Do you have the gall to keep your gallbladder?

It is becoming increasingly more frequent that people are having their gallbladders surgically removed. This is usually due to the advise of a medical practitioner (usually a surgeon) who recommends it as a first course of treatment in cases of gallstones (cholelithiasis) and with “sluggish” gallbladders, or gallbladder inflammation (cholecystitis). Most people in this situation are told that it is perfectly alright for this to happen, and most are under the impression that the gallbladder has no real necessary function in the human body.

This could not be further from the truth. What's more, the procedure of removing the gallbladder would be considered a last resort, when all other methods have failed.

The gallbladder indeed has a very important function as part of the digestive system. Its role is to store a substance called Bile, and to secrete it into the small intestine during digestion. Bile is an alkaline substance, bitter-tasting and greeny-yellow, containing acidic bile salts, cholesterol, bilirubin, electrolytes, and water. Its main role is in the emulsification and absorption of dietary fats. The storage of bile in the gallbladder occurs between meals, removing the water and electrolytes, and storing it in concentrated form, to then be released about 30 minutes after a meal. When dietary fats are present in the duodenum (the upper part of the small intestine), hormonal signals are sent to the gallbladder to begin secretion.

If the gallbladder is removed, it becomes near-impossible to digest any form of dietary fats, requiring one to be on either a no-fat diet, or very small amounts eaten regularly. Dietary fats are required for the operation of the endocrine system (hormones); they provide the pre-cursors to many of the sex-hormones in the form of cholesterol; and they are also important for the absorption and metabolism of important fat-soluble vitamins and minerals. The gallbladder is necessary for dietary fats to be absorbed by the body, so that the endocrine system can perform its role in healing the body when necessary.

In symptomatic cases of gallstones, there is considerable localised abdominal pain and jaundice. Other signs and symptoms of gallstones could include heartburn, flatulence, epigastric discomfort, and intolerances to fatty foods and cabbage. An inflamed gallbladder is usually caused by the lodging of a gallstone in the cystic duct. The pain is similar but will present with specific findings of test results.

In Chinese Medicine, the gallbladder is also said to have a psycho-emotional role, allowing us to be courageous, and having the courage to express our innermost desires in the external world. This is recognised by many other cultures also, with the common expression “having the gall” to do/say something with a degree of audacity. Confucian medical scholars likened the gallbladder to the social role of the judge, whose job it is to make decisions and carry out the (legal) decisions of the State. Thus indecisiveness is said to indicate a weakness of the gallbladder, whilst to have 'da dan' (a large gallbladder) indicates that someone is courageous and decisive.

So how can Chinese Medicine help with gallbladder disorders? Using acupuncture, herbal medicine, and dietary therapy, practitioners are able to dissolve and clear gallstones. Often gallstones are asymptomatic, so if there appears to be some issues with digestion (especially involving foods with considerable levels of dietary fats), it is often useful to do a “gallbladder flush”, which helps clear the ducts that carry bile, and dissolve and clear any stones that are yet to be big enough to cause pain or complete blockage. There are very effective herbal formulas which dissolve the stones, and then flush them out. Apple cider vinegar and artichokes are known to be useful for this, as are lemons, limes, turmeric, parsnips, radishes, mung beans, rye, endives, linseed oil, chamomile tea, and seaweed.

It is a better idea such non-invasive and less-radical procedures to clear the gallbladder of stones and inflammation before heading down the route of surgical removal. The gallbladder has an important function in digestion, and it is probably worth the effort to keep it.