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The sensation of passing a gallstone, or even of just passing “gravel” from the gallbladder can be excruciating painful. Usually described as a dull, heavy pain during the first few attacks, a complicated case of gallbladder disease can result in pain that feels like stabbing, tearing, twisting, and burning, or “like getting kicked in the gut,” gallbladder pain is debilitating. It can literally take your breath away. It can make going about your daily life impossible. And you can literally turn green as the gallbladder is unable to remove bile salts from the liver to the duodenum (the small intestine), from where they are eventually flushed away.

The most common precipitating event of a gallbladder attack is going on a low-fat, low-cholesterol diet. When there isn't enough extra cholesterol from the diet for the liver to make the bile salts it uses to “lubricate” the gallbladder and the bile duct, gallbladder gravel can stick together and form painful stones. The formation of abnormal, hard material in the gallbladder, however, really takes place over a period of many years.

In about 80% of cases of gallstones, the underlying problem is that the liver removes too much cholesterol in the bloodstream. There is so much cholesterol going into the green, liquid bile that is stored in the gallbladder that the bile salts can't keep it dissolved, so it begins to accumulate as a kind of thick sludge. The sludge slows down the release of bile into the small intestines but does not completely stop it.

If the liver keeps clearing cholesterol out of the bloodstream at a high rate, however, it can become completely insoluble. Sludge becomes gravel, and gravel provides a home for bacteria. These bacteria stick themselves to the gravel with a glue-like protein known as a biofilm, and the biofilm causes bits of gallbladder gravel to form gallstones.

Gallstones can travel down the bile duct past the point that the pancreas sends its digestive enzymes to the intestines, and cause both bile and pancreatic juices to back up into the pancreas and liver. This sends tissue-dissolving enzymes up toward the liver, and prevents the normal digestion of food in the small intestines.

The gallstone usually is not large enough to completely block the flow of bile and pancreatic juices down to the small intestine. The stone may roll back and forth causing a condition known as colic, especially after a high-fat meal, when the liver removes an unusually large amount of cholesterol.

The pain of gallbladder attack radiates from the gallbladder up and out from the right side of the abdomen. It is constant, and nothing you take by mouth will relieve it. Changing positions won't relieve the pain, and neither will the vomiting, flatulence, or diarrhea that often accompany an attack. Typically after 4 or 5 hours the pain subsides, but there are cases in which gallbladder pain goes on for days.

What You Don't Want To Eat On A Paleo Diet If You Have Gallstones

If you have gallbladder attacks, you absolutely, positively do not want to indulge in large servings of high-fat meats. Many paleo dieters indulge in that least paleolithic of modern comfort foods, crispy fried bacon. If you have gallbladder disease, you simply can't be eating lots of fatty meat.

On the other hand, if you have gallbladder disease, you don't want to be fasting for more than 24 hours at a time. Very low-calorie diets of all kinds can aggravate gallbladder problems. If you skip one meal, for example, skipping dinner and then eating brunch instead of breakfast the next day, don't skimp on the meal you eat to break your fast. It's OK to activate fat burning by eating less for a stretch of 12 to 24 hours, but if you eat sparsely one day, it is very important that you eat normally the next. Your liver needs a slight excess of cholesterol so it makes the bile salts that dissolve gallbladder sludge, but it does not need so much cholesterol that the process of elimination is overwhelmed.

What You Do Want To Eat On A Paleo Diet If You Have Gallstones

Most paleo dieters don't count calories, but if you do, you need to make sure you consume at least 1200 calories per day if you are a woman, and at least 1500 calories per day if you are a man. You don't need to eat low-fat, as long as you eat lower-calorie, when your calorie consumption is averaged day by day.

Beyond avoiding “pigging out,” especially on fatty foods like bacon, it can also help to make sure you get truly pure drinking water. A study of rural families in northern India, where water contamination with heavy metals is especially common, has found a direct link between consuming water containing nickel, cadmium, and chromium and activating genes that cause accumulation of fat that leads to gallbladder disease. Gallbladder disease was also associated with exposure to the pesticide DDT. Simply getting pure water and pesticide-free food, over the long run, reduces the risk of gallbladder disease.

Scientists working with people in northern India and northern Pakistan have also found out that there is one food that people there who are especially prone to gallbladder attacks often eat to excess—chickpeas. This means that you need to avoid chickpeas, falafel, farineli, hummus, tapas made with chickpeas, and cocido madrileño to avoid gallbladder attacks.