The Under-Appreciated Gallbladder

On the right side of your abdomen, just under the ribcage, is your 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 fats and fat-soluble vitamins (A, D, E and K).

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

• Excessive stress

• Gastrointestinal illness

• Obesity

• Nerve degeneration

• Inflammation

• Hypothyroidism and hormone dysregulation

• Anatomical abnormalities

Gallbladder Conditions

Hyperkinetic Biliary Dyskinesia: 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: Caused by gallstones becoming lodged in ducts and blocking 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.

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 (taken with meals containing fats) used to support the digestion of fats in people who do not have a gallbladder. The ability to break down and use fats properly is crucial to your health and if you notice that you have greasy or floating stools, or excessively dry skin, you may not be breaking down fats sufficiently.

Maintain a Healthy Gallbladder:

If you still have your gallbladder, commit to a diet high in fiber, fresh vegetables and fruits, and low to no hydrogenated or inflammatory fats. If you are at risk for gallbladder disease, consider these dietary adjustments:

• Eat lots of colorful, fresh vegetables for healthy fiber sources

• Drink plenty of water throughout the day - shoot for half your weight in ounces daily

• Exercise regularly; walk leisurely after meals to facilitate digestion

• Sit-up while eating; consider adjusting timing and frequency of meals (at least 4 hours between meals is ideal)

• Chew foods well and take your time eating

• Choose lean cuts of meat and poultry from pasture-raised animals who are fed their natural diets (not corn or soy). Prepare meat in a way that allows fat/grease to drip away, and remove the skin from poultry.

• Include small, wild caught fish in your weekly menu (e.g. wild salmon, mackerel, sardines, anchovies)

• Avoid processed food and foods containing trans-fatty acids and highly processed oils (these include oils like canola, soybean, peanut and refined nut and seed oils as well as animal fats from factory farmed animals)

• Include healthy oils such as olive oil, coconut oil, and avocado oil

• Trade dairy products for minimally processed non-dairy milk, cheese and yogurt

• Take digestive support supplements, such as digestive enzymes and/or ox bile

Dietary changes are unique to everyone so it is important to discuss your needs with a holistic health practitioner or Functional Medicine Doctor who can customize a diet and nutritional supplement plan for you.

Support Digestive Health with Ox Bile

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 your system handle some of the less healthy foods you eat from time-to-time.

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.

Manipulative Therapy for Gallbladder Dysfunction

If you're suffering from gallbladder dysfunction, consider the benefits of manipulative therapy; it's a hands-on method of manipulating the soft tissue and/or bony structures associated with a specific region of the body, as well as the pathways that innervate and nourish that region. Often combined with manual therapy (soft tissue therapy that focuses on massage and trigger points), manipulative therapy is aimed at normalizing structural and functional processes in the body that are under stress. By helping the body move toward more balanced function, it can relieve symptoms of disease, including gallbladder dysfunction.

Gallbladder dysfunction is characterized by the inability of certain parts of the biliary system to facilitate the normal flow of bile from the liver to the gallbladder for storage and concentration. A disturbance in the system can stem from a neural or hormonal signaling problem or inability of the gallbladder to contract. This causes problems with the ejection of bile from the gallbladder -- either too slow or too fast - and can lead to varying symptoms depending upon the individual. Manipulative Therapy helps regulate the bile flow by removing blocks in the signaling pathways and/or supporting the healthy contraction of the gallbladder.

Manipulative therapy can be safe, effective and beneficial for many patients. It can potentially eliminate the need for more invasive treatments, including surgery. Make sure that you choose a physician (not a physical therapist or massage therapist) who specializes in manipulation and gallbladder conditions.

References:

What Your Gallbladder Does & How to Keep it Healthy

• 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

Support Digestive Health with Ox Bile

• 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

Osteopathic Manipulative Therapy for Gallbladder Dysfunction

• Mirocha NJ, Parker JD. "Successful treatment of refractory functional dyspepsia with osteopathic manipulative treatment." Osteopath Fam Phys. 2012:4(6);193-196. Accessed 26 May 2020: https://www.sciencedirect.com/science/article/pii/S1877573X12000366?via%3Dihub

• Heineman K. "Osteopathic Manipulative Treatment in the Management of Biliary Dyskinesia." J Am Osteopath Assoc 2014;114(2):129–133. Accessed 26 May 2020: doi: https://doi.org/10.7556/jaoa.2014.027.

• Branyon B. "Healing hands: using osteopathic manipulative treatment to address visceral structures through somatovisceral reflexes-a case study in gastroesophageal reflux disease". Am Acad Osteopath J. 2008;18(4):29-31. Accessed 26 May 2020: http://ostemed-dr.contentdm.oclc.org/cdm/ref/collection/myfirst/id/8651

• Gallbladderattack.com "Biliary Dyskinesia." Accessed 26 May 2020: https://www.gallbladderattack.com/blog/what-you-need-to-know-about-biliary-dyskinesia/