Cholagogue

Plants traditionally used as choleretics and cholagogues

Barberry, Oregon grape, Greater Celandine, Balmony, Fringe tree, wahoo, dandelion, Veronicastrum (black root), boldo, turmeric, globe artichoke.

Indications for choleretics and cholagogues

• Non-impacted gallstones
• Moderate cholecystitis (gallbladder infection) , in conjunction with immune system support
• Conjugated hyperbilirubinaemia (jaundice due to decreased excretion of conjugated bilirubin through the bile duct)

Other traditional indications:

• ‘Bilious’ conditions associated with heaviness in the epigastrium, nausea, intolerance of alcohol and fats, headaches
• Toxic conditions associated with intestinal congestion, especially in skin and autoimmune diseases
• Chronic constipation due to sluggish digestion.

Contraindications for choleretics and cholagogues

The effects of choleretic and cholagogue agents may be different in the diseased liver than the response produced in the normal liver. For example, experimental evidence suggests that the use of choleretic agents where hepatobiliary damage (e.g. cholangitis) is caused by obstructive jaundice might further depress hepatic functions.

The use of choleretics and cholagogues is either contraindicated or at least inappropriate in the following:

• Obstructed bile ducts (due to impacted gallstones, cholangitis or cancer of the bile duct or pancreas)
• Unconjugated hyperbilirubinaema (jandice following hemolytic diseases, hereditary disease such as Gilbert’s and Crigler-Najjar syndromes)
• Acute or severe hepatocellular disease (for example, following viral hepatitis, cirrhosis, adverse reactions to drugs such as anesthetics, steroids, estrogen, chlorpromazine)
• Septic cholecystitis (where there is a risk or peritonitis)
• Intestinal spasm or ileus
• Hepatic cancer (although heptoprotective herbs that also have some choleretic activity, such as Silybum marianum, can be appropriate, especially for secondary tumors on the liver.