Gallbladder Deep Dive: Western and Eastern Medicine Perspectives on Removal, Function, and Healing

Lemon water in the morning, may be all you need to stimulate the liver and gallbladder; for balance...homeostasis.

The gallbladder is a small, pear-shaped organ nestled under the liver, often overlooked until something goes wrong. When it does, it can become a major source of discomfort and dysfunction. In Western medicine, gallbladder removal (cholecystectomy) is one of the most common surgeries performed.

But why is this organ so frequently removed? And is surgery the only path forward?

From both Western and Eastern (particularly Traditional Chinese Medicine, or TCM) perspectives, the gallbladder has significant roles. Let’s explore its function, why problems occur, when removal becomes a consideration, and how lifestyle, diet, and integrative approaches can make a big difference.

The Gallbladder in Western Medicine

Function

The gallbladder stores and concentrates bile produced by the liver. Bile is essential for digesting fats. When you eat, especially a fatty meal, the gallbladder contracts and releases bile into the small intestine to emulsify fats, aiding absorption.

Deep Dive (...because sometimes, it's never explained!)

The gallbladder is a small, pear-shaped organ located beneath the liver. In Western medicine, its primary function is to store and concentrate bile—a digestive fluid produced by the liver. Bile helps emulsify fats in the small intestine, breaking them down into smaller droplets for easier absorption of fatty acids and fat-soluble vitamins (A, D, E, and K).

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When we eat, especially fatty foods, the hormone cholecystokinin (CCK) signals the gallbladder to contract and release bile into the small intestine via the bile ducts. Between meals, the gallbladder holds bile, allowing it to become more concentrated and effective.

If bile composition becomes unbalanced—too much cholesterol, too little bile salts, or poor flow—it can lead to gallstone formation. Gallstones can block bile ducts, causing pain, inflammation (cholecystitis), or even infections. Other dysfunctions include biliary dyskinesia (poor gallbladder contraction) and, rarely, gallbladder cancer.

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When the gallbladder becomes diseased or dysfunctional, Western medicine may recommend surgical removal (cholecystectomy) to prevent complications. Though not essential for survival, the gallbladder contributes to efficient fat digestion and overall digestive balance.

Common Problems

1. Gallstones (Cholelithiasis)Hardened deposits of bile components can form in the gallbladder, causing pain, nausea, and indigestion. If they block the bile ducts, they can cause severe complications such as cholecystitis (inflammation), pancreatitis, or jaundice.

2. Cholecystitis - Inflammation, often caused by gallstones blocking bile flow, leading to pain (especially in the upper right abdomen), fever, and sometimes infection.

3. Biliary Dyskinesia - The gallbladder doesn't empty properly, causing chronic pain after eating, even in the absence of stones.

4. Gallbladder Polyps ...Cancer - Rare but serious, these growths may require removal even without other symptoms.

Why Do Doctors Recommend Removal?

• Recurring or severe gallbladder attacks

• Blocked ducts with risk of infection or pancreatitis

• Non-functioning gallbladder (low ejection fraction on HIDA scan)

• Suspicion of cancer or necrosis

For many doctors, the risk of complications from a dysfunctional gallbladder outweighs the benefits of keeping it. Surgery is often seen as a definitive solution—especially since the body can adapt without the gallbladder.

Eastern Medicine Perspective: Gallbladder as a Decision-Maker

In TCM, the gallbladder is more than a bile reservoir—it governs decision-making, courage, and judgment. Paired with the liver in the Wood element, it is believed to influence both physical and emotional digestion.

Gallbladder Imbalances in TCM

Signs of gallbladder dysfunction in TCM can include:

• Indecisiveness or timidity

• Headaches, especially on the sides of the head

• Bitter taste in the mouth

• Nausea, bloating, or difficulty digesting fats

• Insomnia or waking between 11pm–1am (gallbladder meridian time)

Why Avoid Removal?

In TCM, organ systems are interconnected. Removing an organ disrupts the body's energetic harmony. Even though Western medicine sees the gallbladder as non-essential, TCM practitioners emphasise its influence on the smooth flow of Qi and emotional balance.

Benefits of Keeping the Gallbladder

From a Western Medical View

• Preserves fat digestion efficiency - Some people without gallbladders experience chronic diarrhoea or poor nutrient absorption.

• Avoids post-cholecystectomy syndrome (PCS) - This condition causes ongoing digestive issues even after gallbladder removal.

• Addresses root cause, not just symptoms - Gallstones often result from metabolic imbalances—such as insulin resistance, obesity, or low-fibre diets. Removal doesn’t solve these underlying issues.

From a TCM View

• Maintains energetic integrity of the body - Avoids disrupting the gallbladder-liver relationship and associated emotional and physical effects.

• Allows for functional healing - Many gallbladder imbalances in TCM can be corrected with herbal formulas, acupuncture, and dietary changes.

Lifestyle and Diet: Western Medical Advice

Many gallbladder problems correlate with metabolic syndrome—a cluster of conditions including insulin resistance, obesity, high triglycerides, and fatty liver.

Specific Advice:

• Eat a high-fibre, low-sugar diet - Whole grains, vegetables, and fruits promote bile flow and reduce cholesterol in bile.

• Avoid rapid weight loss - Crash diets can increase gallstone risk. Aim for sustainable weight loss (1/2 to 1kg /week).

• Healthy fats > low fat - Low-fat diets can reduce bile flow, leading to bile stasis. Include healthy fats (olive oil, avocado, fish oil) in moderation.

• Exercise regularly - Improves insulin sensitivity and bile circulation.

• Limit refined carbs and processed foods - These contribute to fatty liver and poor bile quality.

• Stay hydrated - Dehydration thickens bile and increases stone formation risk.

TCM Lifestyle Advice and Acupuncture Approaches

Dietary Principles:

• Warm, cooked foods - Especially in cold or damp climates, avoid: raw, greasy, or icy foods.

• Avoid greasy, spicy, and fried foods - These create internal Heat and Dampness, two major contributors to gallbladder imbalance.

• Eat on a schedule - Avoid late-night eating, which can disrupt liver-gallbladder rhythm.

• Sour foods (like lemon water) - Helps to stimulate liver and gallbladder harmony, especially in the morning.

Integrative Approach: The Best of Both Worlds

For those who still have their gallbladder and wish to keep it, combining both systems may offer the most balanced approach:

• Use Western diagnostics (ultrasound, liver panels, HIDA scans) to understand the physical state.

• Employ TCM and acupuncture to restore balance, especially in early or mild cases.

• Prioritise metabolic health through diet, weight management, and regular movement.

Even after removal, TCM can be helpful to support digestion and rebalance energetically. The liver may need extra care post-surgery, as it takes on more bile regulation.

In Summary

The gallbladder may be small, but it plays a mighty role in digestion and energetic balance. While Western medicine often leans toward removal when symptoms become severe, many gallbladder problems can be managed—sometimes reversed—through diet, lifestyle, and Eastern Asian therapeutic strategies.

For those facing gallbladder issues, consider both the physical and energetic implications before opting for surgery. And if surgery has already happened, know that support is still available to maintain long-term health, comfort, and vitality.