Hello, My answer is as follows, while bile salts could enhance digestion following gallbladder removal and have many benefits for your health in general. They should be used with caution, as you rightly stated out, there has been evidenced an association between bile salt supplement and gastric cancer. More precisely, bile salts are considered as gastric cancer promoters. Cancer promoters stimulate cancer development through cell proliferation whereas real carcinogens cause cancer through cell mutations. It is not clear the level of importance of bile salts as gastric cancer promoters because literature data are ambiguous with some of them affirming such association and some others claim only a reduced importance of bile salts in such role. Furthermore, bile salts do have other side effects, including digestive side effects (diarrhea, pain, vomiting, constipation); inflammation of the intestine, probably enhancing gastric cancer promoter effects; irritation of the skin, including redness, blisters, itching, etcetera. Therefore, the benefits of bile salts used to have to be weighed against their side effects. My advice is that you should use them if you feel well or better after taking them and if you do not experience any severe side effects. In any case, you have to consult with your doctor and discuss with him/her about side effects of bile salts, including their role in development or initiation of gastric cancer. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ervin Toçi