Bile is a fluid which is yellow-green in color and is produced by the hepatocytes – liver cells. It is stored in the gall bladder. Bile is composed of bile salts, water, cholesterol, and pigments and helps with digestion of fats.
Bile also contains potassium and sodium (body salts) and bilirubin which is formed when red blood cells break down. Small quantities of copper and miscellaneous metals could also make up bile fluids.
Bile is one of the fluids secreted in our body to support digestion. It contains water, bile acids, cholesterol, bilirubin, organic molecules and electrolytes.
The bile is produced by the liver and stored in the gall bladder. The bile ducts are pipes that carry bile from the liver to gall bladder and gall bladder to intestine.
Bile primarily aids in digestion and absorption of fats and fat soluble vitamins. It also supports excretion of waste products.
Average adults are said to produce 400 to 800ml daily. Bile serves as a route for cholesterol excretion.
Gall bladder stores bile and aids in concentrating it. The flow of bile is lowest in fasting state. When the food enters the intestine for digestion, certain hormones are secreted to dilute the bile and facilitate its movement to the intestine.
This happens via the bile ducts. Various disorders can affect the bile duct primarily by causing blockage in the duct. Gallstones are the most common cause of blockage. These blockages can trigger infection.
Certain blockages occur as a result of cancer in bile ducts (cholangiosarcoma). Other bile duct diseases like primary sclerosing cholangitis and primary biliary cirrhosis involve inflammation and are associated with autoimmune diseases.
The chronic inflammation can further trigger what is known as liver cirrhosis which is characterised by scarring and inflammation of the tissue.
A healthy lifestyle can prevent high cholesterol levels and gallstone formation. Endoscopic therapy, surgery and pharmacological treatments are prescribed for treatment of gall bladder disease.
9 Benefits of Turmeric In Bile related Disorders
Turmeric has hepatoprotective properties- it protects the liver function. It also protects the gall bladder function.
Various studies have found out that curcumin found in turmeric can improve bile flow and benefit in various diseases affecting bile duct.
1. It can prevent gallstones
Turmeric and curcumin can help prevent gallstone formations. They improve gall bladder function and also lower cholesterol levels (Read Turmeric for high cholesterol).
A study published in Indian Journal of Medical Research,1992 demonstrated that dietary curcumin can prevent cholesterol gallstone formation. Higher the dose of curcumin better was the prevention.
A significant decrease in the lithogenic index was observed and also a decrease in cholesterol/lipid ratio in the bile was observed.
Researchers at Shenjing Hospital of China Medical University, conducted an animal study that demonstrated the efficacy of curcumin and piperine in preventing gallstone formation.
Previously they had proven that curcumin dose dependently can prevent gallstone formation.
In this study they found that piperine enhanced curcumin’s effect of preventing gallstone formation. A reduction in blood lipids and cholesterol in the bile was observed.
Dietary curcumin and capsaicin (active ingredient of chillies) are also found to prevent gallstone formation by improving antioxidant enzymes of the liver.
However curcumin is proven to cause significant gall bladder contraction and this level of contraction may be painful in active bile duct obstruction or gallstones.
Dietary turmeric may not pose such risk but caution should be exercised. (Read Should you take turmeric If you have gallstones)
What does this mean?
Dietary inclusion of turmeric can help lower cholesterol and prevent gallstone formation.
2. It may benefit in cholangitis
Cholangiopathy is damage to the bile duct caused by insufficient blood flow. Primary sclerosing cholangitis and primary biliary cirrhosis are chronic cholangiopathies that cause severe inflammation and cause fibrosis.
Researchers have investigated the effect of curcumin in an animal model of cholangiopathy. It was observed that curcumin reduced inflammation, fibrosis (scarring and thickening of tissue) and reduced bile duct obstruction.
Curcumin prevented inflammation induced activation of cellular damage. It also blocked proliferation of cells thereby preventing fibrosis.
It was concluded that curcumin could prove to be a promising therapeutic agent in cholangiopathies and sclerosing choliangitis.
What does this mean?
Curcumin’s anti-inflammatory and antioxidant property can benefit in cholangitis or infectious conditions that obstruct bile duct.
3. It can help in bile duct cancer (cholangiocarcinoma)
A study published in Food and Chemical Toxicology, 2010 reports that curcumin exerts chemopreventive effect in cholangiosarcoma or bile duct cancer.
Even at low dose curcumin is found to prevent proliferation of cancer cells in the bile duct. By virtue of its pro-oxidant property it induces apoptosis or cell death of cancer cells. It also increases the level of anti-tumor proteins.
Researchers at Medical College of Wisconsin have found that curcumin exerts anti-cancer action in cholangiosarcoma even at low doses.
Under experimental conditions, high concentration of curcumin shows a 50-56% reduction in cancer cell viability.
A study published in Carcinogenesis, 2011 reported 7 different biochemical pathways with which curcumin interacts in order to inhibit growth of bile duct cancer cells.
What does this mean?
Curcumin exerts anti-cancer and chemopreventive action in bile duct cancer or cholangiosarcoma.
4. It can improve bile flow and stimulate gall bladder emptying
Curcumin, as a constituent of Chinese herbal medicine, is found to protect from liver injury due to choleostasis and helps balance bile production thereby attenuating cholestasis.
A study published in Journal of Science, 2016 describes the choleretic activity of turmeric’s active ingredients. Turmeric oil’s active ingredients are found to have significant choleretic activity in comparison to curcuminoids.
Researchers from University of Nottingham have also identified curcumin as one of the food ingredients that stimulates gall bladder emptying.
Research proves that 40 mg curcumin can cause 50% gallbladder contraction and can cause gallbladder emptying.
What does this mean?
Turmeric and curcumin improve bile flow and cause gall bladder contraction and emptying. This supports digestion and helps in prevention of gallstone formation.
5. It can protect from cholestasis induced damage
Cholestasis is impairment of bile flow. Symptoms include itching, yellowing of eyes and skin, nausea, loss of appetite etc. Chronic cholestasis may cause inflammation and fibrosis in the liver and affect other organs as well.
Various research studies have proven that curcumin can prevent liver fibrosis caused by cholestasis. It does so by protecting the function of liver cells and also reduces the levels of certain proteins that promote inflammation and scarring of tissue.
A study published in Fundamental and Clinical Pharmacology, 2008 suggests that curcumin can reverse liver cirrhosis caused by cholestasis.
Curcumin’s antioxidant and anti-inflammatory property can protect liver and kidney tissue from cholestasis induced injury.
Curcumin also protects from intestinal damage due to cholestasis.
What does it mean?
Cholestasis or impairment of bile flow can affect functioning of other organs and cause liver fibrosis. Curcumin is found to counteract this damage and reverses cholestasis.
6. It protects from drug induced toxicity
Chemotherapeutic agents can affect liver function and bring undesirable changes in structure of bile duct and liver tissue.
Researchers demonstrated that curcumin protects from cisplastin (chemotherapeutic drug) induced structural changes in liver and bile duct.
What does this mean?
Curcumin protects liver and gallbladder function. It can prevent drug induced toxicity that causes damage to bile duct structure.
7. It benefits in bile reflux and Barret’s oesophagus
Barret’s oesophagus is considered as a precancerous condition. It generally occurs as a result of exposure of the food pipe cells to acid reflux and non acid reflux which changes the structure of the cells lining the oesophagus.
The tissue lining the esophagus becomes similar to the lining of the intestine. About 1% of the individuals suffering from Barret’s esophagus develop esophageal adenocarcinoma.
Rawat et. al conducted an experimental study to assess the effect of curcumin in Barret’s esophagus. In the first part of the study they observed that curcumin prevented bile acid induced DNA damage in esophageal cell lines under lab settings.
In the second part of the study, 16 patients of Barret’s esophagus were treated with 500mg curcumin for 7 days and 17 received no treatment.
Based on biopsy tests, it was observed that curcumin reduced inflammation in the treated group compared to non treated group.
It also doubled the rate of apoptosis (cell death, in this case of precancerous cells) thus suggesting its therapeutic efficacy in Barret’s esophagus.
Bower et. al have proven via experimental study that curcumin’s anti-inflammatory and antioxidant properties help in chemoprevention of Barret’s esophagus.
It inhibits the damaging effects caused by bile acid and reduces the level of inflammatory enzymes like COX-2.
What does this mean?
Curcumin is found to have chemopreventive action in Barret’s oesophagus. It protects oesophagus from bile acid reflux.
8. It can benefit in parasitic infections
Opisthorchis viverrini or liver fluke is a parasitic infection that causes inflammation and injury to liver and bile duct. Eating undercooked fish, especially when travelling to South east Asia, is held as a causative factor for this infection.
This infection can trigger cholangitis- blockage of bile duct by infection and cases of major infection can cause risk factors for development of bile duct cancer.
An animal study published in Korean Journal of Parasitology, 2013 demonstrates that dietary curcumin can attenuate abnormalities occurring in the bile duct due to Opisthorchis viverrini infection and thus exert a chemopreventive action.
Curcumin is also proven to protect from oxidative and DNA damage in O.viverrini infection.
What does this mean?
Curcumin is found to be therapeutic in a common parasitic infection of the bile duct caused by liver fluke or Opisthorchis viverrini.
9. It can attenuate abdominal pain in bilary dyskinesia
Turmeric and curcumin has analgesic and anti-spasmodic properties.
A study in humans demonstrated that turmeric root extract combined with chelidonium extract is found to reduce colicky pain in upper right abdomen occurring as a result of bile duct obstruction.
Reduction in secondary symptoms such as vomiting, nausea, food intolerance was also reduced.
What does this mean?
Turmeric has analgesic and anti-spasmodic property that can relieve abdominal pain in bile duct related conditions.
Dosage of Turmeric For Bile Related Disorders
Turmeric in diet can help prevent gallstone formation. You can simply sprinkle turmeric in salads, soups, smoothies or use it in cooking.
Curcumin in turmeric is poorly absorbed in the body. Taking turmeric with black pepper and oil increases the absorption. Golden Paste combines these 3 elements making it an effective way of taking turmeric.
Start with small doses say ¼-1/2 tsp and increase gradually if no side effects are observed. The recommended dose is 1-2 tsp 2-3 times day (precisely 1 tsp 3 time a day).
Avoid taking it on an empty stomach. (Read Does turmeric cause acid reflux?) If taking large doses avoid taking it close to the time of taking medicines. (Read Black pepper in GP: Does it cause Drug interactions?)
The ideal dose depends on what suits you; some do fine on less while some need more.
If taking turmeric supplements, consult a health practitioner prior.
Turmeric in diet is safe but a few precautions need to be noted. (Read Side effects of turmeric)
Large doses of turmeric may cause gastric discomfort. Always start with small doses and increase gradually. Avoid taking turmeric on an empty stomach. (Read Can turmeric cause acid reflux?)
Turmeric has anti-platelet property. So if suffering from bleeding risk or taking blood thinners ,consult a health practitioner before taking turmeric.
Also if scheduled for surgery, it is advised to discontinue turmeric supplements 2 weeks prior to surgery to avoid bleeding risks.
Curcumin in turmeric causes gall bladder contraction. If suffering from active bile duct obstruction or gallstones this level of contraction may cause pain. (Read Is it safe to take turmeric if you have gallstones)
However, many readers, safely continue consuming turmeric in diet even in gallstones.
Turmeric supplements should be avoided in pregnancy and lactation.
Turmeric as a spice is high in oxalates. Therefore one should limit its intake in gout and kidney stones. (Read Does Turmeric Cause Kidney Stones?) In such cases one can opt for curcumin supplements after a doctor’s consent.
Curcumin in turmeric interferes in drug metabolism. Hence it is advised not to take turmeric supplements concomitantly with any medication. Maintain a 3-4 hour gap.
It is best to consult a health practitioner about turmeric supplements.
Turmeric in diet can help prevent high cholesterol and gallstone formation. It can help improve bile flow, cholesterol metabolism and aids in digestion.
Curcumin at low doses causes significant gallbladder contraction. If already suffering from active bile duct obstruction, it is supposed that this level of contraction may be painful.
However this may not be the case for dietary turmeric. Many readers have reported to consume turmeric in diet even when suffering from gallstones and have not experienced any adverse effects.
Current studies suggest that curcumin can benefit in various bile duct related disorders.
Further research is required understand the efficacy of turmeric and curcumin in bile duct related disorders and also need to be supported by human studies.