Gallstones
DEFINITION
Gallstones are stones which form in the gallbladder and are
classified as either cholesterol or pigment stones.
classified as either cholesterol or pigment stones.
DESCRIPTION
Bile is produced by the liver and stored in the gallbladder.
It helps to break down dietary fats into smaller fragments for
digestion and absorption into the body. When fats are eaten, the
gallbladder contracts and ejects bile through the common bile duct
to the duodenum. When the body needs to break down fats into
smaller fragments for digestion, a valve at the end of the common
bile duct will open and allow the liquid to mix with the
food.
It helps to break down dietary fats into smaller fragments for
digestion and absorption into the body. When fats are eaten, the
gallbladder contracts and ejects bile through the common bile duct
to the duodenum. When the body needs to break down fats into
smaller fragments for digestion, a valve at the end of the common
bile duct will open and allow the liquid to mix with the
food.
Problems arise when the bile secreted in the gallbladder becomes
too saturated with cholesterol and stones may start to form. The
small stones travel via the ducts into the digestive tracts and are
excreted in the bowel motions. Larger stones may block the ducts
because of their size. This blockage will cause considerable
pain.
too saturated with cholesterol and stones may start to form. The
small stones travel via the ducts into the digestive tracts and are
excreted in the bowel motions. Larger stones may block the ducts
because of their size. This blockage will cause considerable
pain.
PIGMENT STONES
These stones are less common in the Western world and more
common in developing countries than cholesterol Gallstones. Pigment
stones are brown, crumbly stones, which often result from a
bacterial infection, haemolysis, old age or chronic alcoholic liver
disease.
common in developing countries than cholesterol Gallstones. Pigment
stones are brown, crumbly stones, which often result from a
bacterial infection, haemolysis, old age or chronic alcoholic liver
disease.
CHOLESTEROL STONES
These stones are more common in the Western world than pigment
Gallstones and are comprised mostly of crystallised cholesterol.
The liver, in these cases is producing bile which is saturated with
cholesterol. In some cases, however, a person with cholesterol
saturated bile will not develop stones while another person with
the same type of bile will develop Gallstones. This suggests that
there are a number of factors which contribute to the formation of
the stones and the best approach is to reduce the risk factors as
much as possible e.g., have a healthy diet and avoid excess fat and
sugar.
Gallstones and are comprised mostly of crystallised cholesterol.
The liver, in these cases is producing bile which is saturated with
cholesterol. In some cases, however, a person with cholesterol
saturated bile will not develop stones while another person with
the same type of bile will develop Gallstones. This suggests that
there are a number of factors which contribute to the formation of
the stones and the best approach is to reduce the risk factors as
much as possible e.g., have a healthy diet and avoid excess fat and
sugar.
RISK FACTORS
In people under 40 years of age, women are at a greater risk
of developing Gallstones than men, whereas in the elderly the ratio
is about equal. The reason for this is uncertain. The incidence of
Gallstone formation also increases with age. Other risk factors
include obesity, a Western diet, oestrogen therapy such as hormone
replacement therapy and the oral contraceptive pill, pregnancy,
rapid weight loss, Crohn’s Disease and a family history of
Gallstones. Gallstones also tend to be common in people with liver
dysfunctions.
of developing Gallstones than men, whereas in the elderly the ratio
is about equal. The reason for this is uncertain. The incidence of
Gallstone formation also increases with age. Other risk factors
include obesity, a Western diet, oestrogen therapy such as hormone
replacement therapy and the oral contraceptive pill, pregnancy,
rapid weight loss, Crohn’s Disease and a family history of
Gallstones. Gallstones also tend to be common in people with liver
dysfunctions.
DIET AND GALLSTONES
There is some debate about the role of the diet in the
formation of cholesterol Gallstones. A diet which is high in
cholesterol, saturated (solid) fats, calories, refined
carbohydrates and lack of fibre may all contribute to Gallstones.
Research indicates that a high intake of refined sugar has a direct
link to an increased risk of Gallstone formation. Rapid weight loss
with a significant drop in dietary fat intake may also promote the
formation of Gallstones.
formation of cholesterol Gallstones. A diet which is high in
cholesterol, saturated (solid) fats, calories, refined
carbohydrates and lack of fibre may all contribute to Gallstones.
Research indicates that a high intake of refined sugar has a direct
link to an increased risk of Gallstone formation. Rapid weight loss
with a significant drop in dietary fat intake may also promote the
formation of Gallstones.
SIGNS AND SYMPTOMS
Many people with Gallstones remain free of symptoms for a long
time while others may never develop symptoms at all. If a stone
does cause a blockage in a duct within the body, colicky pain may
be felt and inflammation may develop. This pain usually occurs
suddenly and lasts for approximately one hour as the stone passes
through the duct. The pain may radiate to the right lower shoulder
blade. Jaundice may be present, as well as burping, bloating,
nausea, vomiting and fatigue.
time while others may never develop symptoms at all. If a stone
does cause a blockage in a duct within the body, colicky pain may
be felt and inflammation may develop. This pain usually occurs
suddenly and lasts for approximately one hour as the stone passes
through the duct. The pain may radiate to the right lower shoulder
blade. Jaundice may be present, as well as burping, bloating,
nausea, vomiting and fatigue.
TREATMENT OPTIONS
As with all conditions your Doctor should be consulted. Your
Doctor will diagnose and treat this condition. Ask your Doctor
about the latest advice on this ailment. Usually small Gallstones
will pass out of the body via the digestive tract in the bowel
motion. Pain which continues for more than 6 hours, however, may
indicate that a complication such as cholecystitis or pancreatitis
has developed. Modern treatment of Gallstones includes the
breaking-up of larger stones with ultra-sonic sound waves,
dissolving stones with naturally occurring bile acids or surgical
procedures.
Doctor will diagnose and treat this condition. Ask your Doctor
about the latest advice on this ailment. Usually small Gallstones
will pass out of the body via the digestive tract in the bowel
motion. Pain which continues for more than 6 hours, however, may
indicate that a complication such as cholecystitis or pancreatitis
has developed. Modern treatment of Gallstones includes the
breaking-up of larger stones with ultra-sonic sound waves,
dissolving stones with naturally occurring bile acids or surgical
procedures.
DIET HINTS
- To minimise the risk of Gallstone formation, avoid fatty foods
such as fried foods, full cream dairy foods, chocolates, rich cakes
and desserts, biscuits, slices and snack foods. - Try to cook and make salad dressings with olive oil and avoid
deep frying and frying foods in butter. - It is best to avoid ‘crash’ diets, as losing weight too quickly
is associated with an increased risk of Gallstones. - Lecithin granules or capsules may help with the emulsification
(break down) of fats. - Gallstones have been linked to young people who consume high
amounts of sugar. A low-sugar, high fibre diet is thought to help
reduce the stone-forming potential of bile. - Aim for 3-4 serves each day of fresh fruits and vegetables.
Include 4-6 serves of wholegrain cereals in your daily diet.
Gallstones are also less common in vegetarians. - Reduce cholesterol in the diet; cholesterol is found in animal
products e.g., red meat, dairy products and eggs etc. - Eat regular meals, 5 or 6 small meals per day. This helps to
avoid overloading the digestive system and allows the body more
time to digest any fats. - Try to drink 6 to 8 glasses of fresh water daily to help the
natural elimination processes of the body.
VITAMINS/MINERALS/HERBS
Nutritional supplements are only to be used if the dietary
vitamin intake is inadequate.
vitamin intake is inadequate.
- Vitamin C supplementation may be required in cases of
Gallstones. Low levels of vitamin C in the body may play a role in
the development of Gallstones. Vitamin C appears to lower the
amount of cholesterol in bile, making secretions from the liver
less likely to clump together and form stones. - Low dietary fibre intake is commonly seen in people presenting
with Gallstones. Psyllium is an excellent source of soluble fiber.
It can bind to the cholesterol in bile and help prevent gallstone
formation. In addition, psyllium can prevent constipation, a
condition associated with increased gallstone formation. - An insufficient intake of antioxidant nutrients, particularly
vitamin E, may contribute to the development of Gallstones. Vitamin
E can reduce the likelihood of stone formation by lowering levels
of cholesterol in bile. - Milk thistle (Silybum marianum) can increase bile flow and
lower cholesterol content of the bile. . - Dandelion root can improve bile flow.
- Turmeric has anti-inflammatory properties and mayimprove bile
flow and relax the bile duct. Turmeric is a valuable remedy remedy
for gall bladder inflammation. - Globe Artichoke may improve bile flow.
NOTES
The use of gallbladder flushing techniques is not encouraged,
as stones may lodge in the cystic duct and cause damage.
as stones may lodge in the cystic duct and cause damage.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints.
- Keep the bowels regular. Your Pharmacist may suggest a high
fibre product to help. - Ask your Pharmacist about a suitable pain relieving tablet. If
the patient is suffering pain, it is wise to see a Doctor for an
examination. Remember that pain is a sign that something is wrong,
and it may not be wise to just treat the pain. - Digestive enzymes may be beneficial in helping the gallbladder
to digest fats. Ask your Pharmacist for advice. - Some nutritional supplements might be considered if the diet is
inadequate. Vitamin Cis one example, as it helps the natural immune
system of the body. Fat soluble vitamins such as vitamin A, vitamin
Eand vitamin D may be lacking, as Gallstones may cause a disruption
to fat digestion and absorption. B group vitamins may help to
stimulate the natural elimination process of the Gallbladder.
Lecithin granules or capsules enhance the breaking-down of
fats.