Hey friend,

This is one of the questions that lands in my inbox more than almost anything else.

"Liz, my doctor says I need my gallbladder out. Should I do it?"

"I already had mine removed and I still feel terrible. What's going on?"

"Is there anything I can do to help my gallbladder?"

I hear you. And I want to give you a real, thorough answer — because you deserve more than a ten-minute appointment and a surgery referral.

But before I go any further, let me be very clear:

This newsletter is for educational purposes only and is not medical advice. Gallbladder disease is a serious condition that requires evaluation and management by your healthcare provider. Please do not make any decisions about surgery or treatment changes without speaking with your doctor. Only you, in partnership with your provider, can weigh the risks and benefits of what's right for your specific situation.

With that said — let's talk about what most people are never told.

Most people think of the gallbladder as a spare part. A little sac that stores bile and occasionally causes trouble. But your gallbladder is doing far more than most people realize — and understanding its full role changes how you think about removing it.

Here's what your gallbladder is actually responsible for:

🫐 Stores and concentrates bile
Your liver produces bile continuously — a digestive fluid made from cholesterol, bile salts, water, and bilirubin. The gallbladder stores and concentrates that bile, making it 5 to 10 times more potent than what the liver produces on its own.

🥑 Fat digestion and absorption
When you eat fat, your gallbladder releases a concentrated burst of bile into the small intestine. This emulsifies fat — breaking it into tiny droplets so your digestive enzymes can actually process it. Without this, fat digestion becomes sluggish and incomplete.

🌿 Fat-soluble vitamin absorption
Vitamins A, D, E, and K are fat-soluble, meaning they require fat and bile to be absorbed. If bile isn't being delivered properly, your body struggles to absorb these critical nutrients — no matter how well you eat.

⚡ Enzyme activation
Bile isn't just about fat. It also activates pancreatic enzymes and helps regulate the digestive process downstream, signaling the rest of the digestive system that food is coming.

🦠 Antimicrobial function
Bile has natural antimicrobial properties. It helps control the bacterial environment of the small intestine, playing a role in preventing overgrowth of harmful bacteria (SIBO).

♻️ Cholesterol regulation
The gallbladder plays a role in how cholesterol is managed and excreted. Bile is one of the primary routes the body uses to eliminate excess cholesterol.

🔄 Hormone and toxin clearance
Bile carries toxins, metabolized hormones (like estrogen), and other waste products from the liver into the gut for elimination. When this process is disrupted, those substances can be reabsorbed instead of cleared.

So when we talk about removing the gallbladder — we're talking about removing an organ that touches fat digestion, vitamin absorption, enzyme activation, bacterial balance, cholesterol metabolism, and detoxification. That's a significant piece of your digestive ecosystem.

And technically, that's true — you can survive without a gallbladder. Your liver will continue producing bile, and it will drip continuously into the small intestine rather than being stored and released in concentrated bursts.

But here's what that actually means in practice for many people:

I want to be clear: gallbladder removal is sometimes a necessary decision. Acute cholecystitis, gallstone pancreatitis, and certain other conditions often require surgical intervention. I am not anti-surgery. I am pro-information.

What I am saying is that the common framing of "just take it out and you'll be fine" leaves out an important truth — for a significant number of people, the symptoms don't fully go away and sometimes other problems develop.

I can't tell you how many times I've heard some version of this story:

"I had my gallbladder out and I thought everything would be better. But I still have bloating, I still have pain after fatty meals, and now I have diarrhea all the time that I didn't have before."

This is so common there's actually a name for it: Post-Cholecystectomy Syndrome — a collection of persistent or new digestive symptoms that continue after gallbladder removal.

Reported symptoms include:

Why does this happen? Because the gallbladder wasn't the root cause in the first place — it was a downstream consequence of something else going on in the digestive system. And this brings us to a conversation I believe everyone deserves to have before making a surgical decision.

If you're facing a gallbladder removal recommendation, I encourage you to go into that appointment prepared. Here are questions worth discussing with your doctor:

About your specific situation:

About what to expect after surgery:

About alternatives and adjunct support:

You deserve complete answers. A good provider will welcome these questions.

The answer is: it depends on your specific situation — and this is exactly why working with your provider matters. But there is real evidence that dietary and lifestyle factors influence gallbladder function significantly.

What tends to aggravate gallbladder symptoms:

What tends to support gallbladder health:

This is not a one-size-fits-all answer. For some people, dietary changes make a profound difference. For others with advanced gallstone disease, diet alone isn't enough. The key is knowing which situation you're in.

Here's where I want to go a little deeper — because this is the piece that ties everything together, and it's almost never part of the gallbladder conversation.

Your gallbladder and your gut microbiome are in constant, bidirectional communication.

Bile shapes your microbiome. Bile acids are powerful antimicrobials that help regulate which bacteria thrive in your small intestine. When bile flow is disrupted — whether by gallbladder dysfunction, removal, or poor bile quality — the microbial balance of your gut shifts. Harmful bacteria can overgrow, beneficial strains can decline, and SIBO risk increases.

Your microbiome shapes your bile: gut bacteria transform bile acids through a process called biotransformation. The types of secondary bile acids your body produces — which affect everything from cholesterol levels to inflammation to colon health — depend heavily on which bacteria are living in your gut.

Dysbiosis contributes to gallbladder disease. Research increasingly points to gut dysbiosis as a contributing factor in gallstone formation, gallbladder inflammation, and poor bile composition. When the microbiome is out of balance, it can affect how cholesterol is processed and excreted through bile — contributing to the conditions that lead to gallbladder problems in the first place.

After removal, microbiome support becomes even more critical. Without the gallbladder's concentrated bile bursts, the antimicrobial defense of the small intestine is weakened. This is why people who've had gallbladder removal are at increased risk for SIBO and ongoing digestive imbalance. Supporting the gut microbiome isn't optional after a cholecystectomy — it becomes essential.

This is the root-cause lens I always come back to: the gallbladder didn't just spontaneously malfunction. Something upstream in the digestive ecosystem created the conditions for disease. And unless we address that upstream dysfunction, removing the gallbladder addresses the symptom without healing the system.

One of the most practical tools I recommend for anyone dealing with gallbladder issues — or recovering from gallbladder removal — is a high-quality digestive enzyme supplement.

Here's why:

If you still have your gallbladder:
Gallbladder dysfunction often means bile isn't being released efficiently at mealtimes. Digestive enzymes can help compensate by supporting the breakdown of fats, proteins, and carbohydrates, reducing the burden on a struggling digestive system and easing symptoms like bloating, heaviness, and nausea after meals.

If you've had your gallbladder removed:
This is where I feel most strongly. Without concentrated bile release, fat digestion is genuinely compromised. Digestive enzymes — particularly those that include lipase (the fat-digesting enzyme) and ox bile or bile salts — can help bridge that gap, supporting fat and fat-soluble vitamin absorption that would otherwise be incomplete.

Many people who still feel terrible after gallbladder removal find that adding digestive enzymes with meals makes a significant and immediate difference in how they feel.

My recommendation: Restore

Restore has a unique blend of enzymes including amylase, lipase, lactase, cellulase, and protease. It also has a combination of four probiotic strains- lactobacillus acidophilus, lactobacillus Rhamnosus,, B. longum infantis, and lactobacillus plantarum— these help support a healthy, balanced gut microbiome. It also contains healthy herbs, and it is third-party tested.

Given everything we now know about the microbiome-gallbladder connection, probiotic support is a foundational piece of the puzzle.

Whether you're supporting gallbladder function before surgery or rebuilding your digestive health afterward, restoring beneficial bacteria helps re-establish the microbial balance that bile regulation depends on. It also helps reduce the SIBO risk that comes with altered bile flow post-removal. My recommendation to support a healthy gut and improve the lining of the gut is Zenith. It also has the added benefit of supporting the gut brain axis (how the gut and the brain communicate).

I get asked from time to time how long to take a probiotic. While it can depend on the individual, 3-6 months is a typical time frame alongside adding in probiotic rich foods.

There's something humbling about realizing how much our body works quietly, faithfully, without us ever noticing — until something goes wrong. The gallbladder is a perfect example. I think most of us never give it a second thought.

I think that's true for so much in our lives. We don't always see what God is doing behind the scenes — until we're forced to slow down and pay attention.

Whatever you're facing with your health right now, whether it's a hard decision about surgery or the discouragement of still not feeling well, know that you are not walking through it alone. God is present in the waiting, in the research, in the doctor's appointments, and in the healing — however it comes.

"He heals the brokenhearted and binds up their wounds."— Psalm 147:3

I want to say this one more time before I close, because it matters:

This is not medical advice. I am not your doctor. I am a nurse and a wellness coach who believes you deserve the full picture.

Gallbladder removal may be the right decision for some people. But if you have been told your gallbladder needs to come out and you have time to ask questions, please ask them. I want you to understand what your gallbladder does and that symptoms may continue after removal for some people. I want you to have a plan for your digestive health no matter what the case is.

Your body is not a collection of parts to be removed when they cause trouble. It is an interconnected, beautifully designed system — and when one part struggles, there is almost always a deeper story worth understanding.

"But those who hope in the Lord will renew their strength."— Isaiah 40:31

Healing isn't always quick, and it isn't always linear. But there is value in seeking to understand the root causes of illness while supporting the body in the ways we can. My hope is that this newsletter has given you knowledge, confidence, and encouragement to become an active participant in your own health journey.

With faith, science, and wellness,
Liz | The Wellness Nurse 🌿

P.S. Did any of this resonate with you? Hit reply and share- I read every response and want to hear from you. Share this with someone you know who’s having gall bladder problems.

P.P.S. If you've been reading these newsletters and finding yourself thinking, "This sounds like me, but I'm not sure where to begin," you're not alone.

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⚕️ Medical Disclaimer The content in The Wellness Nurse is for educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making changes to your diet, supplement routine, or health practices.

A note on transparency: some links in this newsletter are affiliate links, meaning I may receive a small commission if you choose to purchase through them — at no added cost to you. I share what I personally use,  believe in, and would recommend to someone I care about. My goal is always your health and wellbeing.