Critical Natural Support for An Overlooked Organ

Many well-functioning steps in what is really called the digestive system contribute to a healthy gastrointestinal (GI) tract. Digestive function is more complex than just food-in and waste-out, as evidenced by the exceedingly high amount of annual healthcare visits involving GI problems. Sixty to 70 million people are affected by overt diagnosable digestive diseases. Annually, an astounding 234,000 people die from GI diseases including cancer. Yet, far more people (14 million per year) end up in the hospital from nonfatal GI conditions.^1-3

In fact, it’s a teachable tenet, among many healthcare practitioners, that if you “fix the gut” you’ll often “fix the patient.” In addition to the working parts of the digestive tract, the endocrine, immune and nervous systems engage in considerable communication to and from the GI system. Thus, improving and maintaining the health of the GI system is fundamentally important because gastrointestinal function impacts all other functions in the body.

Mention “digestion” and most folks think of the stomach, but the liver and gallbladder (hepato-biliary) also contribute significantly to healthy digestion, and just as the stomach needs to secrete hydrochloric acid (HCL), the liver and gallbladder need to secrete bile. Bile is produced by the liver and streams through ducts on its way to the gallbladder for concentration and storage between meals. Bile has several functions. The flow of bile ensures the transportation of detoxified waste products and fats from the liver to the intestinal tract for elimination. The pH of bile (>7) helps neutralize the acidified stomach contents coming into the small intestine. This alkalization is in part necessary to activate digestive enzymes produced by the pancreas. Dietary fats (or lipids) and fat-soluble nutrients such as phospholipids, vitamins A, D, E and K, and carotenoids need pre-treatment with bile before they can be absorbed into the body. Bile protects the intestinal cells that line the GI tract from enteric bacterial invasion⁴ and has also been shown to inhibit H. pylori.^5-7 Together, the liver and gallbladder are a team for the production and secretion of bile, but this discussion is primarily devoted to gallbladder and bile or simply, “biliary” function.

Addressing this aspect of health is crucial since a recent new study has revealed that gallbladder disease in the US increases the overall death rate, pointing particularly to mortality from cardiovascular disease and cancer.⁷ Some of the common symptoms of gallbladder dysfunction include fatigue, indigestion, gas and bloating for hours after a meal, burping and belching, distress from high fat meals, itchy skin, bitter taste in the mouth, pain in and around the area of the gallbladder or referred pain to the right shoulder and shoulder blade, and the effects seen from insufficient fat intake such as dry skin and hair and fat-soluble vitamin insufficiencies. (Table 1.)

Benefits of Bile

Bile is a greenish-yellow fluid composed mainly of water-soluble bile acids that are made in the liver cells from cholesterol. After their synthesis from cholesterol, these “primary” bile acids are linked-up with the amino acids, taurine or glycine to become “conjugated” bile acids, a process that makes them impermeable to cell membranes and allows for high concentrations in the intestine.⁸ These bile acids will provide the detergent-like emulsification action that is necessary for proper fat digestion. The conjugated bile acids subsequently enter the alkaline bile, rich in sodium and potassium, to exist as bile salts. The bile salts account for about half of the total dissolved substances in bile. Bile also contains water, free cholesterol, phospholipids—predominantly as phosphatidycholine (lecithin)—conjugated bilirubin and the usual electrolytes of plasma. The ratio of these ingredients in bile is important in preventing gallbladder problems. Key levels of water, bile salts and phosphatidylcholine keep the normally insoluble cholesterol in solution, promoting its elimination and ensuring it does not precipitate out as gallstones (cholelithiasis).

Fat Digestion

During a meal, acidified food (chyme) moves from the stomach into the duodenum of the small intestine. This acid stimulus, along with the presence of dietary fats, results in gallbladder contraction and the release of concentrated bile. The gallbladder sac makes possible the delivery of adequate amounts of concentrated bile (at least 5 times more concentrated than the bile produced directly from the liver to help deal with fatty meal intake). This ensures the body’s best chance at fat digestion. The duodenum is also the site for the delivery of pancreatic digestive enzymes such as lipase. Because dietary fats are insoluble in water, bile salts are needed to physically break fat globules into very fine droplets that can be digested by pancreatic lipase. This emulsification process is sometimes compared to the action of household detergents for the removal of grease. The bile salts form tiny micelles with the digesting fats, making them soluble in the watery digestive fluid. The micelles then “ferry” the finished products, mainly free fatty acids and glyceride, to the intestinal epithelial cells for uptake into the blood or lymphatic tissue. The bile salts are left behind but significant amounts will be reabsorbed in the lower region of the small intestine (ileum) and returned to the liver. Bile salts may be recirculated several times with each meal. However, a major pathway for cholesterol elimination is through the un-recirculated bile. Partially soluble fiber in the diet can bind to bile salts and prevent re-absorption back to the liver. This forces the liver to use more cholesterol to make more bile acids and consequently can reduce blood cholesterol levels.⁹

It is important to mention here that some of the bile acids in the intestine may undergo further conversion by intestinal bacterial enzymes to become “secondary” bile acids. Secondary bile acids are toxic to cells lining the GI tract and may cause diarrhea. Studies show that an increase in these secondary bile acids and their ratios is associated with an increased risk for gallstones, polyps, ulcerative colitis and colorectal cancer.^10-14 The increase in these secondary bile acids is commonly seen with small intestinal bacterial overgrowth (SIBO) associated with low hydrochloric acid (HCL) levels in the stomach and with the use of acid-suppressing (antacid) drugs used to treat gastroesophageal reflux disease (GERD).¹⁵ Additionally, the relationship of high fat diets to colon cancer involves the secondary bile acids and not only the amount but the type of fat consumed. In studies, diets high in omega-6 fatty acids, such as corn oil, led to higher levels of secondary bile acids associated with colon tumor promotion compared to diets high in omega-3 fatty acids such as fish oil.^16-17

A lack of sufficient bile directly affects the digestion and absorption of dietary fats, risking profound negative health implications. When fat digestion is impaired, all food digestion is impaired because fat in, around and covering food makes it hard for enzymes to digest it. As with insufficient HCL, the activity of the intestinal bacteria on undigested food causes considerable putrefaction and gas production (flatulence). An aversion to fats or fried foods may also result as a consequence of poor fat digestion.

Common Biliary Problems

One common biliary problem is a decrease in the flow of bile from lack of production or secretion and is called biliary stasis or in some cases, cholestasis. It means bile is standing still. The genesis of this condition is multi-factorial and involves the development of a viscous “sludge” which may result in inflammation of the gallbladder and the bile ducts, changing the capabilities of the gallbladder and leading to biliary tree and/or gallbladder stone formation.^18-19 Gallstones arise when a component of bile becomes less soluble or supersaturated causing it to precipitate.

Decreased flow or blockage of the bile in the bile ducts may result in retention of bile salts in the blood, which are toxic at high levels, causing considerable itching (pruritis) and fatigue and can also cause tenderness and swelling due to over-distention of the ducts. Increasing blockage may lead to jaundice with yellow discoloration of the whites of the eye and skin. Biliary dysfunction affects liver detoxification and elimination of wastes and can potentially raise cholesterol levels by also interfering with cholesterol elimination. If cholesterol concentration increases in the bile, it may become supersaturated, initiating gallstone formation. Most gallstones are a mixture containing cholesterol, bile pigments, calcium salts and varying amounts of cholesterol derivatives.

A partial list of additional factors that contribute to gallbladder dysfunction by affecting bile production, flow or gallbladder contraction, thus increasing the likelihood of gallstone formation, are included in Table 2.

Gallbladder Formula

A new and advanced nutritional blend aims to improve liver and gallbladder function by providing ingredients that support gallbladder contraction, adequate bile production, bile flow and its solubility. This new hepato-biliary support product called Gallbladder Formula contains multiple well-substantiated and time-honored agents such as milk thistle (silymarin),⁴² dandelion root,^43-44 beet root,⁴⁵ phosphatidylcholine,⁴⁶ the amino acid taurine,⁴⁷ betaine,⁴⁸ inositol,⁴⁹ pancreatic lipase,⁵⁰ plus alpha-lipoic acid⁵¹ for antioxidant protection, vitamin C⁵² for enzyme support and magnesium.⁵³

Additionally, fish oils high in omega-3 have also been shown to have a protective effect on gallbladder and intestinal health especially with regard to secondary bile acid potential.^16-17 Hydrochloric acid (HCL), with its multiple benefits, helps to create the acid stimulation for efficient gallbladder contraction. Relaxation while eating and lowering stress improves parasympathetic nervous system activity, which governs overall digestion.

Avoiding sugar and known sensitivities to food allergens/lectins along with increasing dietary fiber are also very important steps for improving gallbladder function. Detoxification support to help “cleanse” and refresh the liver and biliary tract by using Detox Complex will help support the team effort of liver and gallbladder performance.

In the event the gallbladder has been removed, then the cystic duct acts as a reservoir for bile, making support for optimal synthesis and flow of bile especially important.

Conclusion

Optimal gallbladder function paves the way for healthy liver and intestinal function. A poorly functioning gallbladder, on the other hand, can be responsible for a wide variety of symptoms including fatigue, indigestion, gas and bloating. Gallbladder Formula helps improve digestion and ensures the liver and especially the gallbladder are functioning at peak capacity.

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