Integrative Treatment Options for Common Gallbladder Disorders: Specialty Testing, Nutrition, Supplements

The gallbladder is a pear-shaped organ of digestion. This organ serves an important function in the body, specifically assisting in the digestion of fats. This article will discuss what the gallbladder is, including its role in the body and common conditions that affect the gallbladder. We’ll then discuss how gallbladder diseases are diagnosed, including functional medicine labs that can further evaluate gallbladder diseases. Lastly, we’ll discuss conventional and integrative, as well as complementary treatments for gallbladder disease. 

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What is The Gallbladder?

The gallbladder is an organ located inside the abdomen. The gallbladder is a smaller organ, ranging from 3.7 to 4.9 inches in length and about 2 inches wide. It sits underneath and is connected to the liver. The gallbladder also connects to a structure called the cystic duct, which will eventually lead to the small intestine. In fact, there are many ducts in this area, connecting the liver, pancreas, and gallbladder to the first part of the small intestine. This network of ducts, along with the gallbladder, is referred to as the biliary tract.  

What is The Gallbladder's Role in The Body?

The gallbladder's role in the body involves its connecting organ, the liver. A main function of the liver is to produce a substance called bile. Bile is a type of digestive juice made up of bile acids, bilirubin, cholesterol, inorganic salts, and more. Bile is used explicitly in the breakdown of dietary fats and the absorption of the fat-soluble vitamins A, D, E, and K. The liver produces bile and sends it directly into the small intestine when food containing fat is being digested. In the absence of fat, the liver will send the produced bile via small ducts to the gallbladder for storage. Once food containing fat is being digested, the gallbladder will begin its pumping action to squeeze out and move bile into the small intestine. 

What are the Top Medical Conditions Associated with The Gallbladder?

The top medical conditions associated with the gallbladder include:

Gallstones

Gallstones are small structures that form as a result of bile precipitation and hardening and often include cholesterol. Gallstones can be tiny or as large as a golf ball. Symptoms of gallstones occur when one or more gallstones get stuck in a duct of the biliary tract, causing a blockage. Symptoms include sudden onset pain in the upper right portion, or center, of the abdomen. The pain may continue to worsen before being relieved. Pain radiating between the shoulder blades and nausea and vomiting are also common symptoms. Certain conditions may increase the risk of gallstones, including diabetes, liver disease, pregnancy, inflammatory bowel disease, cystic fibrosis, and biliary tract infections. Increased intestinal permeability or “leaky gut”, dysbiosis in the gut microbiome, and small intestine bacterial overgrowth (SIBO) predispose someone to gallstones. Additionally, bone marrow or organ transplants, the use of estrogen-containing medications, including oral contraceptives and hormone replacement therapy, and medications that cause the destruction of red blood cells can all raise the risk of developing gallstones. Women, those over the age of 40, people who are overweight, a family history of gallstones, and individuals who eat a diet high in processed fats and sugars with low fiber intake are more likely to develop gallstones. 

Cholecystitis

Cholecystitis is inflammation of the gallbladder. Cholecystitis is the most common form of gallbladder disease. Cholecystitis occurs when there is a blockage in the biliary tract, causing backflow of bile into the gallbladder. Symptoms of cholecystitis include abdominal swelling, abdominal pain worse with breathing, pain in the back or right shoulder blade, nausea, vomiting, yellowing of the skin (jaundice), loose stools that are light in color, and fever. Cholecystitis may require immediate medical care. Gallstones, tumors in the pancreas or liver, bacterial infections, or conditions that reduce blood flow to the liver can cause cholecystitis.

Bile Acid Diarrhea

Once the digestive process is complete, bile in the small intestine should enter the bloodstream to be reabsorbed and recycled by the liver. If this does not happen, bile continues down the digestive tract and moves to the large intestine. Due to its presence, water and salt will be pulled into the large intestine, leading to watery diarrhea. Symptoms of bile acid diarrhea include increased amounts of stool, bowel movement urgency, gas, abdominal pain, night-time bowel incontinence, and possible loss of control of bowel movements. If bile acid diarrhea becomes chronic, it may lead to dehydration and bile acid deficiency, which would cause malabsorption and deficiencies of the fat-soluble vitamins, vitamins A, D, E, and K. Causes include Crohn’s disease, surgical removal of parts of the intestine, and high triglycerides. Malabsorptive diseases of the liver, gallbladder, pancreas, and intestines, including chronic pancreatitis and Celiac disease, can also cause bile acid diarrhea. 

How is Gallbladder Disease Diagnosed?

‍Gallbladder diseases are often diagnosed with the help of ultrasound machines. Ultrasounds use sound waves to produce a visualization of the area and are often used to evaluate the gallbladder. Gallstones can be seen on an ultrasound. Other forms of visualization may also be needed, including hepatobiliary iminodiacetic acid (HIDA) scan. A HIDA scan involves a radioactive tracer that can show movement through the biliary tract. There are certain types of X-rays of the gallbladder that may also be used. Additional imaging may also be needed, including computerized tomography (CT) scans.

Liver blood panels may also be checked, such as the Hepatic Function Panel by Access Laboratories. This panel includes enzymes produced by the liver that can indicate liver dysfunction. It also shows different measurements of bilirubin. 

Functional Medicine Labs That Can Help Individualize Treatment for Patients with Gallbladder Disease

There are many functional medicine labs that can aid in evaluating the gallbladder and the various diseases of the gallbladder. The most common functional medicine labs for gallbladder diseases include: 

Metabolic Markers

Metabolic dysfunction, diabetes, and obesity are all risk factors for the development of gallstones, cholecystitis, and bile acid diarrhea. These factors are often interdependent and intertwined. Additionally, cholesterol specifically has a strong connection to gallstones, as cholesterol stones account for 80% of gallstones. The Cardiometabolic Profile by Doctors Data is an excellent choice to evaluate metabolic markers. This test reveals cholesterol levels and markers related to cholesterol, as well as markers involving blood sugar, such as glucose and insulin. 

Micronutrient Testing 

A micronutrient test, such as the Micronutrient Test by Spectracell Laboratories, shows levels of numerous vitamins and minerals on one test. Since various gallbladder diseases can lead to malabsorption of fat-soluble vitamins, this test can be useful to monitor and avoid deficiencies. 

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Conventional Treatment for Gallbladder Diseases

‍Conventional treatments for gallbladder diseases can include pain medications and antimicrobials to treat infections. In certain cases, surgical removal of the gallbladder, called cholecystectomy, may be needed. 

Complementary and Integrative Medicine Treatment for Gallbladder Disease

Complementary and integrative medicine treatments for gallbladder diseases include nutritional interventions and supplements, and herbs. 

Nutrition for Patients With Gallbladder Disease

A high-fiber diet may be recommended for those with gallstones but also for those who are concerned with developing them. Fiber, found in foods such as chia, flaxseeds, oat bran, psyllium, and many fruits and vegetables, is able to bind to cholesterol and transport it out of the body, thus lowering cholesterol levels. In turn, this helps reduce cholesterol stone formation. 

A high-fiber diet may also be beneficial for bile acid diarrhea. Fiber can bind to the bile acids in the colon and aid in their elimination. Additionally, fiber supports a healthy microbiome which in turn produces short-chain fatty acids (SCFAs). SCFAs lower the pH of the colon and stop the enzyme that breaks down bile acids. These breakdown products of bile acids are what trigger diarrhea. 

Top Supplements and Herbs for Patients with Gallbladder Disease

Many herbs and supplements can aid in reducing inflammation and enhance the proper function of the gallbladder. Commonly used herbs and supplements for gallbladder disease include: 

Lemon Essential Oil for Gallstones 

Lemon essential oil contains an active ingredient, d-limonene, which is used in the treatment of gallstones. D-limonene has been shown to reduce cholesterol levels; cholesterol is the most common component of gallstones. Lemon essential oil has also demonstrated its ability to improve insulin resistance, a marker of metabolic dysfunction that can lead to obesity and thus increase the risk of gallstones. Lastly, d-limonene can reduce fat storage in the liver, lowering inflammation and aiding in healing the gut. Because of these mechanisms, d-limonene has been shown to reduce the size of or entirely dissolve gallstones. 

Probiotics for Bile Acid Diarrhea

Probiotics are supplements that contain beneficial microbes that support a healthy and diverse gut microbiome. A specific type of bacteria genus, Lactobacillus, that is found in many probiotic supplements has been shown to be beneficial for bile acid diarrhea as it can reduce the amount of bile acid in the large intestine, thus reducing diarrhea severity. 

Milk Thistle Gallbladder Disease

Milk thistle is an herb and has been traditionally used for conditions of the gallbladder and liver due to its antioxidant, anti-inflammatory, and anti-fibrotic properties. Milk thistle has been shown its effectiveness in the treatment of insulin resistance and obesity, which are increased risk factors for many gallbladder diseases. 

Vitamin C for Gallstones

Ascorbic acid, or vitamin C, is needed for many functions of the body, including iron absorption, immune regulation, antioxidant function, and the creation of collagen and neurotransmitters. Gallstones may also be prevented by vitamin C in the biliary tract. An observational study published in BMC Gastroenterology assessed vitamin C supplementation in over 2,000 people. In those supplementing with vitamin C, 4.7% developed gallstones, whereas 8.2% of those not supplementing with vitamin C developed gallstones. 

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Summary

The gallbladder is a useful organ, taking specific measures to appropriately break down dietary fats. Conditions that affect the gallbladder can lead to unpleasant symptoms such as pain and diarrhea. Conventional testing is required for gallbladder diagnosis, and functional medicine testing can help to further evaluate these conditions and create personalized treatment plans focused on the root cause. A combination of conventional and complementary, and integrative treatments can be used to resolve symptoms and get to the root cause of gallbladder diseases.