Gall Bladder Removal and Gout
I had my gall bladder removed a few years ago and since then I have noticed the gout creeping in.
Is there any significance with that? Because of the digestion changing (no gall bladder).
That message from a lapsed GoutPal member started a long discussion about gout and gallbladder. Keith concluded:
Is there a link between gall bladder removal & gout? You need to look at all the circumstances. Is it just surgery that is the problem, or is there a gout link?
Several gout sufferers joined the discussion to say they had gout after gall bladder removal (cholecystectomy). But, nobody supplied any useful, relevant facts. We rarely got the time difference between surgery and gout symptoms starting. We never got any uric acid blood test results.
One member introduced the related topic of gallstones. Lea and son both had a history of gallstones. And both developed gout. They wondered if they had done something to start their gout problems. Brian, a GoutPal regular back in 2008, responded:
“The tendency to have gout runs in families so it is very possible that you didn’t have to do anything. There is no gout gene but there seems to be genes that predispose people to develop hyperuricemia, too much uric acid in the blood. For many gout sufferers, the hyperuricemia precedes the gout often by as much as twenty years. You and your son might have these genes.
Though younger men do develop gout, it is far more common in men over forty. Bile is produced in the liver and stored in the gall bladder. There it becomes more concentrated. The bile does several things including carrying substances (including uric acid) from the liver into the intestines where the uric acid is eliminated. About ninety percent of the hyperuricemics are termed “under secretors” because they do not secrete enough uric acid from their bodies. This lets the uric acid build up in the blood and contribute to gout attacks. About thirty percent of the uric acid is secreted through the intestines in the feces. The body guards the bile very jealously. When the bile has finished transporting the uric acid and other substances, the body reabsorbs the bile through the intestinal lining into the blood. The bile is extracted by the liver and then restored in the gall bladder. Any substance that the body guards jealously is important to the body.”
Keith’s conclusion is:
There is little evidence to suggest a link between gall bladder removal, and gout. Without detailed case histories, including uric acid blood test results, it is impossible to say. The significant points are:
- “Cholecystectomy does not significantly increase the risk of fatty liver disease” has significant information, though it is not a gout study. Over 34,000 subjects were analyzed. People who had gall bladder removed showed no significant change in uric acid levels.
- There are several reports of surgery increasing uric acid level, but this is short term, and not conclusive.
- Where gallstones are present, they should be analyzed for uric acid content.
- There are “between the lines” suggestions that some people who are susceptible to gall bladder problems, might also be susceptible to gout, through poor eating habits.
- Uric acid deposits in the gall bladder might cause damage that necessitates surgery.
As with all aspects of gout, gall bladder involvement has to be investigated on an individual basis. I’ve included this in the Secondary Gout Group, as there is a suggestion that gall bladder removal might cause gout. However, all the evidence suggests that a connection is unlikely. Therefore, gout sufferers who suspect gall bladder problems need to discuss their situation with their doctors. If problems that led to gall bladder removal have been resolved, but uric acid is still high, then they must decide which form of uric acid control is best.
What is your experience with gall bladder removal and gout?
Are Gall Bladder Removal and Gout linked?