How Gallstones And Pregnancy May Impact Each Other
The gallbladder is a small pear-shaped storage organ thats located just below your liver. It stores extra bile the liver produces and helps the body digest fats. When a person eats a high-fat meal, the gallbladder releases bile to the small intestine. Extra substances can form hard stones in the gallbladder. The gallstones stop bile from leaving the gallbladder and can cause other problems like inflammation If it causes severe pain, it can be a medical emergency.
Women are more prone to gallstones, especially Pregnant women are at high risk because their bodies make more estrogen that can lead to an increased amount of cholesterol in the bile, and also reduce gallbladder contractions. This slowing of gallbladder contractions during pregnancy is known as cholestasis of pregnancy.
Cholestasis of pregnancy can increase pregnancy complications, such as
- Premature birth
- Passing meconium before birth, which can affect a babys breathing
Gallstones may cause the following symptoms. These attacks mostly take place after a high-fat meal and last about an hour
- jaundiced appearance
- pain in the upper right or middle part of your stomach where your gallbladder is located
Some pregnant women may develop silent gallstones, without any symptoms.
You must seek emergency medical attention if your symptoms dont go away within one to two hours as they indicate that the gallbladder is inflamed or infected
How To Boost Female Fertility
There are many things women can do to boost their fertility and increase their chances of becoming pregnant. Some simple tips include:
1) Make sure you are getting enough folic acid. This vitamin is important for maintaining a healthy pregnancy. Good sources of folic acid include leafy green vegetables, legumes, and fortified foods.
2) Watch your weight. Being overweight or underweight can impact your fertility.
3) Exercise regularly. Exercise has been shown to improve fertility.
4) Quit smoking and drinking. Smoking and drinking can damage your fertility.
5) Avoid exposure to environmental toxins. Chemicals and pollutants can harm your fertility.
6) Take a multivitamin. A multivitamin can help ensure you are getting all the nutrients you need for optimal fertility.
7) See a fertility specialist. If you have been trying to conceive for a while and are not having success, it may be a good idea to see a fertility specialist. They can help you determine what may be causing your fertility problems and provide treatment options.
Symptoms Of Gallbladder Problems During Pregnancy
Cholestasis of pregnancy can cause very specific symptoms. These include:
- intense itching
- jaundice, where a persons skin and eyes take on a yellow tint because theres too much bilirubin in a persons blood
- urine thats darker than usual
Cholestasis of pregnancy can sometimes be hard for a pregnant woman to recognize. Thats because her growing belly can cause the skin to become itchy as it stretches. But itching related to the gallbladder is because bile acids that builds up in the blood can lead to intense itching.
Gallstones can cause the following symptoms. These attacks often occur after a high-fat meal and last about an hour:
- jaundiced appearance
- pain in the upper right or middle part of your stomach where your gallbladder is
If the pain doesnt go away in a few hours, this could indicate that something more severe is happening with your gallbladder.
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Are My Gut Symptoms Telling Me Something About My Fertility
Sometimes gut symptoms can be a signal that there is something else happening in the body, too. This includes conditions that may affect our fertility.
One of the possible symptoms of endometriosis is altered bowel habits. It is not uncommon for women with endometriosis to experience frequent bloating, abdominal cramps, diarrhoea or constipation. There are high rates of gastrointestinal symptoms and IBS in women with endometriosis .
This is not meant to sound scary, but rather to encourage you to seek professional advice and have things investigated if you are experiencing long term gut symptoms.
If you receive a medical diagnosis of endometriosis, making changes to your diet may help. With professional supervision, a low FODMAP diet may potentially help in the management of gut symptoms.
Read more about the low FODMAP diet for endometriosis here.
Egg Count Female Fertility Age Chart
There are many factors to consider when trying to conceive, and egg count is one important consideration. This chart shows the average number of eggs remaining in a womans ovaries at different ages.
Age Egg count at birth 1,000-2,000 20-30 400-500 30-40 300-400 40-50 200-300 50-60 100-200 60-70 50-100
As you can see, the number of eggs decreases as a woman gets older. This is why it is important for women to consider their fertility sooner rather than later. If you are trying to conceive, it is important to track your ovulation and consult with a doctor if you have any questions or concerns.
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How Is Gallbladder Disease Treated During Pregnancy
Your doctor may prescribe medication and suggest that you make lifestyle changes like eating fewer fatty foods and getting regular exercise.
If the inflammation is severe, or if there’s an infection, an operation may be necessary to remove your gallbladder and prevent more serious complications.
If you need your gallbladder removed it will probably be done laparoscopically. The surgeon makes two small abdominal incisions, inserting surgical instruments and a laparoscope. The laparoscope has a tiny camera that transmits a picture of the organs to a video monitor.
The gallbladder can then be removed without having to create a large incision. This means less pain and an easier recovery.
Symptoms And Complications Of Gallstones During Pregnancy
Not everyone experiences symptoms with gallstones, but if you do, they can be quite serious. The following occurrences are all signs of a gallstone:
- Severe and continuous pain in the upper right part of the abdomen especially after a fatty meal
- Intense itching
- Fever and chills may be present
- Yellowing of the skin and whites of the eyes
- Clay colored stools
Seek immediate medical attention with any combination of these symptoms. Gallstones cause inflammation and can develop into cholestasis of pregnancy, and the slowing of gallbladder contractions. This most often occurs due to an insufficient amount of bile release.
Excess hormone production is another common contributor to gallstones. Having too much estrogen in the body increases the amount of cholesterol in our bile, which then begins to trigger cholestasis of pregnancy and additional complications.
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Surgical Removal Of The Gallbladder Or Gallstones
Around 80 per cent of people with gallstone symptoms will need surgery. Surgeons may remove your entire gallbladder , or just the stones from bile ducts.Techniques to remove the gallbladder include:
- laparoscopic cholecystectomy keyhole surgery. The surgeon makes a number of small incisions through the skin, allowing access for a range of instruments. The surgeon removes the gallbladder through one of the incisions
- open surgery the surgeon reaches the gallbladder through a wider abdominal incision. You might need open surgery if you have scarring from prior operations or a bleeding disorder.
Food Sensitivities Or Intolerances
Food sensitivities trigger low-level inflammation, making them potential suspects in any case of infertility. The same is true of food intolerances, which can occur when the body is deficient in an enzyme necessary to break down certain food substances, like lactose in dairy or gluten in wheat. If you have a food intolerance, eating even a small amount of the offending food can trigger systemic immune activation, causing widespread inflammation.
Unlike anaphylactic allergies that can close your airways upon exposure, the symptoms of food sensitivities can take up to 72 hours to set in and may seem counterintuitive. This makes them difficult to recognize. How theyre manifested can be different in different people, says Myers. It could be headaches, swelling, digestive issues, or brain fog.
What You Can Do: If youre unsure whether you have sensitivities or intolerances, work with a practitioner who tests for and treats immunoglobulin G, or IgG, sensitivities. Avoid trigger foods and load up on anti-inflammatory whole foods and spices, like turmeric and ginger.
Be aware that these tests can produce false negatives. The gold standard for sleuthing out both food sensitivities and intolerances is an elimination diet, like the one created by the Institution for Functional Medicine.
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Gallbladder And Sex Hormones
It has long been known that both pregnancy, long-term oral contraceptive use and hormone replacement therapy contribute to the formation of gallstones and the accompanying symptoms of pain, indigestion, burping, gas and bloating, and possibly nausea. But what are the underlying mechanisms involved?
Estrogen and progesterone when present in excess cause three separate alterations in the biliary system:
- a higher ratio of cholesterol to bile salts also called super saturation of bile
- a higher propensity of the bile to aggregate or clump together or stickiness of bile
- a lower than normal functioning of gallbladder emptying leaving bile sitting stagnant in the gallbladder sac
Note from Magdalena: On the other hand, the bile helps the liver to excrete hormones like excess estrogen and its harmful metabolites. That explains why women who have their gallbladders removed often suffer from symptoms of estrogen dominance a few months after the surgery.
Counteracting the effects of the female hormones on the biliary tree
There are always choices that can help pregnancy excluded.
- Choosing contraceptive measures other than hormones.
- Chinese and western herbs including adaptogens, nutrients and adrenal support to manage the symptoms of both menopause and peri-menopause.
- Support bile thinning, bile flow and liver detoxification.
Blood Test For Fertility Female
There are many blood tests that are used to diagnose fertility problems in women. One common blood test is the FSH test. This test is used to measure the level of FSH in a womans blood. FSH is a hormone that is produced by the pituitary gland in the brain. This hormone is responsible for the development and release of eggs from the ovaries. A high level of FSH indicates that the ovaries are not responding well to the FSH hormone and that the woman is not producing enough eggs. This could be due to a number of factors, including age, weight, and health problems. A low level of FSH indicates that the ovaries are responding well to the FSH hormone and that the woman is producing enough eggs. This could be due to a number of factors, including a young age, a healthy weight, and good health.
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The Gallbladder Hormone Connection
What is the gallbladder, and what does it do?
- Sudden onset pain just underneath your right ribcage, in your abdomen, occasionally associated with heartburn, nausea, gas, and fullness
- Pain between your shoulder blades
- A chronic ache in your abdomen that intensifies after eating
- complete blockages will result in pale, greasy, floating stools, and dark amber colored urine
So where do hormones come into play? MelatoninThyroxineEstrogen and ProgesteroneCortisol,What other variables contribute to gallbladder dysfunction?Eating less oftenRapid weight lossWomen are more likely than menMaintaining Gallbladder Health
- Heart-healthy nuts like almonds, brazil nuts, or cashews
- Fatty fish like salmon, tuna, or sardines
- Foods rich in fiber, like broccoli, lentils, and legumes
How Are Gallstones Diagnosed
In some cases, asymptomatic gallstones are discovered byaccident–during testing for another diagnosis. However, when painpersists or happens again and again, your health care provider may wantto conduct a complete medical history and physical examination, inaddition to the following diagnostic procedures for gallstones:
Ultrasound. A diagnostic technique that uses high-frequency sound waves to create an image of the internal organs.
Cholecystography. X-ray that shows the flow of contrast fluid through the intestines into the gallbladder.
Blood tests. These look for signs of infection, obstruction, jaundice, and/or pancreatitis.
Computed tomography scan . A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Endoscopic retrograde cholangiopancreatography . A procedure that involves inserting an endoscope through the stomach and into the small intestine. A special dye injected during this procedure shows the ducts in the biliary system.
Sphincterotomy. Opening the muscle sphincter, a ring of muscle around a natural opening that acts like a valve, wide enough so stones can pass into the intestine.
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How To Prevent Gallstones During Pregnancy
Here’s what you can do to help lower your risk of gallstones during pregnancy:
- Gain a healthy amount of weight. Obesity is a major risk factor for the development of gallstones in women. Pregnancy is not a time for weight-loss diets, but working with your doctor to avoid excess weight gain can help.
- Eat a high-fiber diet. Too little fiber can increase your risk of developing gallstones. Eating more fiber-rich foods can help keep your gallbladder and your baby healthy.
- Choose the right fats. Monounsaturated fats and omega-3 fats help prevent gallstones, while foods high in saturated fat tend to promote their formation.
- Cut back on sugar and other refined carbohydrates. Sugar and products made from white or refined flour such as many types of bread, pasta, crackers, and chips increase the risk of gallstones. They also provide mostly empty calories, which is not something you or your baby really need.
- Manage diabetes. People with diabetes often have high triglyceride levels, and both conditions have been linked to an increased risk of gallstones. So work with your doctor to keep your diabetes under control while you are pregnant.
Avoiding gallstones during pregnancy may just take some small tweaks to your routine. But talk to your doctor if you are at higher risk for gallstones, or are developing any worrisome symptoms during your pregnancy.
Additional reporting by Erica Ilton, RDN.
How Can People Find Out If They Took Des During Pregnancy Or Were Exposed To Des In Utero
It is estimated that 5 to 10 million Americanspregnant women and the children born to themwere exposed to DES between 1940 and 1971 . DES was given widely to pregnant women between 1940 and 1971 to prevent complications during pregnancy. DES was provided under many different product names and also in various forms, such as pills, creams, and vaginal suppositories . The table below includes examples of products that contained DES.
|DES Product Names|
Women who think they used DES during pregnancy, or people who think that their mother used DES during pregnancy, can try contacting the health care provider or institution where they received their care to request a review of their medical records. If any medications were taken during pregnancy, obstetrical records could be checked to determine the name of the drug.
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Gallbladder Disease After Pregnancy
It’s not uncommon for gallbladder disease symptoms to appear two to four months after delivery. This may be because pregnancy hormones aggravated the problem during the preceding nine months, and it takes a while for things to go back to normal. Changes in your hormone levels after delivery may also be the culprit.
Gallbladder problems may also result from rapid weight loss after delivery. When you burn fat quickly, extra cholesterol accumulates in the bile, which can lead to gallstones.
To reduce your risk of developing gallstones after pregnancy:
- Eat a high-fiber diet that includes plenty of fruit, vegetables, and whole grains.
- Keep weight gain during pregnancy to recommended amounts.
- Keep your postpartum weight loss to no more than a pound and a half a week if you’re breastfeeding.
- Get a healthy amount of exercise.
If you had gallbladder disease that was controlled during pregnancy and no surgery was required, it’s important to have a follow-up evaluation. Symptoms can occur in the postpartum period or later in life, so have an evaluation when you’re not in pain. Your doctor may recommend that you have your gallbladder removed to avoid an emergency situation later.
Fong ZV et al. 2019. Cholecystectomy during the third trimester of pregnancy: Proceed or delay? Journal of the American College of Surgeons. 228: 494-502.
All Paths Lead To Inflammation
Blum, like most functional- and -integrative-medical practitioners, believes inflammation is the root of most health challenges, including infertility. Searching for a remedy without addressing inflammation, Gottfried says, is like trying to clean up the house while a frat party is in progress.
Pain, swelling, redness, and heat are inflammations four signature characteristics. You can see it when its on the outside of your body, says Blum, but imagine thats happening on the inside of your organs and you dont even know it.
Chronic inflammation involves constant immune activation the body is flooded with inflammatory cytokines. This occurs when the immune system faces an overabundance of triggers, including environmental toxins, food sensitivities, and chronic stress.
Inflammatory responses can easily trigger early pregnancy loss. The successful introduction of an embryo requires the maternal immune system to distinguish between a hostile invader and a welcome guest, a process that has its roots in the evolution of mammalian reproduction, when some creatures evolved beyond laying eggs.
The problem with eggs was that they were tasty and other animals ate them, says Jeffrey Braverman, MD, a specialist in reproductive immunology in New York City. So, creatures that could hold babies inside the body until they were fully developed began to evolve. This required a change in the immune system because these babies had paternal genetics that were foreign to the mother.
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