Is gallbladder sludge linked to your gut bacteria?

Gallbladder sludge is an initial step in the development of gallstones. It causes many people pain but is arguably too early for surgery.  There are, of course, many natural ways to address this issue including a basic protocol, lecithin, and castor oil packs and research is indicating that probiotics might be helpful as well. While it stands to reason that a healthy digestive tract, i.e. one with a thriving colony of beneficial bacteria, will help protect against any digestive disease it is still nice to see the results on paper.

This study, published in the online journal PLoSOne, was actually conducted on different types of mice. These mice were from four groups of genetically related strains that were purchased from different vendors with a very different treatment of the mice in terms of their good bacteria. The researchers use genetically similar mice because genetics plays a role in gallbladder stone and sludge development so having similar genetics eliminates that variable and puts all the mice on an even playing field. The groups of mice differed mostly in their gut flora.  One vendor maintains the mice in a germ-free environment but doesn’t introduce any good bacteria. Another colonizes the mice with a healthy bacterial flora and then maintains a pathogen-free environment after that.

Good gut bacteria like these may be able to help prevent gallbladder sludge and stones. Image from Rocky Mountain Laboratories, NIAID, NIH

Good gut bacteria like these may be able to help prevent gallbladder sludge and stones. Image from Rocky Mountain Laboratories, NIAID, NIH

All of the mice were fed a “lithogenic diet”  meaning a diet that is known to induce gallstones. This diet was essentially similar to a high-fat human diet. Specifically 1% cholesterol, 15% triglycerides and 0.5% cholic acid (one of the components of bile – in humans we would produce this naturally). Results were based on gallbladder weight, the percentage of mucin (or mucus) in the bile, cholesterol crystal formation, sandy stone formation, and presence or absence of true cholesterol stones.




The study found that the mice with the good flora were more resistant to gallbladder sludge than the mice without the good flora. The total gallbladder weight was lower which is important because it represents a measurable way to test inflammation. Inflamed gallbladders grow thicker walls that have a higher content of immune cells and inflammatory particles.  Also the mice without the good flora showed higher percentages of mucin and researchers were able to determine that the good bacteria actually influence the gene expression of those mice.  Healthy gut bacteria is able to down-regulate the action of mucin genes, which contribute to mucus formation in the digestive tract.

Actual cholesterol crystal formation, sandy stone formation and cholesterol stones were also all significantly less in the mice with healthy gut flora.

What Does This Mean for Humans With Gallbladder Sludge?

Mice aren’t people, and although this is certainly something to think about, we can’t jump to the conclusion that gallbladder sludge can be prevented by good bacteria.  We can, however, use common sense to say that chances are having healthy digestive bacteria can help our bodies to maintain healthy digestion. That means that gut inflammation will probably be lower with good flora, there will probably be less mucus, and digestive processes will run more smoothly.  Logically it makes sense that this would lead to less gallbladder sludge formation.

How Do I Get Healthy Gut Flora?

Of course, there are a million probiotic formulas out there all claiming to be the “best” and as a consumer, it can be very difficult to wade through unless there is specific research on a specific product for the specific issue you’re having (which happens only in a handful of cases). There are not any products currently on the market which are researched for gallbladder sludge.  There are a number of ways to increase your good bacteria, many of which are from food.

Increasing Your Good Gut Flora

Your gut bacteria are 100 trillion friends you didn’t know you had. Take care of them!

  • Reduce Antibiotic Use. If at all possible, minimize or eliminate all antibiotics from your life.  Life-threatening illnesses are a different matter and some situations do require antibiotics but work with your doctor to minimize usage that is not absolutely necessary. Antibiotics kill off your good bacteria along with any bad bacteria and overuse is linked to obesity, serious digestive disease along with the more globally threatening antibiotic resistant bacteria.
  • Moderate Processed Foods. Processed foods are typically filled with preservatives, emulsifiers, stabilizers, colors and other chemicals that are foreign to your body and to your more fragile gut flora.  A whole food diet has been shown to foster a very different digestive environment than a processed food diet and so eating foods with fewer chemicals will help your host of tiny helpers.
  • Increase Dietary Fiber.  If you’ve read this blog before you probably know I’m a big fan of fiber. Fiber, especially soluble fiber, helps to feed the good bacteria and provides material for fermentation in your gut.  All of those good bacteria really like fermentation and need the “prebiotics” or bacteria food that the fiber provides.
  • Get More Fermented Foods. Naturally fermented foods like yogurt, kefir, sourkraut and other fermented veggies like spicy kimchee are all rich sources of good bacteria and can help to reintroduce those good strains into your digestion.
  • Grow Some (Organic) Veggies. Many of our good bacteria are soil microorganisms that we are supposed to through contact with, well, soil.  We are supposed to have these good bacteria from the earth and historically we would have got plenty of them by gardening, harvesting, farming and eating vegetables that aren’t “sanitized” before being put on grocery store shelves or irradiated to prevent foreign plant diseases from entering the country with produce. So growing some of your own or buying from a good local organic grower.  Rinsing your veggies as you normally would won’t eliminate all of the healthy bacteria so as long as they haven’t been sprayed with pesticides and herbicides they’re a great source of some of your most potent good flora.
  • Take a Supplement.  The supplements are always an option if that is easiest for you, but don’t forget to do some of the rest of it too. In terms of supplements, every digestive tract is different so it can be helpful to rotate through different types of products with different strains of beneficial bacteria because there isn’t a great way to predict which strains will colonize best in your system.