Most surgeons on call on Thanksgiving or Christmas Day are not surprised when they get called into the ER to see a patient with right upper abdominal pain and tenderness radiating through to the back. There are also no surprises when an abdominal ultrasound shows a dilated gallbladder, possibly with a thickened wall, and gallstones ranging from the size of a pebble to the size of a marble or even an egg. At this point, the appropriate next step would be laparoscopic cholecystectomy, or removal of the gallbladder. This is one of the most common surgical procedures in the Western world today.

So how does a person find themselves in the operating room on Thanksgiving night? First of all, it didn’t just happen all at once. Gallstone formation takes months or even years. It is believed that low-fiber, high-cholesterol diets high in processed starchy foods contribute to the formation of cholesterol stones. Over-consumption of fatty and fried foods and refined sugar, as well as inadequate intake of vitamins B, C and E, are also factors thought to contribute to gallstone formation. Inadequate water intake and lack of exercise also play a role.

With the above diet, a bacterial imbalance in the gut will develop. The effect in the gut of this imbalance will be increased intestinal permeability (also known as leaky gut). As a result of leaky gut, more toxins are delivered to and processed by the liver. These toxins are sent from the liver to the gallbladder, where they are stored and concentrated along with the bile, which can lead to gallstones.

So how do the holidays fit into this? Very simply – a large meal high in fat and sugar will release the hormone cholecystokinin (CCK) from the duodenum (upper small intestine). CCK triggers the gallbladder to begin contracting and may move the stones into the cystic duct (which drains into the common duct and then into the duodenum) causing gallbladder obstruction, swelling, more inflammation, and severe right upper quadrant pain.

Many people do not realize they have gallstones. They may go years without symptoms and only discover the gallstones in an emergency room visit such as I described above. Other people do experience periodic attacks and are able to recover from them and choose not to have surgery. In either case, it’s prudent to take extra care at major holiday meals. A combination of gravy, ham, buttery mashed potatoes, candied yams and alcohol, followed by pumpkin pie and ice cream is the perfect recipe for a gallbladder stress test. The following recommendations could help you avoid that ER visit this holiday season:

• Eat smaller portions of any high fat, high-sugar foods
• Chew thoroughly
• Eat slowly, taking the time to enjoy the meal and company
• Take digestive enzymes with the meal
• Limit alcohol consumption

Most importantly, as a preventative measure, follow a high-fiber, plant-based, antioxidant-rich diet low in processed foods and saturated fats, fried foods and sugar. In addition to getting regular excise and having regular bowel elimination to reduce toxins, it is important to have a healthy balance of intestinal bacteria. This can be achieved by eating fermented foods (which are naturally high in beneficial bacteria) and taking high-quality probiotic supplements every day.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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It’s a subject you’ve heard me talk about before, but considering new research it’s definitely worth repeating. A recent CBS news segment revealed that not one but five new studies showed that using acid-blocking drugs called proton pump inhibitors (PPIs) can be potentially dangerous to your health, and that “more than half of prescriptions for these drugs are unnecessary”. Folks, this is an eye-opener if there ever was one!

Every year more than 100 million Americans are prescribed PPIs to help relieve symptoms of heartburn and acid reflux, but what many people don’t know is that these drugs often come with some pretty serious side effects—including a nearly 75 percent greater risk of developing a severe intestinal infection known as C. diff, according to new evidence. Essentially, taking PPIs upsets the healthy bacterial balance in your intestines (which is where the majority of your natural immune defenses can be found), leaving your body vulnerable to illness and infection.

Widespread PPI use has also been linked to higher rates of pneumonia, as well as esophageal candidiasis (yeast overgrowth), inflammation of the stomach lining, increased permeability of upper GI tract lining, and even osteoporosis-related bone fractures due to the fact that PPIs block calcium absorption in the body. Because long-term PPI use also leads to hypochlorhydria (low stomach acid secretion), bacterial overgrowth and acetaldehyde production, PPI users have an increased risk of developing gastric cancer. 

The good news? There are simple things we can do every day to help prevent heartburn and acid reflux without relying on harmful drugs. Diet changes like limiting our intake of caffeine, alcohol, chocolate and fatty or spicy foods can make a big difference, along with maintaining a healthy body weight, getting plenty of exercise and quitting smoking—all pretty good advice if you ask me! Natural supplements made with ingredients such as ellagic acid (from raspberries and pomegranates) can also provide soothing relief for occasional heartburn, and digestive enzymes with added HCl can help ensure complete digestion and reduce the chances of heartburn and acid reflux happening in the first place.

The bottom line is this: why take a potentially dangerous drug when smarter, safer alternatives exist? My hope is that the more people learn about PPIs and their side effects—including why they may not even need them in the first place—the more people will take steps to improve their digestive health naturally.

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