Gallstones: Diagnosis and Treatment

gallstones

The gall bladder is a hollow sac-like organ that is attached to the liver; it stores a thick liquid substance called “bile” that the liver secretes to help you digest fats. After a meal, the gall bladder contracts and bile passes through to the small intestine through tubes called ducts.

Excess bile cholesterol can cause solid deposits inside the gallbladder that range in size from miniscule to, say, the size of a golf ball. These are commonly referred to as “gallstones”.  Gallstones are relatively common; perhaps ten to fifteen per cent of the population has them. That means a large enough group of people in a survival community will likely include someone with the condition.

Luckily, most people won’t have any symptoms.  In one or two per cent, however, the stones block the ducts, causing pain as the gall bladder becomes distended from excess accumulation of bile. The inflammation caused by this condition is called “cholecystitis”.

There are two main types of gallstones:

1)            Cholesterol stones: The grand majority; these may not be related to the actual cholesterol levels in the bloodstream.

2)            Bilirubin stones: Sometimes called “pigment stones”, this type may occur in people who have illnesses that destroy red blood cells. The by-products of this destruction release a substance called “bilirubin” into the bile and forms a stone. In other cases, however, it’s difficult to identify a cause.

gall bladder anatomy with bile ducts and liver ( By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons)

The pain associated with cholecystitis is known as “biliary colic”. It’s is cramping in nature and is usually seen in the upper right quadrant of the abdomen; it may radiate to the back. If not relieved, inflammation of the liver, gall bladder, and pancreas (“gallstone pancreatitis”) can become life-threatening in some cases.

A serious blockage of the bile duct with corresponding liver/pancreas inflammation can lead to fever, nausea and vomiting, and a yellowing of the skin and eyes known as “jaundice”.

Gallstones are commonly diagnosed by ultrasound, but you won’t have modern technology off the grid. The classical finding on physical examination is called “Murphy’s Sign”. Press with one hand just below the midline of the lowest rib on the front right. Then, ask your patient to breathe deeply. If the gallbladder is inflamed, the patient should complain of tenderness at the site.

In a less politically correct era, risk factors for this condition were described as the 4 “F’s”. For historical purposes, here they are:

Fat: The majority of those with gallstones are overweight.

Female: The majority of sufferers are women.

Forty: Most sufferers are over 40 years old.

Fertile: Most women with gallstones have had children.

Today, more sensitive souls prefer the acronym G.O.L.D.

Genetics: Ethnicity plays a role; Native Americans and Hispanics seem to have more gall bladder issues than Caucasians, Caucasians more than African-Americans.

Obesity: Obesity, especially in women, is associated with at least twice the frequency of gall bladder disease.

Location of Body Fat: Those with obesity concentrated in the torso are more likely to be at risk.

Diabetes: Those with Diabetes are more likely to have gallstones.

The most common treatment for gallstones, other than pain meds, is to surgically remove the gall bladder (you can live without it and stay healthy). Over 800,000 gall bladder surgeries (called “cholecystectomies”) are performed every year. New methods include shock-wave disintegration of stones and acid treatments that may show promise for non-surgical therapy.

Operating rooms, surgeons, and high technology, however, are likely to be in short supply when the you-know-what hits the fan, so it’s useful to know some alternative remedies. These are mostly taken orally::

• Apple cider vinegar (mixed with apple juice or water)
• Chanca Piedra, (Phyllanthus niruri), a plant native to the Amazon; translated, the name means “Break Stones”.
• Peppermint
• Coffee
• Turmeric
• Alfalfa
• Ginger root
• Psyllium
• Red Yeast Rice
• Dandelion root
• Artichoke leaves
• Beet, Carrot, Grape, Lemon juices

It should be noted that hard scientific data proving the effect of the above items is still lacking in many cases. Results from use of the items in the above list will vary from person to person.

Sadly, it is very difficult to eliminate some of the known risk factors for gall bladder disease. You can’t change if you’re forty, female, and have children. You may be able to do something about being obese, however. Dietary changes to lower fat intake may help you lose weight and decrease the risk of gallstones.

Joe Alton, MD

Joe Alton, MD

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