Ox Bile

Bile Extract · Bovine Bile · Ox Bile Extract

Snapshot

Indications	Contraindications
Dietary fat solubilization^{1, 2} Bile loss after ileal resection^{3, 4}

Ox bile is a bovine bile extract supplying bile salts, which act as detergents that emulsify and solubilize dietary fat in the small intestine^{1, 2}. Supplementation aims to replace bile where delivery or recirculation is reduced, as after ileal resection, which increases fecal bile salt loss³. Patients also describe taking it after gallbladder removal and for gut symptoms, uses reported in patient communities rather than trials.

In a 2020 in vitro and ex vivo study, acidic bile salts with pepsin disrupted esophageal cell barrier function and raised inflammatory signaling; no trial has tested ox bile in reflux. Products listing ox bile are sold as capsules and tablets, often with digestive enzymes; see Form comparison.

Bosentan inhibits the bile salt export pump, causing intrahepatic accumulation of cytotoxic bile salts and transient liver enzyme rises⁵. Whether exogenous bile salts add to that burden has not been studied.

Last updated October 15, 2026. Read how we make monographs.

In the full monograph

45 sources, 28 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources