endoscopic Retrograde Cholangio-Pancreatoscopy” (say that 5 times fast!) can be used not only to assess the situation in your gall bladder but can be used to treat the problem as well. Using this procedure, some stones can be removed from the gall bladder or bile duct without the need for surgery. Basically the doctor runs a fancy endoscope down your throat and then up through the ducts from which your bile flows, and dissolves the stones with chemicals injected by the scope. With this procedure, you do not need to be opened up with knives, and the doctor will have a camera’s-eye view of the inside of your bile ducts and gall bladder, by which he/she can further assess just how bad the situation may be.

Bile Acid Supplementation:

Some stones can be treated with oral ingestion of bile acid. This has a roughly 75% rate of success on cholesterol-based stones, but 15% of the patients of this treatment still end up with recurring gallstones within 2-3 years.

Lithotripsy:

The use of sonic shock waves, or Lithotripsy, to break up gallstones can be very effective . This treatment is good in that it does not require the patient to be anesthetized, however repeated treatments will be necessary to ensure that the stones have all been broken down into small enough pieces that they can be passed through the bile duct without getting stuck. Patients with a single large stone have much higher success rates than patients with multiple smaller stones. 95% of stones treated this way are passed within 12-18 months. This treatment does increase the risk of pancreatitis and gall bladder inflammation (acute cholecystitis) because the small pieces still need to pass through the bile ducts and can cause irritation along the way.

Contact Dissolution:

Another more meat-and-potatoes way to get rid of gallstones is “contact dissolution” which involves injecting chemicals directly into the gall bladder by way of a percutaneous catheter (a really long needle) to dissolve the stones. In cases with multiple gallstones, this method is the most effective, with a 95% success rate. MTBE (methyl tertiary-butyl ether) is commonly used as the solvent. Side effects are caused by the body’s absorption of the MTBE and can include vomiting, difficulty breathing, drowsiness, and bad breath. Of course you also have to deal with having a needle stuck into you for 5-12 hours for the treatment; Anesthesia, while preferable, is not mandatory. But you get to keep your gall bladder.

Coeliac (Celiac) disease and gall bladder problems

This is an excerpt from my book (see links for editions in print and Kindle, in English and Spanish). Studying the search-terms that bring traffic to the blog, I thought it might be a good idea to post this information to the general public.

The Coeliac Connection

Coeliac Disease (spelled Celiac in the USA) is an autoimmune disorder caused by a reaction to gliadin, a gluten protein found in wheat. The reaction causes inflammation of the small intestine, which leads to atrophy of the vilii (surface cells), which then causes malabsorption of nutrients. Coeliac Disease is not a symptom of gall bladder dysfunction, but it can definitely be a cause. If you are suffering from gall bladder problems you should definitely be screened for Coeliac Disease. It affects about 1% of the population in the USA.

Coeliac Disease gets in the way of proper gall bladder function by dampening or canceling out the Cholecystokinin (CCK) signal sent from the duodenum. If the duodenum can’t sense fat content because its lining is inflamed or atrophied, it doesn’t know to send the CCK and call the gall bladder to action.

The gall bladder, not getting the proper signal, either sits idle waiting or does an inadequate job and doesn’t give 100% effort. Therefore bile doesn’t circulate properly, it has a greater opportunity to settle and crystallize, and the chance of gallstone formation is greatly increased.

Not only does Coeliac Disease cause malabsorption of nutrients in general due to its inflammatory nature, but its problems are further compounded by a double dose of malabsorption caused by reduced bile output from a lazy or unresponsive gall bladder. As the atrophy of the intestinal lining worsens over time, more symptoms and digestive disorders can result (such as lactose intolerance).

Symptoms of Coeliac Disease:

• Diarrhea: often pale and foul-smelling

• Abdominal pain and cramping

• Bloating

• Often misdiagnosed as IBS (Irritable Bowel Syndrome)

• Vitamin A, D, E, and K deficiencies

• Calcium malabsorption/deficiency

• Bacterial overgrowth in the bowels

• Dermatitis Herpetiformis (DH), an itchy skin rash

• Mouth ulcers

• Hypothyroidism

• Iron deficiency

• Chronic fatigue

• Osteoporosis

• Intestinal cancer

• Sterility

Getting tested for Coeliac Disease:

Blood tests are the fastest way to screen for Coeliac Disease. The tests you should get are as follows:

• IgA or tTG antibodies: Sensitivity 90%, Specificity 99%. IgA means anti-transglutamase antibodies. These antibodies are very specific, occurring 100% in people with Coeliac Disease, and 80% in people with DH (Dermatitis Herpetiformis). IgA is also called tTG (tissue trans-glutamase). If your test comes back IgA positive, there is a 97% chance that you have Coeliac Disease. This test does give occasional false-negatives; if you test negative, there is only a 71% chance that the negative result is accurate.

• IgG anti-gliadin antibodies: Sensitivity 87%, Specificity 91%. This test shows positive results more readily but does not have as strong a correlation to proving Coeliac Disease. For ecample, IgG-positive results show up in 21% of people suffering from non-Coeliac digestive disorders. This test may not provide as good a test-positive result as the IgA/tTG but it provides less false-negatives, and therefore should be done at the same time.

Other testing methods:

• Endoscopy with biopsy of duodenum or jejunum. Most Coeliac sufferers have a bowel that appears normal through the endoscope but inspection of a tissue sample viewed through a microscope reveals proof of the disease.

What to do if you have Coeliac Disease:

Presently, the only cure is to go on a gluten-free diet for the rest of your life. There are no miracle medications. Fortunately the solution requires only willpower, and costs nothing extra. In time, the intestinal walls will heal and the symptoms will abate or disappear completely.

Unfortunately, this means that you will have to stop ingesting anything containing gluten. The list of forbidden ingredients containing gluten is as follows:

• Wheat

• Spelt

• Kamut

• Rye

• Barley

• Triticale

• Oats (if your oats are pure, you may not need to exclude them; normally they do not contain gluten but the machines that process oats are also used to process the other grains and may be cross-contaminated. There are also studies that show oats contain peptide sequences very similar to gluten which can cause problems in 10% of Coeliac patients)

The list does not stop there; all things derived from the above products must be avoided as well:

• Bread and flour products of all kinds, with exception to pure corn bread.

• Beer (Rest In Peace!)

• Most types of Whiskey

• Malts

A general list of things that are gluten-free:

• Corn

• Potatoes

• Rice

• Cassava

• Yams

• Chickpeas/garbanzo

• Meats (be careful of sausages, as some use ingredients containing gluten as filler or flavor enhancers)

• Wine, rum, brandy, sake, vodka, and other spirits derived from fruit, honey, sugar, rice, potatoes, or corn.

The particulars of following a gluten-free diet could easily fill their own book. There are a wealth of gluten-free diet books on the market. It is such a common problem that there is even a “Celiac Disease for Dummies” book in addition to a “Living Gluten-free for Dummies” and a “Gluten-free Cooking for Dummies.” All three are quite informative, and rated 4 stars or higher on that online bookstore everyone knows. Fortunately, many product manufacturers are more aware of dietary gluten problems, and label their ingredient list clearly as either containing gluten or being gluten-free.

How to eat healthy (for your gall bladder) when you travel

Either traveling, or commuting, or anywhere you can’t be at home, it is tough to eat things that are compatible with a body which has no gall bladder (or has one, but it’s “out to lunch”).

I travel quite a bit, internationally. As such, it is very difficult to maintain a fresh refrigerator stocked with the things I need to eat. Need, as in “not want but need.” The things I want, I really shouldn’t eat. The things available to a traveler with no stocked refrigerator are usually all things which are incompatible with gall bladder patients: mostly bready, starchy things made with trans fats.

Bread and starch tends to puff us up and turn us into gas machines. Not good for polite company. Greasy starch even worse.

I offer the following solution which has served me well: eggs and apples.

Eggs can be prepared in multiple ways but the way they travel best is hard-boiled. Whenever I arrive in a new location the first thing I go to buy is 2 dozen eggs and a bag of apples. Then I hardboil a full dozen of the eggs.

Instant breakfast, just peel and eat. Take a few for lunch. Snacks, whatever. There are few things more excellent than a simple hardboiled egg with some salt and Tobasco or sriracha sauce. They are also filling. I’m a big guy and 2-3 hardboiled eggs will keep me fed for half a day before I start to feel hungry again.

The apples, well, they’re for variety 🙂 And they are also good for you and contain fiber and vitamins to go with the eggs.

Not only that, but eggs contain everything a gall bladder patient needs for nutrients and proper digestion. I have noticed that in cases where I have slipped out of a healthy routine and begin to suffer from new bouts of diarrhea (yes, I am prone to binges of pizza and burgers), a few days on eggs and fruit brings me quickly back to normal. Give it a try, the worst that can happen is that you get tired of eggs and fruit.

Thinking chemically, you could probably live forever on a diet of nothing but eggs, fruit, and greens.

Hashimoto’s Syndrome: something else to consider

To make a long story short, Hashimoto’s Syndrome is an autoimmune/thyroid disorder which can have similar results (and causes) to Celiac Disease. Basically unwanted protein infiltration through a leaky or compromised gut. Supposedly there are some 30 million undiagnosed cases of Hashimoto’s Syndrome in the USA. You can read all the specific details here on Wikipedia.

How does it relate to gall bladder problems? Well, the same problems from Hashimoto’s and Celiac Disease can also incapacitate your gall badder. If you are a gall bladder patient, you may want to test yourself for Hashimoto’s Syndrome.

The wife of my friend Bill (who is writing a book on the subject) has Hashimoto’s and has found successful treatment through dietary changes:

My wife has found that by partioning her meals – eating protein first and giving the stomach at least 30 minutes to break the protein down into assimilable fragments that can be digested by the upper gut enzymes before the fragments have a chance to leak through the gut wall, and then eating the vegetable portion of her meal, almost completely eliminated the auto-immune response.

Bill goes on further to say:

Second let me URGE any reader who has been diagnosed with any kind of gut issue – celiac, IBS, crohns, SIBO, etc – and ESPECIALLY gluten intolerance! – get yourself tested for Hashimoto’s. In most cases, Hashi’s is confirmed by two antibodies labs: anti-TPO and TgAb. The first antibody, anti-TPO, attacks an enzyme normally found in your thyroid gland, called the Thyroid Peroxidase, which is important in the production of thyroid hormones. The second antibody, TgAb, attacks the key protein in the thyroid gland, the thyroglobulin, which is essential in the production of the T4 and T3 thyroid hormones. If you have insurance you may find that your doc resists ordering the tests – though for the life of me I don’t know why. We have no insurance and the damn things only cost @ $60 – and they are absolutely diagnostic. SO – do not let your Doc tell you that since your T4 tests are normal there’s no need for the anti-body tests. MAKE them order the damn tests ( voice of frustrated experience here).Then, if it turns out that you do have Hashi’s, there are several well-established pathways back to health.

Last, let me say that after years of working on this together with my wife and having to do almost all our own research since docs just don’t seem to know or care ( gastroenterologists are the worst IMO) we are convinced that whole-body inflammation is the bottom-line, underlying issue not just in Hashi’s but in a huge range of disease – and most gut disease in particular. Get control of the inflammation and you get control of the disease. A quick story to illustrate this. Within a month of eliminating grain, dairy and eggs from her diet my wife, who had weighed 110 pounds all her life before all this began and then for years she see-sawed between 125-140 but the amount of food she was taking in did not vary and she never ate junk food, sweets etc – the stuff that “makes you fat” – within a month she was back down to 110. But here’s the kicker – she had zero loose skin, the way you do when you lose weight, especially in places like the back of your arms. That’s because her extra weight wasn’t fat – it was inflamed tissue. Once the inflammation was under control, the tissues returned to normal state, and there was no extra loose skin. None. So in my mind that is pretty good evidence that an awful lot of the obesity that’s around these days probably isn’t fat, but inflamation. Just an opinion.

Low-carb diets and gall bladder health

Lots of people ask me how I can offer advice on gall bladder health when I no longer have a gall bladder. Well, that’s kind of the point. Been there, done that, killed it. Literally. And the search for solid poop afterwards occupied years. I know how to kill a gall bladder, trust me. And following a low-carb diet is definitely not something that will endanger your gall bladder. In fact, minimizing carbs is what finally ended the Age of Soft-Serve Poop for me. And, had I known better and not followed a low-fat diet for untold years (doctor’s recommendations due to hereditary high blood pressure), I might very well still have a gall bladder today.
If you have gall stones, whenever you eat fatty foods you may experience discomfort or fits of incapacitating pain. This is because the gall bladder is triggered to squeeze when your intestine signals the intake of fatty foods. This does not mean that low-carb eating is incompatible with gall stone sufferers or gall bladder amputees. Understanding which fats rebel and which ones comply with your system is key.  In fact, educated, controlled gall bladder activity can actually help eliminate existing stones.
The gall bladder is probably one of the body’s most, if not the most, poorly designed organs (think of it as the Yugo parked next to the Rolls Royce of your liver). It is designed to both store and squeeze out a portion of liver-manufactured goo down the biliary tree where it exits into the duodenum by the same pipe the pancreas uses to release digestive enzymes.
Not only does the gall bladder have an absurd curly valve mechanism (perfect for trapping granular material) to control its output, but it is also oriented with its exit near the top, which allows any particulate trash to settle to its bottom and eventually form stones. And trash it receives. Basically the garbage your liver can’t use or doesn’t want gets tossed down the bile chutes. Worn-out or surplus cholesterol, bilirubin, salts, etc. all combine into bile. This “fresh” bile is then further concentrated into a thick sludge within the gall bladder, by up to five times, increasing the odds of crystallization of whatever crud happens to be present.
Bile is used for two things: to emulsify fats and to increase the pH (reduce acidity) of the stomach acid. The pancreatic enzyme Lipase is used to break those emulsified fats into fatty acids your intestine can absorb, but it can’t work efficiently unless the bile has emulsified the fats and increased their surface-area-to-volume ratio. The two chemicals work as a team. Once the bile has done its job it is reabsorbed at the end of the small intestine and sent back to the liver, which usually cycles it straight back into the gall bladder. The same bile molecules can be re-used some 3 times in a single meal.
In a normal human diet, the gall bladder is able to cycle properly. What goes in, goes out, in a regular pattern. However, in a low-fat diet (or, in the case of celiac disease sufferers), the gall bladder is not called to action enough and bile stasis can occur. If you put garbage into a can, concentrate it, and empty only 80% of it every time, you will eventually end up with some really nasty junk stuck in the bottom of the can. This is the case with underactive gall bladders.
To further exacerbate the situation, diets high in sugars and trans fats will have the body working harder cycling its cholesterol in order to control cellular inflammation, in addition to having surpluses of chylomicrons, VLDL, and their resulting LDL blood cholesterol to get rid of, which means more trash tossed down the bile chute. Which means higher odds of gall stones.
Once you have gall stones, you will have a couple of growing problems. You will tend to shy away from fatty foods as they cause you digestive discomfort. This comes from the stone causing you pain when the bladder contracts, and also from the fact that the bladder cannot hold as much bile as it once did (especially if you have large or multiple stones), so it cannot issue enough bile to emulsify the volume of fat in hearty meals. This under-treated fat will cause havoc later down the tract; your pancreatic lipase will not be able to break it down as efficiently, so you will not be absorbing the fats you need, and what is left unprocessed will become food for gas-forming bacteria. And what they don’t eat, will come out in the form of soft-serve nastiness.
Less fat processing by bile and lipase means you absorb fewer fatty acids and fewer fat-soluble vitamins. You will have less energy and feel cravings to eat fatty foods. But you don’t want the discomfort or the diarrhea… until your body is so needy of fat that it screams for that bucket of wings you can no longer deny, and leaves you hugging the toilet all night with the pained sweats and dry-heaves of a gall stone attack.
Gall stones, long story short, are the result of over-concentrated chemical solutions in your bile. They can dissolve, given the right environment. Proper diet (paleo or low-carb) will bring the biliary, lymph, and cholesterol cycles to where they should naturally be and will have your liver pushing less-nasty junk out the exit. When your liver no longer needs to throw so much of its weight around your system taking care of sugar damage and oxidation, it no longer has the need to pour so much toxic waste down the garbage chute. The proper balance of bile chemicals will return in time.
Chemistry nerd joke: If you are not part of the solution, you are part of the precipitate. Joking aside, it’s absolutely correct. The right concentration of chemicals in your bile can and will shrink, break down, or dissolve those stones eventually and bring them back into solution, whereupon they can be flushed out with the rest of the trash. Taking dietary bile acid supplements has also proven fairly effective (85%) in getting rid of stones as they help return your bile to a healthy and balanced “formula” which will dissolve existing stones. I am not a doctor, but I would definitely recommend a paleo or low-carb diet with bile acid supplements to someone suffering from gall stones.
What if you have no gall bladder and want to do a low-carb diet, but you are afraid of uncontrollable grease-poop? Try it, you might find that it better suits you than whatever you were doing before. It worked for me. I am not strict about avoiding all carbs at all costs but I cut out almost all bread and wheat from my diet completely; despite the fact that I do not have celiac disease, my system returned to some semblance of normal and the unrelenting butt-volcano went dormant within a couple of weeks.
And you don’t have to eat grease to eat low-carb. A body without a gall bladder will tolerate animal fats better than vegetable fats, because their chain structures break down more easily, and because phytosterols (plant cholesterols) will slow and block absorption of animal cholesterol. Furthermore, phytosterols contain estrogen and progesterone precursors which, interestingly, contribute to gall bladder laziness and/or inactivity.
Even lean meat should contain enough fats to keep you healthy. What you want to avoid is heavy doses of vegetable oils (like salad dressing) and hydrogenated fats, which I can assure you a gall-bladder-less body does not tolerate. Pork fat, I am happy to say, is the most tolerable fat I experience without my gall bladder. I can now eat eggs fried in bacon fat, with the bacon, and not have to run to the bathroom in 15 minutes. Without a gall bladder, and without dietary supplements.
Milk from cows and goats (and horses, if you are into that) contain short and medium chain fatty acids that do not require lipase to break them down before absorption, meaning that the presence of bile is not required to digest and absorb them. These go nicely with low-carb and paleo, though ultimate low-carb nazis may take issue with the lactose content.

Here is a list of things to avoid while eating low-carb with gallstones or without a gall bladder:

• Olive oil in excessive amounts; for cooking it’s ok, but do not use it for salad dressing.
• Any other vegetable oil that is liquid at room temperature
• Hydrogenated oils of any kind
• Soybeans or derivative products
• Margarine or fake-butter products

Things to encourage while eating low-carb with gallstones or without a gall bladder:

• Cook your food in real butter, clarified butter (ghee), coconut oil, palm kernel oil, or pork fat.
• Eggs from happy chickens (contains lots more Omega-3/6)
• Grass-fed beef (contains 4x more Omega-3/6 than unhappy cows)
• Pork from happy pigs (yes, surprise surprise it also contains higher levels of Omega-3/6)
• Whole (not skim) milk from cows or goats
• Cheese and yogurt (especially yogurt with active cultures)
• Omega-3/6 Fish oil supplements, essental fatty acids
• Plenty of dark leafy greens like cale, spinach, etc.
• Avocados but don’t go overboard
• Vitamin supplements of A, D, E, and K optional, don’t go overboard on them especially if you are eating plenty of dark greens
• Do eat your greens in the presence of fats, otherwise their vitamin enrichment is wasted.