The gall bladder, a pear-shaped sack hanging between the lobes of the liver, is a reservoir for bile. A small, V-shaped canal, or duct, carries bile from both the gall bladder and the liver to the small intestine. When food containing fat leaves the stomach, hormones cause the gall bladder to empty by inducing vigorous contractions in its muscular walls and simultaneously stimulate the liver to produce more bile at an accelerated rate. A diet rich in B vitamins also stimulates the emptying of the gall bladder by increasing energy production.

The bile contains water, lecithin, cholesterol, minerals, acids, and pigments. Its lecithin content breaks fats into microscopic droplets that can be surrounded by enzymes, digested, and absorbed; and its bile acids are essential before digested fats, carotene, and vitamins A, D, E, and K can be carried across the intestinal wall into the blood.

Inadequate Bile Flow

When a diet is high in refined carbohydrates and low in protein, little bile can be produced. If the amount of bile is insufficient or the gall bladder is not made to empty itself and the liver is not stimulated to produce bile, fats remain in such large particles that enzymes cannot combine readily with them; hence fat digestion is incomplete and fat absorption markedly reduced.

Part of the undigested fat quickly combines with any iron and calcium and iron; thus these minerals are prevented from reaching the blood, causing overly firm stools, bring about constipation. If this condition is prolonged, it can cause porous bones, spontaneous fractures, severe anemia, and the crumbling or collapse of one or more vertebrae. Poor elimination associated with gall bladder problems invariably indicates a major loss of vital minerals.

Most solid fats obtained in foods quickly melt at body temperature. If little bile is present, this melted, undigested fat coats all foods, preventing enzymes from combining efficiently with proteins and carbohydrates, thus decreasing their digestion. Simultaneously, the lack of bile acids prevents the absorption of carotene and vitamins A, D, E, and K and whatever fat has been broken down by enzyme action; hence deficiencies of linoleic acid , carotene, and the fat-soluble vitamins are produced. People with insufficient bile flow are usually so deficient in vitamin A that they have difficulty in driving a car at night, sewing, or doing other close work.

Intestinal bacteria enormously multiply on this huge mass of undigested food, releasing quantities of gas and histamine, which cause discomfort, foul-smelling stool and halitosis. Much undigested food is usually lost in the stools, and becomes a serious problem when the calorie requirements are high and proteins badly needed for repair.

Dangers of a Low-Fat Diet

The purpose of any diet must be to build health, yet to prevent the gall bladder from emptying by adhering to a low-fat diet can actually be harmful, though such a diet may be temporarily desirable before and after surgery to keep the gall bladder quiet until healing has occurred.

The American Medical Association suggests that a diet for people with gallstones, obstruction of the bile duct, and gall bladder diseases contain 25 per cent of the calories in the form of fat. It emphatically states that low-fat and fat-free diets should be avoided, pointing out that such diets both under supply and prevent the absorption of essential fatty acids, carotene, and vitamins A, D, E, and K, thus causing deficiency states that may be far more devastating than gall bladder problems.

Individuals who have suffered acutely while passing a gallstone or when the gall bladder has been inflamed often become so fearful of food that they frequently live on self-imposed, severely restricted diets free from all fats without realizing that they are making their condition continuously worse.