By Dr. David L. Pollack

It’s a conversation I have with new patients multiple times a week. They tell me their doctor suspected a gallbladder problem based on their symptoms, but tests—such as ultrasounds, HIDA scans, and specialized CT scans—came back normal. So why don’t these tests find the issue?

The main problem is that most of these tests only detect calcified gallstones, which are essentially hardened rocks. However, gallstones are less common than people might think. More frequently, people with gallbladder dysfunction suffer from what is called biliary stasis, a slowing of bile flow. Normally, bile should have the consistency of dish soap, but when it thickens into a sludge or gritty substance, it can’t pass easily through the bile ducts. In fact, this thickened bile becomes highly inflammatory to the digestive lining.

When we eat foods that stimulate the gallbladder—typically greasy or fatty foods, dense proteins, and even certain vegetables like raw onions and peppers—the gallbladder contracts to release bile. If that bile is too thick, it can lead to discomfort or pain as it moves through the bile ducts. Additionally, this sluggish bile can irritate the stomach and the lining of the small intestines.

While we often expect gallbladder pain to present under or behind the lower right rib cage, this isn't always the case. In practice, the most common symptom of gallbladder dysfunction is bloating, which can range from mild to severe, sometimes with visible distention that makes the abdomen look “pregnant.” Other digestive symptoms—ranging from loose stools to constipation, heartburn and reflux—can also occur.

But it doesn’t stop there. Gallbladder dysfunction can lead to a range of secondary symptoms. For instance, the gallbladder shares nerve roots with the right shoulder, similar to how the heart shares them with the left shoulder. As a result, many people with gallbladder issues experience right shoulder or neck pain.

The gallbladder’s main function is to aid in the digestion of fats and to a lesser extent, proteins. If biliary stasis prevents fats from being properly processed, many bodily systems that rely on fat begin to suffer. Healthy fats are vital for heart function, hormone production, nerve and brain health, youthful skin, and reducing inflammation. Without proper fat digestion, people may experience weight gain, increased pain, and a lack of energy.

The good news is that there are effective strategies to help repair the gallbladder and promote healthy bile flow. These include targeted supplements, enzymatic nutraceuticals, acupuncture and dietary adjustments to thin the bile. Other therapies, such as cold laser treatment and emotional release techniques (since gallbladder dysfunction is associated with anger, frustration and oftentimes sadness and depression in Chinese medicine), can also be beneficial.

If you’ve been told your gallbladder is fine but still feel something isn’t right, consider exploring these alternative strategies. Your gallbladder may need attention even if traditional tests don’t show a problem.

Dr. David L. Pollack is the founder of Pollack Wellness, located at 66 Commack Rd., #204, Commack, NY. For appointments or information, call 631-462-0801 or visit PollackWellness.com.