@peartree the “continuous drip of bile” mechanism story seems like it works for most people most of the time, so I’m sure it’s justified in its popularity. But in my new life without a gallbladder, as I run an uncomfortable N-of-one experiment every time I eat, drink, or give myself an enema (or don’t), I can tell it isn’t the only thing going on.
The other story that’s popular is that your liver will “learn,” over time, to better tailor how much bile is produced. I don’t know what feedback loops “teach” it, but I believe this, and believe it came into play well before my scarred and ultimately inflamed gallbladder was removed. My liver wasn’t compensating perfectly for a gallbladder that I bet was very poor at ejecting bile, but it did a pretty good job. Now, without the nonfunctional mess of my gallbladder in the way, it probably needs to re-tune its operations.
But that’s also not the only story that seems to matter for me.
There are even more variables, some that I’m still learning. Monthly female hormones seem to have some strong connection to this process; when my estrogen drops not as much bile goes where it needs to go. Caffeine seems to be a big player in forcing my liver to release more bile; a second cup of black tea is usually a recipe for GI pain and irritation. Too much insoluble fiber per meal seems to cause problems, too, which is lousy because I tend to love foods with insoluble fiber.
I suspect these are just a few of the other physiological and mechanical factors contributing to the release of bile and the ratio of bile to free fats in the small intestine.
I’m learning enemas seem to help only with the resulting constipation and the times when the flow of bile must be less than my digestion needs.
When my gut is very irritated with what I suspect is excess bile, I find it hard to retain an enema and now strongly suspect the enema itself causes the release of more bile. While those enemas feel good at first, I’m coming to think they may leave my colon feeling ultimately even more irritated. (Not to mention the spectacular accidents, which can leave my person feeling irritated at the cleanup. Had I not recently purchased a reusable absorbent mat, into which I quickly lost a good 700 mL of enema, I think I would have been scrubbing down half my bathroom floor last Saturday.)
So for now I’m using enemas before my period and after I’ve chowed down on a lot of insoluble fiber, but after very recent experimentation I’m thinking it’s best to abstain if I’ve had too much caffeine or otherwise have the feeling that excess bile is irritating my gut.
My next step will be to try adding some soluble fiber into the mix, which some gallbladderless people seem to recommend. For me all of this is still very much a work in progress.
Tagging @Iris1858 in the event any of this lands as useful for her.
For as much as we understand about the body, it is still an amazing mystery. Or at least mine is.