Nanci Miklowski, ND
What Your Gallbladder Does & How to Keep it Healthy
Updated: Dec 8, 2022
On the right side of your abdomen, just under the ribcage, is the gallbladder. A small pear-shaped organ, it supports the body's detoxification process and, working with other organs, is crucial to the digestion of certain foods, particularly fatty foods.
The gallbladder connects to the liver and small intestine via ducts that transport bile (a yellowish-green liquid secreted by the liver). Together, the gallbladder and these ducts are known as the biliary system. Bile contains water, cholesterol, lipids (fats), salts, and bilirubin (the pigment that gives bile and stools their color). A healthy gallbladder stores and concentrates bile, secreting it into the small intestine through the bile duct during the digestive process. Once in the small intestine, bile helps digest fat.
Causes of Gallbladder Dysfunction
An unhealthy gallbladder can result in problems with both digestion and detoxification and can be attributed to a number of causes including:
Unhealthy diet and lifestyle habits
Hypothyroidism and hormone dysregulation
Hyperkinetic Biliary Dyskinesia: This is when the gallbladder contracts too frequently. This causes extreme pain that feels like it is emerging from the heart. Symptoms include increased heart rate, decreased muscle strength, and elevated pressure in the gallbladder.
Hypokinetic Biliary Dyskinesia: The gallbladder does not contract frequently enough (more common condition than above). Symptoms include pain in the upper right abdomen after eating a high-fat meal, as well as indigestion, nausea, vomiting, bloating and fatigue. Pain and cramping does not subside when gas is passed or by a bowel movement.
Cholelithiasis: This is the presence of one or more calculi/gasllstones in the gallbladder. There is the potential for them to become lodged in ducts and block the flow of bile. Gallstones develop when substances in the bile, primarily cholesterol and bile pigments, form hard, crystal-like particles. These "stones" can be incredibly small or as large as the gallbladder itself.
The most common symptom of gallstones is intermittent abdominal pain and spasm in the right upper abdomen (may also be felt in the back and right shoulder). Other symptoms include nausea, vomiting, and intolerance to fatty foods. Recurrent duct blockages can lead to a total obstruction that results in significant fever and requires immediate medical attention. Other complications include jaundice, a yellow discoloration of the skin and eyes; infection of the bile ducts; and inflammation of the pancreas. If the bile duct remains blocked for a long period of time, irreversible liver damage may occur.
The Gallbladder and SIBO
Small intestinal bacterial overgrowth (SIBO) is a condition where bacteria normally found in the large intestine have established in the small intestine. The small intestine is not home to many bacteria so this influx can lead to symptoms such as bloating, belching, stomach pain, constipation, and diarrhea. Lack of proper bile flow can increase the risk of SIBO for a couple of reasons. First, bile has antimicrobial properties. This helps keep the bacteria population under control in the small intestine. Secondly, bile stimulates motilin which activates the migrating motor complex (MMC) during the fasted state. The MMC is like a sweeper system that pushes bacteria and food debris to our large intestine. Without a properly functioning MMC, bacteria can accumulate in the small intestine leading to unpleasant side effects.
How to Maintain a Healthy Gallbladder
Commit to a diet high in fiber, low in hydrogenated fats, along with fresh whole fruits and vegetables. If you are at risk for gallbladder disease, consider these dietary adjustments:
Include bile-stimulating produce in your diet like beets, carrots, artichokes, bitter greens, and apples.
Choose organic oats, brown rice, quinoa, or barley for healthy fiber sources.
Sit-up while eating. Chew foods well and take your time eating.
Include more fish in your weekly menu.
Avoid processed food and foods containing trans-fatty acids and highly processed oils.
Include healthy oils such as olive oil, coconut oil, and avocado oil in your daily diet.
Reduce dairy intake.
Drink plenty of water throughout the day.
Exercise regularly; walk leisurely after meals to facilitate digestion.
Take digestive support supplements, such as enzymes or ox bile, if recommended by your health practitioner.
Dietary changes are unique to everyone so it is important to discuss your needs with a holistic health practitioner who specializes in clinical nutrition and can customize a diet and nutritional supplement plan for you.
Support Digestive Health with Ox Bile
If the gallbladder is removed, the body does not have a way to efficiently digest fats. Ox bile (or another bile salt) is a common supplement used to support the digestion of fats in people who do not have a gallbladder.
Before we can talk about what an ox bile supplement is and why you might consider taking it, you have to know a little something about bile. Bile is a greenish-yellow fluid produced by the liver and stored in the gallbladder. In your intestine, bile makes it easier to digest food that contains fat; it also helps the body eliminate waste products and absorb vitamins A, E, D, and K. Bile also helps dissolve gallstones.
Ox bile supplements are commonly used in Traditional Chinese Medicine for the prevention and treatment of digestive illnesses, from the mild (constipation) to severe (IBS). If you're looking to strengthen your gut and digestion, taking an ox bile supplement as recommended by your health practitioner can help support digestion and keep your gut microbiome healthy.
Ox bile works in the body the same way as the bile that is naturally produced by your liver. However, it must be taken at very specific times. A holistic health practitioner is the best person to speak with about using an ox bile supplement, to ensure that you receive the right dose and schedule for taking it.
HealthLinkBC.ca "Eating Guidelines for Gallbladder Disease." Accessed 26 May 2020: https://www.healthlinkbc.ca/healthy-eating/gallbladder-disease
GallbladderAttack.com "What You Need To Know About Biliary Dyskinesia." Accessed 26 May 2020: https://www.gallbladderattack.com/blog/what-you-need-to-know-about-biliary-dyskinesia/
ClevelandClinic.org "Diet for Gastroparesis." Accessed 26 May 2020: https://my.clevelandclinic.org/-/scassets/files/org/digestive/gastroparesis-clinic/diet-for-gastroparesis.ashx?la=en
Pizzorno, Joseph E. (2013). Textbook of Natural Medicine (4th ed). St. Louis, MO Elsevier
Wang, David Q-H, and Martin C Carey. "Therapeutic uses of animal biles in traditional Chinese medicine: an ethnopharmacological, biophysical chemical and medicinal review." World journal of gastroenterology (2014) 20:29, 9952-75. doi:10.3748/wjg.v20.i29.9952
Healthline.com "Everything You Wanted to Know about Bile Salts." Accessed 22 May 2020: https://www.healthline.com/health/bile-salts
Johnson, Leonard R. (2003). Encyclopedia of Gastroenterology. Memphis, TN Elsevier.