How to keep your gallbladder: preventative medicine and herbs for gallbladder health
- Sean Dugan
- Sep 5
- 12 min read
You have most likely found this page because you’re having some trouble with your gallbladder and your doctor has recommended that you have it removed. They may have advised you to reduce fat intake or lose weight, but most likely offered no other solutions. Understandably, you probably have concerns about this and would prefer to keep that little organ if you have the option. I'd like you to be able to keep it too, so you came to the right place.
There are some cases where gallbladder removal is absolutely necessary, especially in emergency situations. But most gallbladder removal surgeries are unnecessary if you take preventative measures and get effective treatment early enough.
Over the years I have helped many patients resolve gallbladder problems and avoid surgery. And I have seen many more who had already had their gallbladder removed and still dealt with chronic digestive problems afterwards. If your gallbladder has already been removed, check out this article on post-operative care.
In this article I will cover the most important things you need to know about gallbladder health, and also discuss situations where gallbladder surgery may be unavoidable. If you’re ready to get started with herbal medicine treatment, visit my herbal clinic page. If you want to learn more first, read on.
Table of Contents
When is cholecystectomy absolutely necessary?
Why bother trying to keep my gallbladder anyway?
What can you do to support gallbladder health on your own?
Gallbladder removal surgeries (cholecystectomies) are performed when patients experience pain or discomfort related to gallstones (cholelithiasis) or gallbladder inflammation (cholecystitis). Gallbladder sludge and congestion, bile reflux, overactive gallbladder (biliary dyskinesia), nausea, and vomiting are other common conditions that result in gallbladder removal. In fact, historically gallbladder removal has been recommended with a wide variety of digestive and abdominal symptoms, including symptoms that are unrelated to gallbladder problems.
When is cholecystectomy absolutely necessary?
Gallbladder removal can be a life-saving surgery in emergency situations. Gallstones can cause a great deal of pain and discomfort, but they are not a danger if they remain in the gallbladder. Gallstones can leave the gallbladder to pass through the digestive tract, and this is where they can be a problem. If they become stuck in the process of passing they can block the common bile duct or the pancreatic duct. This can result in a back up of pancreatic enzymes, where your pancreas essentially starts digesting itself. This can quickly become a life-threatening emergency and requires emergency surgery to remove the stone and the gallbladder. Gallstones blocking the bile duct account for approximately 40% of cases of acute pancreatitis in the US. In cases like this, we can be grateful to have the heroic tools of Western medicine when we need them.
It’s also a reason not to wait to start preventive treatment if you’re experiencing gallstones. With gallstones, the earlier you start treatment, the more likely I can help. If you wait too long, there is a good chance that the gallbladder is coming out whether you like it or not.
Most other gallbladder complaints do not result in a need for emergency surgery, and can be treated effectively with clinical herbal medicine. This includes gallbladder inflammation, overactive gallbladder, gallbladder sludge and congestion, bile reflux, problems digesting fat, nausea, vomiting, and pain.
Why bother trying to keep my gallbladder anyway?
It’s very possible that you don’t need any convincing, and you just have an innate desire to keep your bodily organs intact if possible. Even so, I think it’s helpful to understand what your gallbladder does before we dive into specifics about different types of gallbladder problems.
The gallbladder is simple, but important. The gallbladder stores bile.
Bile is an alkaline digestive fluid that breaks down fat, allowing us to digest and absorb fat. Bile is made in the liver, and stored in the gallbladder.
When you eat a fatty meal, your body senses the incoming fat, and your gallbladder contracts and squirts a healthy dose of bile into the duodenum (the upper part of the small intestine) to start breaking down the fat from your meal. The bile emulsifies the fat, breaking it down into smaller particles so it can be absorbed.
If your gallbladder gets removed, you lose the essential storage piece of the bile mechanism. When you don’t have a gallbladder, your liver continues to make bile. Only now your body has nowhere to store it, so the bile just slowly drips into the duodenum at a slow and steady pace. This would be fine if that’s also how you consumed fat. But we tend to eat several meals throughout the day, rather than little nibbles of fat all day, hence the evolution of the gallbladder to store bile.
If your gallbladder is removed, you will be told after the surgery to significantly reduce your fat intake.
The problem with that is that fat is a very important aspect of a nutritionally complete diet, and your body will crave fat since it needs it. And if there’s still any of the 1980s low-fat diet craze ideas kicking around the recesses of your psyche - just remember that the brain is 60% fat, and your skin, eyes, and basically every body part you have needs fat to function.
So after gallbladder removal, most people will limit their fat intake for a while, but eventually just go back to eating normal amounts of fat.
This usually results in one of two things: diarrhea or constipation.
When the fat isn’t broken down by bile, it often will just run through you - the diarrhea side of things. On the other hand, it’s also not uncommon for this undigested fat to gum things up and slow down bowel motility - resulting in chronic constipation.
So when possible, we want to keep your gallbladder intact so that your body’s fat digestion and assimilation remains healthy and functions to support the rest of your body.
How do I address gallbladder conditions with herbs?
Well, the short answer is that I do it the same way I address every other problem I see in my herbal clinic. With every patient, I use the systematic method of diagnosis and treatment that is Traditional Chinese Herbal Medicine. By examining the clinical signs and symptoms, health history, and tongue pattern of each patient I am able to determine the pattern of illness and then apply the appropriate herbal formulas.
For the long answer, I’ll discuss some of the specifics of gallbladder conditions.
In every gallbladder problem I have seen, the gallbladder function is obstructed by what we call Dampness in Chinese Medicine. Dampness or Damp Heat as is often the case in the Liver and Gallbladder patterns is a way we describe metabolic waste in a variety of forms. In other words, the gallbladder is gummed up, stuck, stymied.
This is true if an ultrasound shows sludge, and it’s also true if it doesn’t. The obstruction can be obvious and visible to imaging, or miniscule and deep in the small bile ducts of the liver.
When treating gallbladder conditions, I use herbs to clean out the gallbladder, stimulate bile secretion, stimulate blood and fluid circulation, and relax tension in the bile ducts. I rely heavily on the traditional formulas Yin Chen Hao Tang and Da Chai Hu Tang. These strong herbal formulas often need to be balanced with other digestive tonic herbs and antispasmodic herbs, like Bai Shao, Bai Zhu, Fu Ling, and Jing Ling Zi San.
*To be safe and effective, Chinese herbal medicine needs to be tailored to the individual and should always be prescribed by a qualified herbalist. It is not advisable to self-treat gallbladder conditions with herbs.
It is common for other digestive functions to be impaired in addition to the gallbladder. When treating gallbladder conditions, I am always looking at the big picture of each person's health. This is one of the reasons Chinese herbal medicine can be so effective.
Here are some notes on a few of the most common gallbladder conditions.
Overactive gallbladder syndrome
Overactive gallbladder syndrome (biliary dyskinesia or biliary hyperkinesia) is incorrectly assumed to be a situation where your gallbladder is “hyper-functioning.” It’s spasming too often, releasing bile too often and too much. Hyper-function is the opposite of what is happening. I can tell you that with certainty because I’ve treated it successfully, and what I do is use herbs that stimulate the gallbladder to work better, not less. In these cases, the gallbladder is not working effectively, so it has to work overtime to get the required work done. It’s hypo-functioning, not hyper-functioning. So what do we do? Clear out the gunk, support normal function, use antispasmodic herbs to relax excessive tension and spasms, and support its other digestive organ pals who are often slacking as well.
Bile reflux
Similar to biliary dyskinesia, bile reflux is also misunderstood. Patients are typically told that their gallbladder is excreting an excessive amount of bile and that’s what’s causing it to reflux. This is not what’s happening. Firstly, any gastric reflux is predominantly a problem of sphincter function - not hyper-secretion of anything, whether it’s bile or stomach acid. If the sphincter is functioning properly, it doesn’t matter how much bile you produce, it still won’t be able to pass the sphincter going the wrong way. And second, if the gallbladder is secreting an excessive amount of bile - it’s for a reason. And the reason is…its function is obstructed and trying its best to clear that obstruction with bile. How do I know this? Because when I give patients with bile reflux herbs that are known cholagogues - herbs that stimulate bile secretion - their bile reflux symptoms improve. Again, we are using herbs to clear out congestion and support normal function. When we help the gallbladder do what it needs to do, the symptoms resolve.
Gallbladder dysfunction and GERD
I have a separate article covering all the ins and outs of gastroesophageal reflux disease (GERD) also commonly known as acid reflux or heartburn. But I’ll include this note since we’re on the topic of gallbladder patterns. When I treat clients for GERD symptoms, it is caused by gallbladder dysfunction in about one third of people I have seen. Bile secretion is an essential part of digestion, and if this is not working properly it can interfere with fat digestion, slow down motility, and result in sphincter dysfunction and intestinal backpressure that results in acid (and in some cases bile and pancreatic enzymes) flowing backwards up into the esophagus.
Nausea and Vomiting
Nausea and vomiting are common symptoms with gallbladder dysfunction. In Traditional Chinese Medicine (TCM) terms this is referred to as Stomach Qi Reversal. It’s pretty much what it sounds like. Your digestive system is supposed to move downwards, meaning the food, bile, acid, enzymes all continue moving through your digestive tract. If things get stuck or start to go backwards (up) then we experience nausea and/or vomiting.
Pain
Gallbladder dysfunction can cause a variety of pain symptoms. Gallstones can cause pain by exerting pressure on areas that don’t like a hard little stone pushing on them. Congestion of bile, blood, or fluid movement in your liver and gallbladder can cause pain. Spasms of the gallbladder can cause pain. Ulceration of the duodenum (the upper part of the small intestine) is another common cause of pain in gallbladder. After chewing and swallowing, your food bolus enters the highly acidic environment of your stomach. When it leaves your stomach and passes into the small intestine, it meets the bile secreted by your gallbladder and enzymes secreted by your pancreas. The bile serves to emulsify fat for digestion, but it is also highly alkaline and acts to counterbalance the acid from your stomach. If your gallbladder is routinely not squeezing enough bile into the mix, this can result in excessive acid exposure of your duodenum tissue and irritation or ulceration over time.
Traditional Chinese Medicine (TCM) Patterns
With regard to gallbladder patterns, the most common patterns that I see are Shaoyang, Yangming, and Taiyin patterns, Damp Heat in the Liver and Gallbladder, Blood Stagnation, Liver Blood Deficiency, and Spleen Qi Deficiency. These are the most common, but they are not the only patterns that can result in gallbladder dysfunction. If this sounds like Chinese to you, check out my articles on TCM Theory and Terminology.
What can you do to support gallbladder health on your own?
If you are dealing with significant discomfort, it is best to get help from a professional Chinese herbalist, like myself. There are a number of tools you can use to support gallbladder health during herbal medicine treatment. If you’re dealing with very mild symptoms or don’t have any problems and just want to stay proactive, then these tips might be enough.
Gallbladder Health Do’s and Don'ts
Artichoke, Burdock, Camellia, and Dandelion
Yes, this is the ABCD of foods for gallbladder health. And yes, I am trying a bit too hard by including Puerh using its latin name Camellia sinensis.
Artichoke. If you eat one food to support your gallbladder health, let it be steamed artichokes. Eat a steamed artichoke once/week or more. Note that you don’t have to dip each leaf (technically these are bracts) in butter for it to be tasty. Just a little salt can make a steamed artichoke a fantastic addition to your meal.
Burdock. The best way to eat burdock is to steam, boil, or stew the fresh root. Fresh burdock can be a little hard to find, but many natural food stores and Asian markets will carry it. You can treat it like a cooked carrot. The mild, nutty, earthy flavor goes great with soups, or as a side to stir fry dishes, rice bowls, and noodle bowls. You can also use dried burdock root as a tea. It’s helpful too, just not as good as the fresh root.
Camellia sinensis. Camellia sinensis is the tea plant, and refers to all teas from this plant including green tea, oolong, black tea, etc. I am specifically recommending puerh tea in this case. Puerh has been studied for its beneficial effects on cholesterol metabolism, and cholesterol stones are the most common type of gallstones. Personally, I am partial to Nuo Mi Xiang "Sticky Rice" Puerh. It has a lovely fragrance and lacks the fishy or metallic notes that some puerhs can have. If you don’t do well with caffeine, skip this item and focus on the foods.
Dandelion greens. Use dandelion greens raw, steamed, or stir fried. Note that most grocery stores sell chicory greens labeled as dandelion greens. Farmers markets, some co-ops, and your backyard will usually have the real deal. Make sure you know how to properly identify dandelions if you’re harvesting them yourself.
Digestive Bitters
One of the most common problems with the modern diet is a significant lack of bitter foods in the diet. Digestive bitters were developed by doctors who observed that taking a small amount of bitter herbs before or after meals stimulated digestion and reduced digestive symptoms. The original purpose of aperitif and digestif cocktails was to combine medicinal bitter herbs with alcohol to support digestion whilst getting tipsy. I’m not against having a good time, but for a more medicinal approach you can just use digestive bitters on their own. There’s a lot of bitters formulas out there. Some are great, some are not the best or just not appropriate for everyone. Herbpharm’s classic better bitters is a well balanced formula which I recommend as a good starting place if you’re looking for bitters.
Reduce oxidized fat intake
Yes, this is the least fun section of the whole article. As we’ve established, fat is an essential part of a healthy diet. When you’re dealing with gallbladder problems, it may be necessary to temporarily reduce overall fat intake. But it is most important to reduce consumption of oxidized fat, aka fried or superheated fat.
Don’t try to treat yourself if you have gallstones
If you refer back to the discussion on emergency surgery and pancreatitis, you can guess why I don’t recommend trying to treat yourself when you have gallstones. Using herbs or foods that stimulate bile secretion can increase the risk of a gallstone getting stuck as it tries to pass. Herbs that dissolve or shrink gallstones, like Jin Qian Cao, can also increase this risk.
Don’t do “gallbladder cleanses”
I am especially talking about the one where you fast for 12 hours or more, then drink a bunch of olive oil, lemon or grapefruit juice, and epsom salts. Firstly, if you have gallstones this can significantly increase your risk of common bile duct obstruction and acute pancreatitis. Second, people do this cleanse and feel that they have passed many gallstones. What’s actually happening is that the large amount of olive oil and lemon juice mixes with bile and gets emulsified, forming small masses that are mistaken for stones. These can seem impressive when passing, but they are not gallstones and ultimately nothing has been cleansed.
So in conclusion, it’s uncomfortable, it’s risky, and it’s not doing anything therapeutic. Take a pass on this.
Ready to get started with healing your gallbladder and digestion?
Visit my herbal clinic page to schedule your first consultation, find more information on the treatment process, cost, herb quality, and more.
Sincerely, Sean Dugan L.Ac.
Sean Dugan L.Ac. is a licensed and board-certified herbalist and acupuncturist. He holds a Master’s degree in Chinese Medicine from the Oregon College of Oriental Medicine as well as a Diplomate in Chinese Medicine from the NCCAOM. He has studied under many Master Herbalists including Dr. Guohui Liu, Dr. Jimmy Wei-Yin Chang, Dr. Fang Zhang, Dr. Greg Livingston, and Dr. Darren Huckle. Sean’s herbal medicine practice draws from both Traditional Chinese Medicine and Classical Chinese Medicine treatment methods, with a focus on clinical efficacy above all. He has been treating patients with Chinese Herbal Medicine since 2013.
Sean works with clients all over the US through the Folkwise Herbal Clinic. In-person appointments are available at our Boise, Idaho clinic.
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