Many kinds of problems (functional, obstructive, infectious, inflammatory and cancerous) affect the gallbladder and liver systems. Eastern Medicine can address some of these, alone or as an adjunct. The more serious problems must be treated by Western/Conventional medical therapies.

The liver produces bile, a liquid substance the intestines need to digest dietary fat. Bile travels from the liver to the gallbladder via ducts for storage. After eating fatty food, the intestines signal the muscular gallbladder to contract and propel bile through ducts into the intestines. Bile then breaks down fat in the intestines.

Diseases of this system include abnormally composed bile; disordered bile flow; or inflamed, infected or cancerous liver/gallbladder or ducts.

When bile fails to form properly, gallbladder “sludge” may then impede bile flow through ducts. In some—like those who are pregnant, taking oral contraceptives, or with diabetes—the gallbladder’s muscular contractions are weak (hypomotile). Whether alone or combined, abnormal bile and/or slow bile flow through ducts causes “bile back up”, or stasis, allowing bile to congeal and form gallstones.

Gallstones in the gallbladder most often produce no symptoms and create no problems. In about 20 percent of people with stones, gallbladder contraction produces pain either temporarily or chronically. In a much smaller percentage, gallstones may lodge in the duct leading away from the gallbladder, producing a surgical urgency. Symptoms of gallstones (and other gallbladder problems) are rather variable, but include vague or severe pain in the right, upper portion of the abdomen, lasting minutes to hours, often after eating fatty/fried foods. Severe obstructions may present with jaundice (yellow skin), itching and possibly fever. Fortunately, laboratory and imaging studies can identify gallbladder/associated structure problems well. Traditionally, medications helped dissolve stones; today, those with symptomatic gallstones usually undergo laparoscopic gallbladder removal.

Acute or chronic obstructive, infectious, inflammatory and cancerous gallbladder (and/or duct) diseases must always be managed by conventional/Western medicine. Antibiotics, anti-inflammatories and/or surgical gallbladder drainage/removal are essential.^[1]

Sometimes, after gallbladder removal for benign (stone) disease, bowel dysfunction ensues (post-cholecystectomy syndrome). The symptoms include gas, bloating, diarrhea, upset stomach, nausea, vomiting, and sometimes lingering pain in the gallbladder region. Half of these patients have a stone remaining behind after surgery, half do not.^[10] It is postulated ^[9] that this dysmotility may reflect exacerbation of an underlying intestinal motor dysfunction. As a functional problem, acupuncture and Chinese Herbal Medicine help manage this problem. Some of this diarrhea after surgery is due to inability to absorb fats (malabsorption). Sufferers may benefit from low fat diets (like those recommended in Ayurveda), Chinese herbs, medications, and/or digestive enzyme and medium-chain triglyceride supplementation.^{[2, 3]}

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