Gallstones diet: foods to eat and avoid

What are gallstones?

Gallstones occur when bile, which is normally fluid, forms stones in your gallbladder. This is the organ that sits beneath the liver. Most commonly, gallstones contain lumps of fatty (cholesterol-like) material that has solidified and hardened.

You can have just a few small stones or a great many. Occasionally, just one large stone is formed. For more information, see the separate leaflet on Gallstones and bile.

How common are gallstones?

About one in three women and one in six men form gallstones at some stage in their lives. Gallstones become more common as you get older. The risk of gallstones forming increases with:

• Pregnancy.

• Obesity.

• Diabetes.

• Smoking.

• Rapid weight loss.

• Having a close relative with gallstones.

• Taking certain medicines such as the contraceptive pill.

• Eating a generally unhealthy diet, particularly a diet which is high in fat.

The role of the gallbladder in digestion

The gallbladder plays a part in the digestion of food. It collects and stores bile, then releases the bile into the small intestine when food enters the small intestine from the stomach. This helps with the digestion of food because the gallbladder contains bile salts and other substances which break down fat.

The bile duct, which connects the gallbladder to the small intestine, can become blocked by gallstones. This may cause symptoms such as:

• Pain.

• Bloating.

• Feeling and being sick.

The stone may cause a blockage and make it difficult for the bile to be released from the bile duct.

Gallstones diet

Foods to eat with gallstones

There is no specific gallstones diet, but eating a healthy balanced diet that's very low in fat can help with symptoms:

• Plenty of fruit and vegetables. Aim to have at least five portions each day.

• Plenty of starchy carbohydrates. Examples include bread, rice, cereals, pasta, potatoes, chapattis and plantain. Choose wholegrain varieties where possible.

• Some milk and dairy products (2-3 portions per day). Choose very low-fat dairy products.

• Some meat, fish, eggs and alternatives such as beans and pulses.

• Limited amounts of foods high in fats and sugars. Limit saturated fat that is found in animal products, such as butter, ghee, cheese, meat, cakes, biscuits and pastries. Replace these with unsaturated fats found in non-animal products, such as sunflower, rapeseed and olive oil, avocados, nuts and seeds. But remember that unsaturated fats can also trigger gallstone pain.

• Make sure your diet is high in fibre. This can be found in beans, pulses, fruit and vegetables, oats and wholegrain products, such as bread, pasta and rice.

• Drink plenty of fluid - at least two litres daily, such as water or herbal teas.

Will a gallstones diet cure my symptoms?

Most people with gallstones will have surgery to remove the gallbladder in an operation called a cholecystectomy. However, eating a low-fat diet is likely to reduce symptoms while you are waiting for the operation. This is because fatty foods stimulate the gallbladder to release bile into the small intestine.

Once you have had the operation there is no need to follow any particular diet, although of course it is always a good idea to eat as healthily as possible.

If you are overweight, attaining a healthy weight will be beneficial. However, it is important to do this gradually, as rapid weight loss has been associated with the development of gallstones. A safe weight loss of 1-2 lbs (0.5 to 1 kg) per week is recommended. See the separate leaflet on Weight reduction.

See the separate leaflet on Healthy eating.

Foods to avoid with gallstones

• High-fat foods - try not to eat too much fat at one mealtime. It might be helpful to have smaller, more frequent meals.

• Individual food triggers -some people find that specific foods are the triggers for symptoms. Keep a food and symptom diary to identify trigger foods. Avoid these foods for a two-week trial period and note any improvements in symptoms.

Cutting down on fat

A high-fat diet and fatty foods can sometimes cause discomfort and painful symptoms. They may also cause fatty poos (steatorrhoea), which are oily, pale and smelly. Steatorrhoea is a sign that fat is not being digested properly.

Here are some ways to cut down on fat in the diet.

High-fat foods	Lower-fat alternatives
Butter, lard, ghee, oils, spreads.	Lower-fat/light spreads, oil sprays for cooking, jam, honey.
Whole milk, cream, full-fat yoghurts.	Skimmed milk, half-fat crème fraîche, low-fat evaporated milk, low-fat or fat-free yoghurt.
Full-fat cheese, such as Cheddar, Brie and Stilton.	Cottage cheese, light soft cheeses such as , quark, reduced-fat Cheddar cheese or naturally lower-fat cheeses such as mozzarella and ricotta (matchbox-sized portion).
Snacks, such as cakes, biscuits, pastries, crisps and nuts.	Toasted teacakes, low-fat popcorn, fruit and vegetables, dried fruit, meringues, rice cakes.
Puddings, such as pies, ice cream and custards.	Jelly, sugar-free jelly, low-fat custard, rice pudding made with skimmed milk, sorbet, tinned or stewed fruit, low-fat yoghurts.
Sauces and dressings, such as mayonnaise, creamy sauces.	Vinaigrettes, mustard, lemon juice, fat-free salad dressings, tomato-based sauces (some can contain oil), salsa, balsamic dressing.
Meats and processed meats, such as sausages, salami, corned beef, bacon, gammon, pork, lamb, beef mince, beef burgers, meat pies, fish tinned in oil.	Chicken, turkey, lean ham, lean or extra lean beef mince, turkey mince, red meat with visible fat cut off, and white fish, such as cod, haddock, pollock, and fish tinned in brine or water.

Note: many processed foods that are low in fat can contain high amounts of sugar. Check the labels for high-sugar products and try to keep these to a minimum. A product that is high in sugar contains more than 10 g of sugar per 100 g.

Reduced-fat, light and low-fat are not the same thing. If a product is low-fat, this means that the product contains 3 g or fewer of fat per 100 g and is actually low in fat. A reduced-fat product does not mean that the product is necessarily low in fat. It means that the product contains 25% less fat than the original product, which is usually a very high-fat product, such as mayonnaise or Cheddar cheese.

This is similar for 'light' products, which contain about a third fewer calories than the original product, or 50% less fat. Therefore, keep these to a minimum when choosing reduced-fat or lighter products.

How to prevent gallstones

You can also reduce your risk of developing gallstones through what you eat:

• Eating vegetable protein - for example, beans and pulses.

• Increasing fibre intake.

• Eating nuts.

• Increasing dietary calcium.

• Increasing vitamin C intake.

• Drinking coffee.

• Drinking a moderate amount of alcohol.