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There have always been anecdotal reports of people starting to experience gall bladder problems after adopting a low carb (and, usually higher fat) way of eating. The research now shows that this is most common in people who are switching over from long periods of severely restricting fat intake. The gall bladder stores and concentrates bile, which is required for fat digestion, and it delivers the bile to the stomach on an "as needed" basis. If a person has underlying gall bladder disease, it is possible to have relatively few symptoms on a fat restricted diet.   In people like that, suddenly challenging the gall bladder with a low carb way of eating can unmask the underlying problems in a dramatic way.