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Taking Bile Salts as Supplements

Have you had your gallbladder removed, and you have digestive issues such as indigestion, gas, and bloating? Are you experiencing a slow but constant downward spiral in your health? You may have had your surgery a month ago or 30 years ago – you may suddenly have symptoms, or you may have been living with them for years. Doctors offer little assistance in dealing with these problems, because according to them, “you don’t have to change what you eat.” Unfortunately, having your gallbladder removed only treats the symptoms, not the underlying causes of the gallstones in the first place.

However, with thousands of patients suffering indigestion, bloating and a slow decline in health post-surgery, naturopaths have done their own research, and a lot of evidence points to a lack of bile salts.  Find out about this supplement below and how it can benefit you.

biliary system

Why Bile Salts?

Because the gallbladder aids in the digestion of fats, removal of the gallbladder can result in such symptoms as indigestion and gas due to improper absorption of fats. This is because bile, which includes bile salts, is no longer gushed into the intestines in adequate quantity to digest the amount of fat found in a large meal.

Bile is produced in the liver and stored in the gallbladder. When the gallbladder is removed, bile will continually trickle into the digestive system, whether you are eating or not.

Normally when you eat a heavy meal, the gallbladder responds by forcing a large amount of bile to efficiently digest the fats – not just fats from greasy foods, but healthy essential fats such as omega-3 fatty acids.

So, without a gallbladder, you are not only inefficiently digesting your meals, but your body is missing out on some of the healthy fatty acids and oils needed for your heart, nervous system, absorption of sugars and a healthy brain. Over the years, your body will wear down faster than it should be.

Bile Salts as a Solution

Much research has pointed to the use of bile salt supplements as an effective means of dealing with the digestive disorders common after gallbladder surgery. Ox bile benefits:  Taken with a meal, bile salts help to digest fats and aid in absorption of the fat soluble vitamins. They may also help with occasional constipation.

When shopping for bile supplements take into consideration that the best way to take them is to vary the dose each time. That is difficult to do with a 500 mg capsule. Therefore, many prefer 110 or 125 mg capsules and they can take 2, 3 or 4 tiny capsules per time. And since one of the functions of bile acid is to move the bowel, 500 mg or more on a regular basis could result in diarrhea

Bile Salts Booster

Bile Salts Booster

or loose stools.Taurine is used in the body to convert bile salts to the more water soluble form which is the less toxic form of bile. Therefore, taking taurine along with bile salts would be supportive to healthy bile formation. Also, cholic acid is a more water soluble form of bile acid than most, so look for a supplement that is has cholic acid in it.Any ox bile supplement is purified. Purified essentially means sterilized. Ox bile is the same thing as bovine bile. The bovine family includes bison, ox, bull and cow, etc. and therefore, there is no such thing a vegetarian ox bile extract or supplement. It doesn’t exist.

How to Take Bile Supplements

  • Rotation of Dosage – Randomly alternate your dosage with each meal, using 1, 2, 3 or 4 capsules per meal. While it makes sense to take more with a high protein/high fat meal, in general be random about your dosing.
  • Dosage – the dosage of bile salts will depend on the brand, the type of bile salt, and the milligram content of the supplement. Also, many people find that adjusting the amount of bile salts to their own comfort level is ideal. Bile salts are best taken with a meal, as they provide the acids needed to digest your food.
  • Brands – a number of brands offer bile salts. These include Good Apple Nutritionals (Bile Salts Booster – 110 mg Ox Bile with 40 mg Taurine) Standard Process (Cholacol, collonsonia with ox bile), NutriCology – bovine bile (500 or 125 Ox Bile), and Dews (Bile Salts, 432 mg per capsule).

Side Effects of Bile Salts

Although many people experience help from bile salts, there is one main side effect some people experience: diarrhea. Bile moves the bowel. After gallbladder surgery this can be a common problem as there is no longer a gallbladder to store the excess bile. Supplemental bile salts can add to the excess and cause diarrhea. If you have constipation, you can get away with more bile salts. If not, it is better to get a supplement with smaller milligrams such as 110 or 125.  You need just the right balance of your body’s production and the supplement. Everybody is different.

On the opposite side of the coin, if you experience constant diarrhea after you have had your gallbladder removed, you may have the opposite effect – bile salt diarrhea, where your liver is producing too much bile salt. This spills over into the colon, where it acts as a laxative.

Some people never get rid of this; some people take years to get rid of it and some people have found that taking cholestyramine, a prescription cholesterol drug that also soaks up excess bile salts, stopped it quickly and stopped it for good. It could certainly be worth a try. For some who do not get help with cholestyramine, the natural remedies below sometimes help. It is estimated that 5% of people who have had their gallbladder removed will suffer from this.

Other Supplements To Take After Gallbladder Removal

Taking bile supplements can be one part of your regimen for digestive health, but there are several others supplements that may be helpful as well.

  • Apple Pectin – Research studies conclude that pectin fiber may help to control the symptoms of diarrhea, and may be a great companion to deal with the side effect of bile salt diarrhea. The are several choices for this product but this is the only one I could find with vegetarian capsules.
  • Medi-Clay – a bentonite clay product that may help to adsorb excess bile acids.
  • Fiber Supplement– not only will fiber absorb water and firm up the stool, it may also work as a digestive sweep; aiding in the digestion of fats and eliminating toxins.
  • Probiotics – another great key to digestive health is probiotics. Made up of “good bacteria” commonly found in the intestinal tract, probiotics help maintain balance in the intestinal tract. They have been found helpful in dealing with gas and other digestive issues.
  • Betaine – Betaine HCl stimulates digestive secretions, including bile and pancreatic enzymes. It is essential for the digestion of proteins. If you are experiencing constant diarrhea, swap the bile salts for betaine instead.
  • Choline – the bitartrate form is another aid in digestion. Choline supplements help absorb excess cholesterol and fats. They also help with fatty liver. Many take bile salts and choline together. In fact, the experts on natural solutions for gallbladder symptoms, put bile salts and choline together in a kit for Gas & Bloating. Check it out.


Symptoms That May Benefit from Bile Salts Supplements

Aside from people who have had their gallbladder removed, anyone with difficulty digesting fats accompanied with gallbladder-like symptoms,u could benefit from taking bile salts and other bile thinning supplements. Gallbladder symptoms may include:

* Pain in the upper right side of abdomen
* Pain in right shoulder blade
* Diarrhea and/or constipation
* Indigestion after eating, fatty food
* Full feeling
* Nausea
* Vomiting
* Bloating
* Gas
* Burping

Gallbladder Supplements

There are other supplements in addition to bile salts that are supportive of both the liver and the gallbladder as well as the bile itself.

  • Bile Salts – 110 mg purified ox bile with taurine.
  • Organic Beet Root – beets contain betaine which aids digestion and supports healthy bile flow.
  • Choline – assists digestion of fats and when taken with Bile Salts Booster may help with gas and bloating.
  • Fos Formula – supports bile thinning as well as sludge. Also helpful in relieving symptoms of discomfort.

Actually, the foremost authority on natural solutions for gallbladder problems is GallbladderAttack.com. You will find everything there from a good gallbladder diet as well as answers to all of your questions. There’s a section on what different things can go wrong with the gallbladder as well as the largest list of causes of gallbladder disease. They make it easy by providing a Gallbladder Starter Kit – everything you know in one package. And you’ll find they have great customer service with an online chat so you can get your questions answered.


Dealing with Bile Salt Malabsorption

Bile salts are produced in the liver. They are included in the bile and sent to the gallbladder, where the bile is concentrated and stored. When the stomach empties its contents into the upper intestines (duodenum) for further digestion, the gallbladder releases the bile into the duodenum to aid in the digestion of fats in the food.

If bile salts are not absorbed properly, they are passed into the intestine where they can cause diarrhea. If your gallbladder has been removed, bile constantly trickles into your duodenum and small intestine – while this is not usually a problem, a percentage of people without a gallbladder will have digestive problems – either because of too much bile (causing diarrhea) or too little (causing improper digestion of fats and indigestion – a bile salt supplement is recommended).

The diarrhea may be watery, and frequently occurs after meals. Testing of the diarrhea specimens will reveal excess amounts of bile salts (acids) present. While the disorder is not life-threatening, it can disrupt normal life due to the number of trips to the bathroom.

Causes of Bile Salt Malabsorption

woman stomach ache bile acidBile salt malabsorption is connected to two primary diseases: Crohn’s disease and Irritable Bowel Syndrome. However, it is difficult to determine if the malabsorption causes the diarrhea in those diseases, or if the diseases themselves trigger the malabsorption.

The lower part of the small intestine, called the ileum, is responsible for absorbing bile salts. In patients who have had part of their ileum removed, bile salt malabsorption is common.

Another possible cause of bile salt malabsorption is pancreatic insufficiency. In other words, improper function of the pancreas. This can be the result of alcoholism, but can have other causes as well.

If you have had your gall bladder removed, you may experience this as well – about 5% of patients report painful diarrhea after surgery, which does not abate. Studies show that the liver sometimes produces extra bile salts to compensate for the lack of a storage area for bile. This excess bile overwhelms the small intestine and spills over into the colon, where it acts as a laxative.

How Intestinal Bacteria Relates

Recent studies show that the malabsorption of bile acids may also be due to improper balance of intestinal bacteria. The body normally maintains about 400 types of good bacteria (called probiotics) in the intestinal tract. These flora can be killed off when antibiotics are taken for infection. The resulting imbalance of intestinal bacteria may contribute to failure to properly absorb bile salts. (Whenever I take antibitotics, I always take a probiotic supplement afterward.)

Treatment for Malabsorption

The most common treatment for bile salt malabsorption is bile salt binders, called sequestrants. The most common binders are cholestyramine and colestipol, which are both available by prescription. Even though these drugs are effective at stopping the diarrhea, they are often hard for patients to tolerate. Side effects can include abdominal pain and bloating. Other possible treatments may include:

  • Welchol (Colesevelam) – a newer drug called Welchol – generic name of colesevelam, is said to be 4 times more potent than traditional binders. This drug has shown fewer side effects and greater likelihood of success. It is available by prescription.
  • Medi-Clay – a purified bentonite clay product that adsorbs excess bile salts in a similar way that the drugs do. Although not as potent, every body is different and some may get better results with this.
  • Apple Pectin – also helpful for binding excessive bile acids
  • Probiotics – because some research points to an imbalance of intestinal bacteria, it may be helpful to supplement with probiotics. These supplements are natural, have few, if any side effects, and can be beneficial for dealing with other digestive disorders. They help gas, bloating, and diarrhea in certain cases. Because of their safety, probiotics may be an excellent way to support the digestive process and correct the cause of bile acid malabsorption. (Probiotics are also found in yogurt.)
  • Pancreatic Support – because some bile salt absorption is linked to poor function of the pancreas, treatments that support the pancreas may help the problem. Pancreatic enzymes are readily available over the counter and help the digestion of proteins and fats.

Diarrhea: Dealing with the Unpleasant Side Effect of Bile Salts

man with bile salt diarrhea


If you are one of those people who are dealing with diarrhea while taking bile salts, you are not alone. Bile salts may help many people find relief from indigestion and other symptoms related to gall bladder removal, but they may face a few side effects. Diarrhea is one of them.

Nothing is more frustrating than taking a supplement to help one issue, only to have another one develop. However, there are steps you can take to combat the diarrhea and allow you to continue reaping the benefits of taking bile salts. The first one is to get a bile salt supplement in a small capsule, with 125 mg or less. That amount rarely causes side effects. Secondly, take some taurine along with it, especially if you have had gallbladder surgery. The body’s own bile composition after gallbladder removal tends to be more fat soluble and toxic. Taurine is used in the formation of water soluble bile salts. Adding that to your bile salt pool may help and certainly can’t hurt.

Why Do Bile Salts Cause Diarrhea?

woman with bile salt crampingSome people who take bile salts begin having issues with the loose, watery stools normally associated with diarrhea. These symptoms can also appear after gall bladder removal (called a cholecystectomy) in people who are not taking supplemental bile salts. The reason for both of these situations appears to be related: a more constant, less concentrated flow of bile into the intestines. In order to understand this, it is important to know a little about how the gall bladder functions.

Normally, the liver secretes bile, which is made up of bile salts, cholesterol, and phospholipids. When a person is not digesting food, the bile is directed to the gall bladder where it is concentrated and stored. When food enters the area below the stomach, called the duodenum, the gall bladder begins to pump bile in to break down fats in the food. This is an important part of digestion.

If a person has had their gall bladder removed, there is no storage for bile. Instead the bile runs continually into the intestine. This is caused by too much bile salts, which act as a laxative. About 5% of all patients who have their gall bladder removed will experience this. Unfortunately, there is not often help with this, but there is medication. Talk to your doctor.

Taking a bile salt supplement also increases the amount of these substances entering into the intestinal tract, which may produce a similar laxative effect.

What Can be Done to Help?

Loose, watery stools for any reason are not pleasant. Doctors sometimes prescribe medication that attempts to control diarrhea caused by the removal of the gall bladder. However, there are some natural steps that can be taken to help regulate diarrhea, whether it is caused by gall bladder removal, bile salt supplementation, or both.

  • Apple Pectin – Research studies conclude that pectin fiber may help to control the symptoms of diarrhea, and may be a great companion to deal with the side effect of bile salt diarrhea. The are several choices for this product but this is the only one I could find with vegetarian capsules.
  • Medi-Clay – a bentonite clay product that may help to adsorb excess bile acids.
  • Fiber – the addition of fiber in the diet can add more bulk to the stool, helping with diarrhea. Patients will want to add fiber slowly to the diet, to avoid additional gastrointestinal discomfort. Fiber works by soaking up excess water and firm up the stool. Everyone one needs at least 20 to 30 grams of dietary fiber per day, but extra will not hurt, as it will be eliminated from the body. Soluble fiber, such as the inside of beans, peas, apples, and pears, as well as oatmeal and oat bran may be better for the control of diarrhea than insoluble fiber. Fiber supplements are also available.

Other Thoughts

Other ideas for dealing with diarrhea include limiting fat intake, and eating smaller, more frequent meals. Eating more frequently will put food in the digestive track more often, using up more of the bile salts.

Also, some people trying to find a right balance of supplements to enjoy proper digestion have also tried choline and betaine. Read this article for information.

Bile Salts – Can They Help?

A common concern after gallbladder surgery is frequent indigestion, gas, and bloating. If you experience these symptoms, you know the discomfort they bring. You may not have found a lot of help from your doctor but understanding the cause of these issues may help find solutions. One possible solution is taking bile salts. But do they really help?

Those Awful Symptoms

Many people think that all their digestive problems will be over after their gallbladder is removed. Unfortunately, this is rarely the case. There are several reasons for this. One is the fact that gallbladder difficulties are often related to diet and obesity. Unless these factors change, a person may continue to have digestive issues, even without their gallbladder.

bile salt abdominal painAnother issue is how the body responds to the removal of the gallbladder. When the gallbladder is intact and functioning properly, it releases bile into the intestines to aid in the digestion of fats. The timing of this release is coordinated with the digestive process.

After the gallbladder is removed, bile flows in small, but steady amounts into the intestine. This may cause diarrhea in some patients, due to bile not being mixed with sufficient food. However, another, more common side effect can occur: gas, indigestion, and bloating. The reason for this is because there is not sufficient bile available to mix with the stomach contents when a large or high-fat meal is consumed. The result is improperly digested fats, which results in digestive upset.

Help – I need it!

People often wonder if it is possible to find relief from these difficult symptoms. Thankfully, the answer is usually yes. Sometimes these issues can be caused by other disorders such as peptic ulcers, irritable bowel syndrome, and pancreatitis. But many times they are easier to treat. Here are a few suggestions:

  • Eat a low-fat diet – reducing the amount of fat your body has to digest is an easy to understand solution. The more fats you consume, the harder your body has to work to digest them. Because you do not have a gallbladder to dump larger amounts of bile, you can help your body by reducing fat intake.
  • Eat smaller, more frequent meals – eating smaller meals means that your digestive tract has less content to deal with at a time. This means that the smaller, but constant amounts of bile can be mixed with the food better.
  • Use probiotics – certain studies show that adding probiotics to the diet helps with digestive issues such as gas and indigestion. Your body normally maintains around 400 different strains of these “good bacteria” in the intestine, but they can be killed off by the use of antibiotics. Eating yogurt with live cultures or taking probiotic supplement may be a great help for your symptoms.
  • Bile Salts – because the bile normally contains bile salts, these substances have been found to help break down fats. When the amount of bile salts is reduced due to gallbladder removal, supplementing the diet with bile salts can be helpful. Many suffers have found that Bile Salts Booster (ox bile salts plus taurine) works better for them. Taken with meals, bile salts assist the absorption of the fats.

More on Bile Salts

Bile Salts Booster

Bile Salts Booster

Bile salts occur naturally in the body and are produced by the liver as part of bile. They are intended to help the digestion of fats in the body, and aid in absorbing fat soluble vitamins such as vitamins E, A, D, and K.

If these fat soluble vitamins and fatty acids are not absorbed, they are passed onto the colon, where they can contribute to diarrhea.

Most people produce adequate amounts of bile salts, but when the gallbladder is removed, fewer bile salts are available when food is digested. This can lead to indigestion, gas, and even deficiency of fat soluble vitamins. For these people, supplementing the diet with bile salts may improve their quality of life.

Other functions of bile salts include:

  • Breaking down and eliminating toxins – the liver is the body’s primary toxin filter and sends most of the filtered toxins into the bile to be eliminated. In addition, bile continues to break down the walls of viruses and other substances in the digestive tract. When the body fails to properly break down these toxins they can cause skin problems, such as those found in psoriasis. Some research reveals successful treatment of psoriasis with bile salts. This demonstrates the powerful effects these substances can have on the body.
  • Re absorption – bile salts are reabsorbed into the body for re-use in the liver. This ensures continual supply for optimal digestion.

The Good and Bad of Bile Salt Supplements

As with any supplement, it is important to evaluate the benefits and any negative effects of bile salts. Rather than quickly taking something and wondering about the results later, an informed decision will help prepare a person to observe how the substance effects their body.

  • The Good – many people find relief from their digestive discomfort, indigestion, gas, and bloat while taking bile salts. In addition, some people have found other, seemingly unrelated symptoms clear up, including skin conditions, and toxicity of the blood.
  • The Bad – a reported side effect of taking bile salts is more frequent diarrhea. This would be similar to the malabsorption of bile salts found in some people with conditions like Crohn’s and Irritable Bowel Syndrome. While diarrhea is never pleasant, steps can be taken to minimize it, allowing patients to find digestive relief without unpleasant side effects.

Since the main drawback to bile salt supplementation is diarrhea, it may be helpful to address how this can be managed. Two simple solutions have been found:

  • Fiber – increased fiber intake bulks up the stool by absorbing excess water. Bile salts produce watery stools, so fiber is often an adequate solution. Fiber can be taken as a supplement, or may be acquired in the diet by eating high-fiber foods such as whole grains and vegetables.
  • Calcium Carbonate – a common ingredient in medications for diarrhea, calcium carbonate has proven success in slowing diarrhea. It can be found in supplement form, and may help to reduce the diarrhea associated with bile salt supplementation.

If you are considering taking bile salts, it is recommended that you start slowly and add more as needed. Monitor your symptoms and only take as much as is needed to regulate digestion and provide relief. Too much can cause painful diarrhea.