Welcome to the Dr. Burg's healthy keto and intermittent fasting podcast where Dr. Burg takes

you on the journey for the truth about getting healthy and losing healthy weight.

You know, when some people do prolonged fasting, they might end up with various symptoms

related to the gallbladder. And that would be right shoulder pain or tightness that can go into

the right side of the neck through here. You can even cause jaw issues or even a headache on the

right side of the head, nauseousness, bloating, a full feeling underneath the right ribcage or pain or

tightness or discomfort underneath the breastbone. And what's happening is the bile is becoming a sludge,

okay. It's called biliary sludge or bile sludge because the bile is becoming very, very thick

because normally when you have the right ratio of bile and cholesterol, everything's fine. But

when the bile becomes deficient to a certain degree, the concentration of cholesterol and other

things in bile become more concentrated or super concentrated. And things start getting thicker

and it backs up to the pipes or tubes, bile ducts. And that causes the symptoms that I just mentioned.

The person may even find that their cholesterol goes up because one of the purposes of bile

is the elimination of cholesterol. And they may even notice on a blood test that they have higher

levels of bilirubin or alkaline phosphatase. That is just an indication that there's some type of

problem with the gallbladder and it's backing up into the liver. Now, normally this shouldn't happen

when someone fast unless there is a pre-existing problem with bile, like a bile deficiency going

into the prolonged fast. Because what happens normally when you eat, the gallbladder contracts

and it squeezes out the bile. But if you're not eating, it doesn't contract. And the purpose of

the gallbladder is to concentrate the bile. But if there's a deficiency of bile for some reason,

which I'll go through those reasons, the person can start developing this sludge that kind of backs

up through these little ducts. So we should probably get our ducts in a row, another definition

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