The Gallbladder
ORGAN OF THE MONTH
Howard F. Loomis
Jr., DC
Introduction
This series of articles deals with the common symptoms and underlying problems caused by “stress” and the importance of understanding its many ramifications. Simply stated, stress occurs any time the body has insufficient energy to meet the three essential demands placed on it, namely:
• Energy to oppose gravity (structure)
• Energy to maintain homeostasis in the extracellular fluids (visceral)
• Energy to maintain emotional and cognitive stability (brain)
Recently, I reviewed a study that appeared the week of June 17, 2019, in the journal PNAS. The study, conducted by investigators at Yale and Harvard, was entitled “The Biology of Leptin: the Hunger Hormone.” Briefly stated, leptin is a hormone made by adipose cells and the small intestine that helps regulate energy balance by inhibiting hunger. It acts on receptors in the arcuate nucleus of the hypothalamus to regulate metabolism, appetite, and body weight. Researchers discovered that, in a fasting state, rats with poorly controlled type 1 and type 2 diabetes had lower plasma insulin and leptin levels and large increases in plasma corticosterone, the so-called stress hormone.
Organ of the month - Gallbladder
During stress, lipids are pulled from storage and sent to the liver for conversion to glucose. This month, we discuss how the stress response affects fat digestion and biliary functions in the liver. It doesn’t matter if patients have had their gallbladder removed since the same problems that caused its dysfunction are still prevalent in a patient’s lifestyle and diet.
As important as limiting your fat intake, it is equally or more important to ensure that you properly digest the fat you do eat. If fats (lipids) are not properly broken down before they are absorbed, incomplete digestion of fat allows fat to coat food particles and, therefore, interferes with the breakdown of other food components, such as protein and carbohydrates. Normal digestion of dietary fat requires emulsification of fats by bile before pancreatic enzymes can work effectively. Pancreatic enzymes simply cannot penetrate fats.
Bile breaks down the large fat molecule into tiny droplets, which provide lipase with an enormously increased surface to work on. Therefore, our next question is what stimulates the flow of bile? Oddly enough, it is not fat in the diet; it is stomach acid. Insufficient stomach acid allows bile to thicken and flow more slowly. Space simply does not allow description of this process here, but we teach it in our seminars and in the several books I have written.
That brings us to lipase, the lipid-digesting enzyme. It hydrolyzes the ester bonds in triglycerides to form fatty acids and glycerol. Fats require special digestive action before absorption because the end products must be carried in a water medium (blood and lymph) in which fats are not soluble.
Because lipase requires the coenzyme chloride, lipase-deficient people have a tendency towards hypochlorhydria. The stomach acid molecule is hydrogen plus chloride. Low chloride levels in the urine (because the body is trying to hold the electrolyte) are also found in stress when the adrenal medulla struggles to maintain a sympathetic response to stress.
So we have come full circle. Energy deficiency leads to symptoms of stress and pulling stored lipids into the blood for conversion to glucose in the liver. Their presence in the blood elevates triglyceride levels, which lower insulin levels, and leads to energy deficiency (stress). Bile is needed to emulsify fats, stomach acid stimulates the flow of bile, stomach acid is made of H and Cl, and lipase requires the prosthetic group chloride to be an enzyme. Lipase is needed to breakdown fats so the body can store them and respond to stress.
Embryologic Development of the Gallbladder
The hepatic diverticulum (a blind tube leading from a cavity or passage) appears in the anterior wall of the primitive midgut early in the fourth week of embryonic development. This small tube is the beginning of the development of the liver, extrahepatic biliary ducts, and gallbladder. By the fifth week, all elements of the biliary tree are recognizable. At about the tenth week, the muscle of the sphincter of Oddi undergoes differentiation. The sphincter of Oddi refers to the smooth muscle that surrounds the end portion of the common bile duct and pancreatic duct. This muscle relaxes during a meal to allow bile and pancreatic juice to flow into the intestine.
Structural relationships
Muscles of the Upper abdomen
Last month, I discussed the involuntary muscle contractions under the left anterior costal arch associated with pancreatic dysfunction. These are identical to those associated with biliary dysfunction on the right side.
The rectus abdominis, internal oblique muscle, and external oblique muscle run diagonally down and in from the lower ribs to the pelvis. They allow you to flex, bend sideways, and rotate your torso. Involuntary muscle contraction in these muscles can be palpated under the anterior costal arches and is often found when there is dysfunction of the biliary system or pancreas.
CHART OF AUTONOMIC EFFECTS
Symptoms of Sympathetic Stimulation
Function
Symptoms of Sympathetic Exhaustion
Inhibits
Digestive secretions
Inadequate
Relaxes muscle Contracts sphincter
Biliary system
Inadequate secretion
Obviously, when these muscle groups are involuntarily contracted, the other muscles, as well as the linea alba, are impacted, affecting both posture and spinal range of motion, especially between T7 to Til. Very often, this causes compensatory involuntary muscle contractions in the midthoracic spine resulting in loss of the normal thoracic kyphosis, often referred to as Pottenger’s saucer.
Symptoms of Biliary Dysfunction
These are well known, but I might add that they can vary with the ability of the body to respond adequately to stress, regardless of its source.
1. History of gallbladder stones or gallbladder surgery
2. Loss of appetite, especially for meat
3. Frequent sour taste in the mouth and intolerance of fats and spicy foods
4. Frequent constipation with light-colored stool
5. Shoulder discomfort or soreness associated with involuntary muscle contractions under the right anterior costal arch after eating.
Sympathetic Stimulation - A decline in stomach acid secretion is almost universal, with one-third of all people over 60 failing to secrete any at all.
Sympathetic Exhaustion - This decline has adverse effects on the absorption of calcium, vitamin B12, and iron, as well as the utilization of protein.
Conclusion
The point of this article is to educate readers that when the body is under stress (energy deficiency), it resorts to increasing cortisol and pulling triglycerides into circulation, which lowers insulin secretion and leads to type II diabetes. Now it is known that it also lowers leptin secretion, the hormone that reduces hunger, thus increasing the appetite so it can store more fat.
Next month, we look at visceral and structural stress and their effects on the reproductive system.
Howard F. Loomis, Jr., DC, has an extensive background in enzymes and enzyme supplements. He is the founder and president of the Food Enzyme Institute™. His extensive knowledge of physiology, biochemistry, and enzymology has made him a sought-after speaker and a prolific writer. Dr. Loomis published ENZYMES: The Key to Health in 1999, as well as The Enzyme Advantage: For Healthcare Providers and People Who Care About Their Health, in 2015. Tel: 800-662-2630
