Gall Bladder Stones

Gallstones are stones, which form in the gallbladder and are classified as either cholesterol or pigment stones.

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.

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.

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.

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.

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.

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.

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.

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.

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 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 may improve bile flow and relax the bile duct. Turmeric is a valuable 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.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints.
2. Keep the bowels regular. Your Pharmacist may suggest a high fibre product to help.
3. 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.
4. Digestive enzymes may be beneficial in helping the gallbladder to digest fats. Ask your Pharmacist for advice.
5. Some nutritional supplements might be considered if the diet is inadequate. Vitamin C is one example, as it helps the natural immune system of the body. Fat-soluble vitamins such as vitamin A, vitamin E and 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.