Cholic acid is a primary bile acid that is naturally produced by the liver and plays a central role in the digestion and absorption of fats. Its clinical use is FDA-approved primarily for the treatment of certain rare, inherited bile acid synthesis disorders (e.g., inborn errors of bile acid metabolism), rather than for routine support of gall bladder function. However, there is scientific rationale for its use in patients who have had their gall bladders removed (cholecystectomy) or in those with impaired bile flow, particularly where endogenous bile acid production or secretion is insufficient.

In these cases, cholic acid supplementation can help restore the bile acid pool, improve fat digestion, and reduce fat-soluble vitamin deficiencies. Clinical studies and case reports have demonstrated that exogenous cholic acid can normalize liver function tests, improve growth, and decrease symptoms in patients with bile acid synthesis defects. For people with a sluggish gall bladder, there is less direct evidence, but the concept is that cholic acid may help compensate for reduced bile acid delivery to the intestine. Nonetheless, for most patients with a removed gall bladder, the liver continues to produce bile, and cholic acid supplementation is not standard unless there is a diagnosed deficiency.

In summary, while cholic acid is not traditionally used for gall bladder support, there is moderate scientific evidence for its use in specific cases of bile acid deficiency, but not as a general supplement for all individuals after cholecystectomy or with sluggish gall bladder function.