Thursday, October 23, 2014

Fish oil digestion after gallbladder removal

Last Updated Jan 2008

Q: Hi, I am 51 years old and in excellent health. A year ago during a RUQ ultrasound, polyps were found in my gallbladder. There are approximately six polyps ranging in size from 4 to 9 mm. They are asymptomatic, and the number and size has remained stable over the past year based on ultrasound performed at three month intervals.
I have visited two gastroenterologists to determine what to do about the polyps. One suggested that I follow a surveillance program with repeat ultrasounds (which I have been doing as stated earlier); most recently, the second doctor recommended that I consider gallbladder removal due to the number (at least 6) and the size of the largest polyp (approaching 1 cm). Neither suggested a biopsy (I assume this would require advanced endoscopy and could carry a fair amount of risk trying to reach the polyps) or an approach to "shrink" the polyps using diet and/or medication (there is a 65 percent chance that the lesions are cholesterol "polyps," which one would think could be treated).
My questions are: will I be able to digest fish oil supplements if I decide to have the gallbladder removed? Is stored (on demand) bile required to digest small (2400 mg per day) amounts of fat or does the liver/biliary tree provide a continual supply that would be sufficient? Would you recommend spreading the 2400 mg per day over three or four doses versus a single dose? How important is the gallbladder to overall health and bodily function (I have read that after GB removal, the biliary tree/common bile duct adapts to provide additional bile storage)? Do you have any diet/supplement recommendations with regards to gallbladder polyps?
I am currently consuming 1800 mg of your fish oil capsules per day and plan to increase to 2400 mg within a week. I also take a well balanced multi-mineral/multi-vitamin/plant extract in addition to 1000 mg of vitamin C each day. I have been following your Zone Diet recommendations for the past year so fortunately I do not have a high-fat diet.
Dear John,
A: I would divide the daily dose into at least four doses to minimize the demand on the lower bile supply. Since the bile acids primarily emulsify any oil, I would also recommend taking each of the fish oil doses with one ounce of SeaHealth Plus to help emulsify the oil for even better absorption.
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