Gallbladder Sludge in Pregnancy – What Now?

Go figure that pregnancy with all of it’s rapidly and vastly changing hormones is one of the most common triggers for gallbladder sludge, and it’s also one of the hardest times to do anything about it. Let’s look at why it happens and what you can do about it. If you’re unclear about what the gallbladder does, and what sludge is then read this post first.

Symptoms of Gallbladder Sludge in Pregnancy

Gallbladder can cause a wide range of issues ranging from mild to severe, but any issue is worth discussing with your doctor because untreated disease can lead to complications for the pregnancy. Symptoms include:

  • Itching – on belly, palms and soles or all over. This can happen with or without a rash. If it’s serious, go to your doctor.
  • Right sided digestive pain – at the bottom of your rib cage on the R side or radiating into the R shoulder blade, R shoulder or even L shoulder blade.
  • Gas
  • Bloating
  • Digestive discomfort
  • Diarrhea
  • Constipation

Why is Gallbladder Sludge So Common in Pregnancy?

Gallbladder sludge essentially happens when your gallbladder is overwhelmed by too much cholesterol and not enough bile.  You’ll recall that the bile acts as kind of a “soap” to emulsify fats and make them more water soluble so that they can be both excreted and absorbed in the digestive tract. Just like with dish soap, if there is too much fat or grease and not enough soap you get a sludgy goo that tends to stick to everything and generally get in the way. Hence gallbladder sludge. But why does this happen in pregnancy? Many reasons:

  • Huge hormone shifts – Rapid changes in hormone levels mean that lots of hormones (fat soluble) are being excreted by the liver, and fat soluble toxins are excreted via bile. In fact, below are pictures of a cholesterol molecule and an estrogen molecule – no doubt you’ll notice the similarities (and estrogen along with the other sex hormones is made in your body from cholesterol).

    Estrogen and testosterone (progesterone as well, but it's not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

    Estrogen and testosterone (progesterone as well, but it’s not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

  • High Water Use – Pregnancy uses a lot of water – your body is building a human and that’s no small task. It requires that you also create lots of extra blood, extra fluid to protect and support the baby and of course, all the water that goes into the baby.  Not only that but there are thousands of extra metabolic processes happening to make all of this go.  It’s just a big time for water, and so mild to moderate dehydration is incredibly common – especially in early pregnancy before mama’s intake has adjusted sufficiently to cover it all.  Dehydration is also a risk factor for gallbladder sludge just because all bodily fluids, including bile, get a little thicker and sludgier if there is less water to go around.
  • Estrogen – High estrogen is a risk factor for gallbladder sludge, or cholestasis, independent of pregnancy as well (at least it is in animal studies). In fact, the risk factors for gallstones are called the five F’s – Fair, Female, Fat Fertile and Forty. Lovely.
  • Genetics – There are some genetic conditions associated with gallbladder sludge (more specifically with Intrahepatic Cholestasis of Pregnancy, or ICP). So chances are if your mother, aunties, sisters or grandmother had troubles, you may be at greater risk.

Are There Natural Ways to Help Gallbladder Sludge in Pregnancy?

Yes and no. Pregnancy is a risky time to use any natural or medical treatment and many drugs and supplements are off limits because they may cause harm to the baby. If you’re not pregnant, then here’s a whole post about gallbladder sludge and stones. If you are, then here are the things you can do:

  • Diet – Pregnancy is a great time for a healthy diet anyway, so might as well do a healthy gallbladder-friendly diet. This means:
    • No fried foods
    • Lots of fruits
    • Limited red meat, butter, shellfish and eggs
    • LOTS of veggies – especially dark green leafy veg
    • Good lean meat, poultry and fish
    • High fiber foods – aim for 30 – 50 g per day – some examples below
      • Split peas – 16.3 g per cup cooked (split pea soup. Yummy.)
      • Lentils – 15.6 g per cup cooked
      • Black beans – 15 g per cup cooked
      • Artichokes – 10.3 g each and also gently boost liver function
      • Broccoli – 5.3 g per cup boiled
      • Raspberries – the yummiest 8 g per cup ever
      • Bran flakes – 7 g per cup
      • Avocado – 12 g each



  • Water – Bump the water WAY up. Aim for 12 eight ounce cups with 8 eight ounce cups being the absolute minimum. This will suck because pregnancy makes you pee all the time anyway and drinking this much water will have you running to the bathroom constantly. Sorry! It’s better than a gallbladder attack, believe me.
  • Lecithin – Lecithin is safe in both pregnancy and nursing because as it turns out, one of it’s major ingredients, choline, is great for baby. Typically midwives and doctors suggest 1200 mg 3-4 times per day with lots of water, but here’s more information about lecithin and it’s use in gallbladder issues. It’s also great for blocked ducts when you’re nursing and gallbladder sludge even when you’re not preggers.
  • Gentle Exercise Regularly – Exercise is good for everything in the human body, including the gallbladder. For many women this will actually eliminate mild symptoms.
  • Castor Oil – Topical (NOT INTERNAL) castor oil over the right side of your abdomen and back can help your body to deal with some of the sludge in a gentle way. Here’s a whole post on it with more detailed information. And Here’s info on a great lazy method of doing a castor oil pack. This is both anti-inflammatory and also good for the functioning of the liver and gallbladder.
  • Lukewarm Epsom Salts Baths – The magnesium in the Epsom salts will help to relax the bile duct and allow sludge to pass more easily, and the lukewarm bath can help to relieve the itching.

    Doing all of this in 9 months isn't easy! Great picture from free image.com/Jose Torres.

    Doing all of this in 9 months isn’t easy! Gallbladder is one of the places that fallout can happen. Great picture from free image.com/Jose Torres.

What About Not-Natural Ways to Relieve Gallbladder Sludge in Pregnancy?

If you’re having gallbladder attacks on top of the already uncomfortable state of being pregnant, then sometimes you want a faster option. Also severe gallbladder attacks with protracted vomiting, inflammation or infection can be a serious risk to your baby, so there’s that too.

  • Ursodiol – this prescription drug may be suggested by your doctor to help manage symptoms and increase bile flow.
  • Surgery – It is possible to have your gallbladder removed during pregnancy and sometimes it’s necessary. The second trimester is considered the safest time for both mother and baby to undergo this procedure. Depending on your doctor they  may suggest laparoscopic removal or open gallbladder surgery.

Remember pregnancy is a rough time anyway because your body is doing so much, changing so fast and generally working so hard. Be gentle with yourself, talk with your doctor, and don’t judge – sometimes you can use the natural methods for working with gallbladder sludge in pregnancy and sometimes you really do need something more intense, like surgery.



One thought on “Gallbladder Sludge in Pregnancy – What Now?

  1. Heather

    I commented with my experience/questions with pregnancy and sludge on the post about natural remedies for general gallbladder issues (http://dramyneuzil.com/natural-remedy-for-gallbladder-sludge-and-stones/) before this post was published. I just thought I’d update for the moms-to-be who may find themselves in a situation similar to mine who feel torn about their decisions. I was hospitalized with a gallbladder attack that multiple doses of morphine didn’t touch, along with a couple of days of violent, projectile vomiting that would sometimes randomly recur (making it difficult to tell how much was gallbladder and how much was pregnancy). I heavily debated whether or not I should just try to control with diet until my pregnancy was over and have it removed afterward or go ahead with the surgery during pregnancy. Since my attack was around 9 weeks pregnant and I still had so long to go and was feeling so miserable, I I ultimately decided to have my gallbladder laparoscopically removed when I hit my 13th week. I am SO GLAD I did. I am 4 weeks post-surgery now (and 17 weeks pregnant) about have felt so indescribably better. Being able to eat more things with fat has helped with the pregnancy nausea, I have had zero complications with the gallbladder removal, and the baby seemed to hardly notice anything happened. Now I feel almost as if nothing happened and really haven’t seen any digestive changes since before I was pregnant and had any gallbladder issues.

    Obviously if your attacks/symptoms are not as severe, it may be better to try the methods above. However if you are miserable and struggling to function, I thought it may be encouraging to know my experience as you weigh your options.

    Reply

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