The Basics of the Gallbladder in Conventional Western Medicine
The gallbladder is a small, pear-shaped organ located in the upper right part of the abdomen. It sits just below the liver to the right of the stomach. The primary function of the gallbladder is to store bile that has been produced by the liver, and then release this bile into the duodenum, the first part of the small intestine. The bile that the gallbladder releases is absolutely essential for digestion as a whole, but is specifically important for the digestion of fats and oils (and thus for the absorption of all the nutrients that go along with them, such as the fat-soluble vitamins and fatty acids). In order for the body to produce this essential bile, it must have access to the main constituents that make up bile, which include bile acids, cholesterol, phospholipids, bilirubin, electrolytes (sodium, magnesium, and potassium, for example), and water.
Some common gallbladder problems include these (click here for a more complete, detailed list of gallbladder-specific problems):
- Gallstones - These are small (or sometimes larger) stones that may form in the gallbladder. They can cause inflammation of the gallbladder, or may block bile ducts leading to decreased bile release and further buildup of bile and eventually the development of more stones. Bile duct blockage also causes digestive problems.
- Cholecystitis - This is a more formal term that refers to inflammation of the gallbladder. It may be accompanied by fever and pain.
- Gallstone pancreatitis - This is a unique situation where a gallstone from the gallbladder passes through a common bile duct and lodges itself at the opening of the pancreatic duct, thus blocking the pancreas from releasing enzymes and other pancreatic juices into the intestines.
The symptoms of gallbladder-related issues may include these (note that a lot of people with gallbladder problems may experience more symptoms or more severe symptoms following a fatty meal, especially if the fats in the meal were unhealthy, heated, or without the presence of other fresh ingredients):
- Pain in the upper back, specifically in the upper right shoulder blade
- Upper-right abdominal pain
- Upper mid-abdomen pain
- Pain after eating a fatty meal
- Fever
- Chills
- Jaundice (yellowing of the skin and/or eyes)
- Nausea and vomiting
- Light brown urine or light-colored poop
- Chronic bloating (especially after eating)
- Fatigue
- Sensation of fullness, even after eating light or not eating anything at all
- Belching
- Diarrhea and/or constipation
- Food intolerances
- Chronic flatulence
- Eye pain / Headaches near to or around the eyes
- Blurred vision, cataracts, or other eye complaints
- Bitter taste in the mouth
- A sticky coating on the right side of the tongue
- Dizziness
- Inexplicable nervousness/anxiety
- Low stomach acid levels (this can cause problems like heartburn and GERD)
- Leg and toe cramps (specifically pay attention to whether you have cramping in your fourth toe on the right side; this is the start of the Gallbladder Meridian in TCM)
- Pains along the right side of the body (sciatica on the right side, right shoulder blade pain, right hip pain, right-sided headaches, etc.)
- And more…
The Gallbladder in Traditional Chinese Medicine (TCM)
No conversation about the gallbladder is complete without talking about the liver, too, since a gallbladder dysfunction is also indicative of liver problems in almost all cases. The gallbladder receives bile from the liver and then deposits this bile into the small intestine. If something goes wrong with the liver, the gallbladder won’t be able to do its job effectively. Then, the gallbladder suffers, the small intestine suffers, and ultimately (through the many, many connections in the body between different organ systems), the whole body suffers. Therefore, all gallbladder problems can ultimately be traced back to the liver. When healing the gallbladder, you have to heal the liver too in order to be successful. Traditional Chinese Medicine acknoledges this connection fully and views the gallbladder and liver as an intimately involved organ "pair".Some of the signs of a congested or sluggish liver include these (besides experiencing problems with the gallbladder):
- Food sensitivities/chemical sensitivities (such as in cosmetic products)
- Skin problems
- Dark circles under the eyes
- Gastrointestinal issues (including chronic constipation and low stomach acid)
- High estrogen levels in women
- More severe PMS symptoms
- Gynecomastia in men
- Hypothyroidism
- Candida albicans overgrowth
- Tinnitus (ringing in the ears)
- Nightmares and/or insomnia or other sleep-related problems
- Depression
- Fatigue
- Obesity/difficulty maintaining weight
- And more…
Traditional Chinese Medicine states that the gallbladder is managed by Liver Qi (put simply, "Qi" = energy). When Liver Qi is flowing smoothly and at the correct intensity, the gallbladder holds onto and then releases bile in accordance with when it is needed for digestion. The flip-side of this is that Liver Qi is balanced by smooth digestion. Therefore, this is a circular process where Liver Qi both encourages proper digestion, and is also strengthened by proper digestion (so one could assume, then, that any action taken toward taking care of their digestion would ultimately support the recovery of imbalanced Liver Qi). Liver Fire is a common problem in TCM that can lead to gallbladder complaints, and contributes specifically to symptoms like tinnitus, headaches and migraines, irritability, and related problems.
The gallbladder itself is considered a “Curious Organ” in Traditional Chinese Medicine. It offers a direct link between the Primary Organs of survival (which include the lungs, spleen, kidneys, liver, heart, and pericardium) and the other Curious Organs (the brain, bone marrow, blood vessels, bones, and the uterus in women). The gallbladder's separation from direct contact with food or the elements is also part of what characterizes it as a Curious Organ. The gallbladder is classified as the Yang Wood organ and is responsible for courage, decision making, and judgment. Its closest partner in the body, the liver, is the Yin Wood organ. These two organs work closely together, and whenever one suffers, the other one usually does too.
The gallbladder is acutely responsive to emotions such as anger, frustration, or other related feelings. People who are having trouble asserting themselves, or who lack a passion for life or are generally somewhat shy, are likely to have an imbalance of the gallbladder. Fear and high stress levels can also negatively affect both the gallbladder and the liver. Dreams are affected by the health of the gallbladder specifically, as well as somewhat by the liver, so people who have issues with either of these two organs will sometimes have unusual dreams or even nightmares. Complete lack of dreaming may also indicate gallbladder/liver issues. The gallbladder also governs the ability to plan. Problems in any of these areas can indicate a problem with the gallbladder and/or the liver.
In TCM, each organ in the body has a 2-hour time frame during the day when it’s most active, as well as a 2-hour time frame when it’s least active. The gallbladder is most active between 11pm and 1am, while it’s least active between 11am and 1pm. “Liver Time” happens right after gallbladder time; between 1am and 3am, the liver is most active, while from 1pm to 3pm, it’s at its least active. As mentioned above, these two organs work together, so it’s not surprising that their “times of the day” come so close together like this. Feeling unwell, waking up or being unable to sleep, or having some kind of discomfort regularly during either Gallbladder Time or Liver Time indicates an imbalance in one or both of these organs (in this way, the TCM Body Clock can sometimes be used as a kind of diagnostic tool).
Finally, it's important to be aware of the close connection between the gallbladder and the heart according to Traditional Chinese Medicine. Heart Time corresponds with the least active time for the gallbladder (from 11am to 1pm). TCM indicates that the gallbladder is a kind of protector for the heart (meanwhile, the appendix protects the gallbladder). What this means is that these three organs absorb the consequences of excess heat and dampness in progression from “least important for survival” to “most important for survival”. The appendix suffers first, the gallbladder suffers second, and the heart suffers third. Many people who have had both their appendix and their gallbladder removed (usually in that order) will experience heart problems later in life, since the heart doesn’t have any “protectors” preventing it from being affected by excess dampness or heat in the body.
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The Gallbladder in Ayurvedic Medicine
Ayurvedic medicine views the gallbladder somewhat differently than Traditional Chinese Medicine, but nonetheless both systems acknowledge that cleansing and supporting the liver is absolutely essential for reclaiming gallbladder health. Both systems also give the gallbladder credit as an important organ, and strive to eliminate gallstones or other gallbladder-related complaints without the need for surgery (which is usually what’s recommended for these problems in the conventional western medicine model).Before discussing Ayurvedic perspective on the gallbladder in more detail, it’s important to understand a few key points about Ayurvedic medicine in general. First of all, there are 5 elements in Ayurveda: Akasa (space/ether), Vayu (wind/air), Tejas (fire), Jala (water), and Prithvi (earth). There are also 3 “Doshas”, or constitutional types, which combine the 5 elements and their manifestations in life and health in different configurations. A person may be predominantly one Dosha or another, and organs are categorized according to Doshas as well. Imbalances of the Doshas causes illness (Vata disturbance is one of the most common Dosha imbalances).
Below is a brief overview of the Doshas:
- Vata - A combination of space/ether and wind/air. The Vata organs and systems include the joints, the nervous system, and the colon (the colon is in fact the “seat” of Vata energy). Breath, emotions, the absorption and secretion of fluids and other substances, and movement are all governed by the Vata Dosha. The 8 “Gunas” (characteristics) of Vata are: Ruksha (dry), Laghu (light), Shita (cold+dry), Kara (dry+rough), Suksma (subtle), Chala (constant movement), Sara (lubricated movement), and Vishada (dry+slippery, like a reptile).
- Pitta - A combination of fire and water. Pitta organs and systems include the endocrine system and the digestive system, specifically in regard to metabolic processes (therefore, Pitta would regulate hormones and enzymes, for example). Pitta is present predominantly in the small intestine, though it is also present in the eyes, blood, and lymph. It regulates body temperature, immunity, hunger and thirst, skin health, and digestion. The 9 “Gunas” of Pitta are: Sasneha (oily), Tiksha (sharp), Usna (hot), Laghu (light), Visram (strong smelling), Sara (slippery), Drava (liquid), Amla (sour), and Katu (pungent).
- Kapha - A combination of water and earth. Kapha organs and systems relate to the structure of the body, and include the 7 bodily tissues (these are also known as “dhatu” and refer specifically to the plasma, blood, lipids, marrow, sperm/ovum, muscle, bone, and bone marrow). Its “seat” in the body is in the lungs. Kapha energy is responsible for the lubrication and moisturization of tissues, organs, and joints throughout the body. The 10 Kapha “Gunas” are: Snigdha (oily), Shita (cold), Guru (stable movement+solid), Manda (dull/slow), Slakshna (smooth), Mrtsnah (greasy+binding), Sthira (stable), Hema (very cold+watery), Madhura (sweet+pleasant), and Mrdhu (soft).
Agni, or Digestive Fire, is another concept that shows up frequently in a discussion of Ayurvedic medicine. When Agni is balanced, the Dhatu (7 bodily tissues) will be produced in the right quantities at a high quality. When Agni is too high, the Dhatu will be deficient, and when Agni is too low, too much tissue will be produced, and what’s produced will be of a low quality. An imbalance of Agni can also lead to waste accumulation throughout the body and the eventual development of negative emotions or thought patterns.
Ayurveda also ascribes to the idea of a Body Clock, except instead of organizing the clock solely according to the organs, Ayurveda bases the clock on the times of the day when different Doshas are the most active. In the Ayurvedic Body Clock (ABC), from 2pm-4pm (a Vata time) the Liver and Gallbladder are at their most active. In Ayurvedic medicine, these organs are associated with the emotions of anger, resentment, and hate, the same as in Traditional Chinese Medicine. Again, just like in TCM, changes in emotional or physical state during different times of the day can offer insight into a person’s health situation. People who have low energy, irritability, or some kind of discomfort during the Liver/Gallbladder hours can assume, then, that they have some kind of energetic imbalance in these organs.
In Ayurvedic medicine, gallstones are known as Pittashmari (Ashmari refers to the stones, while Pitta in this case indicates an imbalance of this Dosha). The imbalance of Pitta that causes gallstones occurs when there is an excess of Kapha in the body that infiltrates the (usually) fluid Pitta bile. When this happens, the bile hardens and forms stones in response to the excess Kapha energy. Gallstones in Ayurvedic medicine lead to diminished Agni. Symptoms of weak Agni include some of those seen in gallbladder problems, including constipation/diarrhea, gas, bloating, and diminished nutrient absorption.
Ayurvedic treatments for gallstones (Pittashmari) therefore involve supporting Pitta and calming Kapha. Some traditional Ayurvedic remedies for gallstones that incorporate this principle are:
- A diet with limited red meats, sugars, and refined carbohydrates that incorporates extra vegetables and fruits.
- Flaxseed oil, but not animal fats or fried foods (try the Budwig Smoothie with coconut milk for a pleasant and healing way of eating flaxseed oil).
- Herbal supplements like shilajit, Guggulu, Punarnava, Trikatu (a mix of 3 herbs, black pepper, ginger, and long pepper/Pippali), and neem.
- Regular exercise (at least 1 hour per day)
- Elimination of smoking, alcohol abuse, and other drugs or chemical substances
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Resources:
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