Condition - Gallstones
What are gallstones?
The gallbladder is a small, pear-shaped sac found under your liver. It stores bile, a yellow-green fluid made by your liver that helps the body digest fats. Bile contains water, cholesterol, phospholipids, fatty acids, bile salts, protein and a waste product called bilirubin. The bile salts help to break up fat and bilirubin gives the bile and stool a yellow-brown colour. When food that contains fat reaches your small intestine, your gallbladder contracts, forcing bile through a small tube (called the ‘common bile duct’) that leads into the small intestine.
Gallstones are solid particles that form in the gallbladder. There can be one or multiple stones in the gallbladder, which can vary in size from a grain of sand to several centimetres in diameter. Gallstones can be very painful. Pain usually occurs after a fatty meal, and develops when a stone passes from the gallbladder into the common bile duct. The pain usually lasts between one and five hours (and sometimes longer) and is frequently located between the breastbone and the belly button, or in the upper right part of the abdomen, just below the rib cage. The pain commonly radiates to the back; between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, usually worsens the pain. Other symptoms of gallstones may include nausea, vomiting, excessive sweating and clay-coloured stools. You should promptly seek professional medical attention if you also develop jaundice (yellowing of your skin or the whites of your eyes) or a fever.
About 80% of people with gallstones actually have no symptoms or symptoms so mild they do not affect their lifestyle. They are said to have ‘silent gallstones’. An ultrasound examination is a definitive diagnosis test for gallstones.
Types of gallstones
Cholesterol-containing stones account for about 80% of all gallstones and the remaining 20% are pigment stones. This article addresses cholesterol-containing stones. These are thought to form when bile contains too much cholesterol or not enough bile salts, or when the gallbladder fails to empty normally. They can be further subdivided into cholesterol stones (predominantly made up of cholesterol) and mixed stones (a mixture of cholesterol, bile pigments and calcium salts, with cholesterol as the main constituent).
You're at greater risk of developing gallstones if you're:
Using birth control pills or hormone replacement therapy
Overweight or obese
Not getting enough exercise
Over the age of 60
Diabetic or suffering from liver disease
Losing weight rapidly
Consuming a diet high in saturated fat and low in fibre
Nutrients for supporting gallbladder health
Vitamin C – this stimulates the activity of an enzyme called ‘cholesterol 7α-hydroxylase’, which is responsible for the first step in converting cholesterol to bile acids in the liver. Converting cholesterol into bile acids helps to prevent its build-up in the bile, which could potentially promote gallstone formation. A study of over 13,000 adults showed that women who had the highest blood levels of vitamin C were less likely to develop gallstones. They also showed that vitamin C intake among women helped to maintain gallbladder health. In another study of patients scheduled for gallbladder surgery, vitamin C intake resulted in an increase in the concentration of phospholipids (fat-like molecules)in bile. Phospholipids may help to maintain the solubility of cholesterolin bile and, in doing so, reduce the risk of developing gallstones.
Vitamin B6 – this is required by the body to synthesise the amino acid taurine. Studies suggest that taurine can increase the activity of the enzyme cholesterol 7α-hydroxylaseand help to thin the bile.
Magnesium – a study published in The American Journal of Gastroenterology showed that long-term consumption of magnesium may help to protect against gallstone formation in men.
Phosphatidylcholine – this is an important component of bile that helps to maintain the solubility of cholesterol in bile. Lecithin is a rich source of phosphatidylcholine.
Cynarin – this may help support normal bile production and healthy function of the gallbladder. Artichokeis a good source of cynarin.
Silymarin – this is an antioxidant flavonoid present in milk thistle, which may help to support the normal flow of bile from the gallbladder to the intestine.
Fish oil – some studies have shown that omega 3 fatty acids reduce the amount of cholesterol present in bile. Reducing the amount of cholesterol in bile may help to reduce the risk of developing gallstones. A study reported in The Journal of Nutrition suggests that omega 3 fatty acids also help to reduce the risk of developing gallstones in obese women during periods of rapid weight loss. Fish oil is a good source of omega 3 fatty acids.
Iron – some studies suggest that iron deficiency plays a role in gallstone formation. If you are at risk of developing gallstones or have existing gallstones, consider having your iron status assessed and any deficiency treated appropriately.
Stomach acid – there is some evidence that stomach acid may be low in patients with gallbladder disease. Taking a supplement that contains hydrochloric acid, which mimics the stomach’s natural environment, may help.
A diet low in meat and high in vegetables is associated with a reduced risk of developing gallstones. Increase your intake of vegetables, fruits and dietary fibre – especially the types found in apples, apricots, citrus peel, oatmeal and flax seeds (opt for organic cold-milled and sprouted flax seeds,which can be added to a huge variety of items, including soups, casseroles, baked goods, yoghurt, breakfast cereal and even drinks).
Eat low-glycaemic-index foods, which simply means eating foods that release their sugar more slowly into your blood stream. Therefore, replace foods such as sugar, chocolates, cakes, biscuits, pastries, white bread made with refined white flour, white rice and pasta, sweets, starchy vegetables, sugary drinks and fruit juice, with nutrient-dense unprocessed foods, including whole grains, fruits, legumes (beans, peas and lentils), nuts and seeds and non-starchy vegetables. Some research suggests that this may reduce the risk of developing gallstones. This may be because foods high on the glycaemic index upset blood sugar levels, resulting in an increase in the production of a hormone called insulin, which helps to restore blood sugar levels to normal. However, elevated levels of insulin may also increase cholesterol production by the liver and reduce the ability of the gallbladder to contract efficiently – both of which are risk factors for gallstone formation.
Citrus peel is a good source of a substance called d-limonene, which may have a beneficial effect on existing stones. It also helps to support digestion. Incorporate orange peel into your diet. Try to use organic oranges when possible, as toxins from pesticide sprays may be stored in the skin. You can try a tea made from orange peel, ginger and cinnamon, sweetened with honey. Or try adding orange peel to your normal tea, or even baked goods.
Turmeric is a source of curcumin, which may help support normal bile production and healthy function of the gallbladder.
Recent studies have shown the potential of garlic(raw) and onions (raw or cooked) in reducing the incidence and severity of cholesterol gallstones. They may possibly achieve this by reducing the amount of cholesterol in bile.
Other foods that may be of benefit include ginger root, artichokes, apples, beets (juiced or finely grated), radishes, lemon juice and apple cider vinegar. You could try the following salad dressing: Mix together one tablespoon of flax seed oil(preferably organic and cold pressed) or three tablespoons of extra virgin olive oil (you can also use a mixture of both oils), one teaspoon of apple cider vinegar(preferably unfiltered and unpasteurised) and one tablespoon of fresh lemon juice (you can vary the amounts as needed), one minced or crushed garlic clove, basil leaves (rip the basil leaves by hand) or a pinch of dried mint. Add sea salt and pepper to taste. The amount of oil you will be able to use will depend on how severe your gallbladder problems are at the moment. You may have to slowly introduce good quality oils into your diet.
Eat dark-green leafy vegetables (spinach, kale, collard greens, turnip greens, mustard greens, dandelion greens, romaine lettuce and watercress), as these are a good source of magnesium.
Snack on nuts (peanuts and tree nuts, such as cashews, almonds and walnuts).Nuts are rich in several compounds that may be protective against gallstones. In support of this, studies from Harvard Medical School have shown that frequent nut consumption is associated with a reduced risk of gallstone disease in both men and women.
Reduce your intake of the following as they may increase the risk of gallbladder disease and gallstones; saturated fats (red meat, dairy products and fried foods), trans fats (present in partially hydrogenated oils, most margarines, vegetable shortening, deep-fried fast foods and most commercial baked products), cholesterol and refined sugar . .. Reduce, but do not avoid, fat. Replace vegetable oils with extra virgin olive oil, fish oil (via consumption of oily fish: salmon, sardines, fresh tuna, mackerel and herring) and cold pressed flax seed oil.
Drink plenty of bottled or filtered water, especially in hot weather.
There has been some evidence that diets rich in legumes (beans, peas and lentils) are associated with an increased risk of gallstones. However, this possibility should also be weighed against the many beneficial effects of legumes, including improved blood sugar control and a reduction in blood cholesterol levels. If you are at risk of developing gallstones or have existing stones, avoid an excessive consumption of legumes.
Food allergies may trigger gallbladder attacks. Eliminate suspected food allergens, including dairy products (milk, cheese and ice cream), wheat (gluten), soy and corn. One particular study found that 93% of people with gallstones who consumed eggs had gallbladder pain afterwards. A health care provider can test you for food allergies.
Lifestyle changes that may be helpful
If you need to lose weight, do so slowly. Rapid weight loss may promote the development of gallstones.
Exercise regularly. There are probably a number of other potential mechanisms that may explain the effects of exercise on gallstone prevention beyond facilitating weight control. Exercise has been shown to improve the body’s ability to handle glucose, increase HDL (good cholesterol) levels, reduce blood fats (triglycerides), alter a woman’s exposure to ovarian hormones, and improve gallbladder contractions – all factors related to the risk of developing cholesterol gallstones. Studies have shown that the protective effects of exercise can be achieved not only by vigorous activity but also by moderate forms of exercise including brisk walking.
Relaxation techniques (e.g. yoga) may have a positive impact on gallbladder health.