Prickly ash (Zanthoxylum spp.) has a history of use in traditional herbal medicine, particularly within North American and Chinese herbalism. Herbalists have used it as a "stimulating" or "warming" herb, believed to enhance circulation and promote digestive secretions. Prickly ash bark is considered a "bitter" tonic, and in traditional Western herbalism, bitters are often recommended for sluggish digestion and to support the function of digestive organs, including the gall bladder. When the gall bladder is sluggish or has been removed (cholecystectomy), practitioners sometimes use bitters like prickly ash to encourage bile flow and alleviate symptoms such as indigestion or fat malabsorption. However, there is no robust scientific evidence specifically validating the effectiveness of prickly ash for gall bladder support or for compensating for gall bladder removal.

Most claims for its use are based on empirical tradition rather than clinical trials or pharmacological studies. Research on prickly ash has focused more on its potential analgesic, anti-inflammatory, and circulatory effects rather than on direct actions on the gall bladder or bile production. Thus, its use for gall bladder conditions is justified by tradition rather than scientific validation, and the quality of evidence supporting this use is very low.