What Does the Gallbladder Do? Everything You Should Know

author avatar Dr. Eric Berg 05/12/2024

Many doctors consider the gallbladder an unnecessary organ, but what does the gallbladder do?


The gallbladder is a small organ located under the right rib cage that stores and releases bile, a digestive fluid produced by the liver that helps break down dietary fats for absorption.


Learn how the gallbladder functions and discover four natural ways to promote optimal bile flow.


Liver and gallbladder illustration

What is the gallbladder?


The gallbladder is a small, pear-shaped organ that stores and releases concentrated bile, a digestive fluid produced in the liver. 


This gastrointestinal organ is around four inches long and two inches across at the fundus, where it connects to the liver via the cystic duct.


Where is the gallbladder? 

The gallbladder is situated in the upper right abdomen below and behind the liver and is connected by bile ducts. 


Bile ducts transport bile from the liver to the gallbladder, pancreas, and small intestine. This system of bile ducts is referred to as the biliary tract or biliary system. 


Bile, produced in liver cells, is secreted into the common bile duct, the central duct that connects the liver with the small intestine. 


The common bile duct branches into smaller, hollow ducts called the cystic duct and pancreatic duct, which join the gallbladder and pancreas to the common bile duct. 


Bile passes through the cystic duct into the gallbladder. When food is consumed, the gallbladder contracts and pushes concentrated bile through the bile duct into the small intestines, aiding digestive processes. 


Watch the video below to learn more about the gallbladder and its functions.

The Amazing Gallbladder

What is the function of the gallbladder? 


The gallbladder is the part of the digestive system that stores and concentrates bile produced in the liver between meals. 


Stored bile becomes 20 times more concentrated as the gallbladder removes water, increasing its potency for breaking down dietary fats. 


When dietary fat is consumed, the intestinal hormone cholecystokinin (CCK) triggers the gallbladder to contract and release bile into the duodenum, the first part of the small intestine, to emulsify fats into fat droplets.


These fat droplets stimulate the pancreas to produce digestive enzymes that further break down fats. This allows the intestinal absorption of essential fatty acids and fat-soluble nutrients, such as vitamins A, D, E, and K. 


Additionally, the gallbladder ensures the colon is lubricated and regulates bile flow into the small intestine, which supports healthy bowel movements. 


Without the gallbladder, the liver constantly drips bile into the small intestine, which can lead to diarrhea and anal leak, a condition where stool involuntarily discharges from the rectum.


The gallbladder and bile also play a crucial role in preventing small intestinal bacterial overgrowth (SIBO), constipation, and digestive discomfort.  


According to a study published in Frontiers in Microbiology, “Bile salts are potent antimicrobial agents and are an important component of innate defenses in the intestine, giving protection against invasive organisms.”


What is bile?

Bile is a greenish-yellow digestive fluid produced in liver cells and secreted into the gallbladder. It’s primarily made of water but also contains a mixture of lecithin, cholesterol, and bile salts. 


When the gallbladder contracts, bile is released to break down fats in the small intestines, which promotes digestive processes and nutrient absorption. 


Bile also stimulates the release of pancreatic digestive enzymes needed to process and absorb fats, protein, carbohydrates, and various bioavailable nutrients.


Gallstones

Is the gallbladder an essential organ?


Scientific consensus points to the gallbladder as a vestigial organ, which refers to an organ without apparent use. 


The gallbladder is thought to have evolved in the digestive system of prehistoric humans to accommodate their high-fat, hunter-gatherer diets. However, some argue that it may no longer be essential for digestion.


According to research published in StatPearls, over one million Americans have gallbladder surgery annually to prevent organ failure from gallstones, gallbladder cancer, or gallbladder disease. 


While the gallbladder isn’t essential to life, it still plays a vital role in fat digestion and overall intestinal health.


Gallbladder removal makes it challenging to break down fats, obtain essential fatty acids, and absorb fat-soluble vitamins. 


This can lead to malabsorption and nutrient deficiencies, which may lead to dry skin, night blindness, depression, hair loss, and increase the risk of chronic health issues.  


Can I do keto without a gallbladder? 

Yes, those without a gallbladder can follow the ketogenic diet. 


The liver continues to produce bile after gallbladder removal. Instead of being stored in the gallbladder, unconcentrated bile drips into the small intestine continuously.  


Most individuals following Healthy Keto® aim to obtain around 75 percent of daily caloric requirements from fat. 


With optimal gallbladder function, up to 95 percent of dietary fat is emulsified and absorbed. In contrast, the fat absorption rate without a gallbladder is believed to be as little as 50 percent. 


This can lead to diarrhea, abdominal pain, gas, burping, and acid reflux from undigested fats. However, there are various methods to manage these symptoms and support fat digestion after gallbladder removal.


Gallbladder surgery illustration

What to do if you don’t have a gallbladder 

Quickly switching to a high-fat diet like keto can overwhelm the digestive tract, which may lead to symptoms of fat malabsorption, including floating stools. 


To reduce the risk of digestive issues, it’s recommended to gradually increase fat consumption and limit carbohydrate intake to no more than 50 grams daily to help the body adjust to a high-fat diet.


It’s also advised to avoid high amounts of long-chain fatty acids found in avocados, olives, nuts, and seeds to support optimal digestion without a gallbladder, as the breakdown of these fats requires more bile. 


In addition, purified ox bile and digestive enzyme supplements are recommended for individuals with poor gallbladder function and those who have had their gallbladder removed.


Gallbladder pain

Top signs of gallbladder issues

The most common gallbladder issues are gallstones and bile sludge, the precursor to gallstone formation. 


According to research published in the World Journal of Clinical Cases, up to 80 percent of those with gallbladder problems are asymptomatic, which means there are no noticeable symptoms. 


However, when gallstones obstruct bile flow by blocking the bile ducts, a wide range of symptoms can develop.


Here are common signs and symptoms of gallbladder issues:

  • Visceral pain under the right rib cage

  • Nausea

  • Neck pain

  • Shoulder pain

  • Vomiting

  • Jaundice

  • Constipation


One of the most apparent signs of gallbladder issues is pale stools. Bile pigment, known as bilirubin, is made when red blood cells are broken down in the liver. This pigment gives stool its brown color and urine a yellow hue. 


“Normally, the color of stool is brown. When you’re deficient in bile, stools can become pale or gray-colored,” explains Dr. Berg. “It’s also not uncommon for the stool to float due to the accumulated undigested fats.” 


Gallbladder and pancreas model

4 ways to promote a healthy gallbladder


Impaired gallbladder function can lead to a dysfunctional digestive tract and gallbladder disease, which may require gallbladder removal, also known as cholecystectomy.  


Here are four natural ways to promote a healthy gallbladder.


1. Increase healthy fats

A low-fat diet can contribute to gallbladder issues by reducing the demand for bile. 


Bile is stored in the gallbladder until fat is consumed. Whenever saturated fats are introduced to the digestive system, the gallbladder releases bile to help break down fats into more bioavailable particles. 


Increasing healthy fats can stimulate optimal bile flow. This helps prevent bile from stagnating in the gallbladder and turning into concentrated sludge, a leading cause of gallstone formation.


2. Take bile salts

Supplementing with bile salts before or during meals can improve fat emulsification and digestion. 


Bile contains bile salts, which help break down cholesterol. Without enough bile, excess cholesterol can build up, which increases the risk of gallstones.


Taking an ox bile supplement with meals increases bile salt concentrations, which helps keep bile thin, aids in fat digestion, and improves the absorption of fat-soluble vitamins.


In addition, taking digestive enzymes can also improve the digestion of fats, carbohydrates, and proteins. 


Couple preparing a salad

3. Eat more vegetables

Eating seven to ten cups of vegetables daily can give the liver more time to produce bile for fat emulsification. 


Vegetables such as Brussels sprouts, broccoli, and asparagus are high in soluble fiber, which attracts water into the intestines, leading to slower digestion.


Fiber can also lower cholesterol levels, which may help prevent cholesterol crystal formation, bile sludge, and gallstones.


4. Take betaine hydrochloride 

Stomach acid is crucial for digestive processes and activates the release of lipase, an essential enzyme that initiates fat breakdown.  


In addition, the acidity of stomach acid stimulates gallbladder contraction and triggers bile release to further emulsify dietary fats. This explains why low stomach acid can contribute to inadequate bile production and poor digestion.


Betaine hydrochloride (HCl) is the acidic form of betaine, an amino acid naturally found in certain foods. It’s known to aid digestion by increasing the stomach’s acidity, and taking two capsules with every meal is recommended to support optimal digestive function.


However, following the instructions of the betaine HCl supplement you plan to use is vital to avoid potential side effects.


Virtual gallbladder concept

Key takeaways


The gallbladder is a pear-shaped organ under the right rib cage, but what does the gallbladder do? 


Though often considered a nonessential organ, the gallbladder supports the digestive system by storing and concentrating bile, which helps break down fats and fat-soluble vitamins for absorption. 


Gallbladder problems can lead to severe pain and may require gallbladder surgery. However, you can promote a healthy gallbladder by following a nutritious, high-fat diet, taking purified bile salts, and acidifying the stomach with betaine HCl.



FAQ


1. What is the function of the gallbladder?

The gallbladder is a small digestive organ that stores and concentrates bile produced in the liver. 


When fat is consumed, the gallbladder releases bile into the small intestine to help break down fat. This allows essential fatty acids and fat-soluble vitamins to be more easily absorbed by the intestines.


2. What is bile sludge?

Bile sludge is a concentration of cholesterol crystals, mucins, bilirubins, and calcium salts that occur when there aren’t enough bile salts to keep bile fluid thin. 


This sludge can turn into gallstones, which may block the bile duct system and cause gallbladder inflammation.  


3. What are gallstones? 

Gallstones are hardened deposits of concentrated cholesterol. They most commonly are associated with a bile acid deficiency linked to poor liver function or sluggish gallbladder contractions. 


Thin, free-flowing bile dilutes and breaks down cholesterol and helps prevent gallstone formation. 


4. Do I need a gallbladder?

Yes, the gallbladder plays a vital role in fat digestion. However, a gallbladder attack can cause severe pain and may require removal to prevent infection or organ failure. 


Gallbladder removal can lead to life-long symptoms, including anal leak, diarrhea, bloating, and excessive gas. Supporting healthy gallbladder function with a Healthy Keto® diet and bile salt supplementation can help reduce the risk of gallbladder problems and surgery.


5. What happens when you have your gallbladder removed?

The gallbladder stores, concentrates, and releases bile into the small intestines to help break down fat into easily absorbable droplets. 


After the gallbladder is removed, the liver still produces bile. However, the bile is not concentrated, and its release is unregulated. This can make it more challenging for the body to digest fats and absorb fat-soluble vitamins. 


6. What are the main functions of the gallbladder?

The gallbladder stores bile and releases bile, which is needed to absorb fatty acids and fat-soluble nutrients.


Bile also has antimicrobial properties, which means optimal gallbladder function can help prevent small intestinal bacterial overgrowth (SIBO) linked to malnutrition. It also lubricates the colon, which supports healthy bowel movements.


7. What are the signs that your gallbladder is not working?

Though many people with gallstones and other issues are asymptomatic, common signs of a poorly functioning gallbladder include floating and pale stools, pain under the right rib cage, nausea, and shoulder pain. 


Symptoms such as yellowing of the skin and eyes, known as jaundice, vomiting, and neck pain, can also be indicative of gallbladder issues.  



Sources


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572772/ 

  2. https://www.ncbi.nlm.nih.gov/books/NBK448176/ 

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9602237/ 

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