Drugs That Dissolve Gallstones | Chron.com Drugs That Dissolve Gallstones Bile acids may be used to dissolve gallstones. NA/Photos.com/Getty Images [Dyspepsia] | Dyspepsia & Gallstones Gallstones are hardened bits of bile, a fluid that helps the body digest dietary fat. Most people with gallstones have no symptoms and do not require treatment. If gallstones cause abdominal pain or present a risk for complications, the preferred treatment is usually gallbladder removal. This is commonly performed using a minimally-invasive procedure called a laparoscopic cholecystectomy. People who want to avoid surgery or cannot safely undergo a surgical procedure may be candidates for nonsurgical management with medication intended to dissolve gallstones. Oral Medications Medications given by mouth to dissolve gallstones are appropriate for approximately 30 percent of people with gallstone-related disease. These medications, called chenodeoxycholic acid and ursodeoxycholic acid, are made of bile acids. The composition of gallstones affects the success rate with these medications. People with small cholesterol gallstones have the greatest chance of success with dissolution therapy.

Those unlikely to benefit are people with large cholesterol stones, pigment stones composed of bilirubin and obese patients. Treatment can take several years and gallstones may recur. Ursodeoxycholic Acid Ursodeoxycholic acid (ursodiol, Actigall) dissolves up to 80 percent of very small gallstones within six months. Treatment with this medication is less successful when the stones are large. Even if treatment is successful, as many as 50 percent of patients experience recurrent gallstones. Ursodiol is not an appropriate treatment option for people with calcified cholesterol or pigment gallstones. Possible side effects of ursodiol include diarrhea, constipation, upset stomach, indigestion, dizziness, vomiting, cough, runny nose, sore throat, back pain, joint or muscle pain, hair loss and frequent urination or painful urination. Chenodeoxycholic Acid Chenodeoxycholic acid (Chenodiol, Chenodal) is a bile acid that gradually dissolves cholesterol gallstones in certain patients, especially those with small stones composed primarily of cholesterol. Even when the medication is successful in dissolving gallstones, an estimated 50 percent of patients have a recurrence within 5 years.

Chenodiol should not be given to pregnant women or people with liver disease, gallbladder obstruction, gallstone complications or large, noncholesterol gallstones. Side effects may include diarrhea, liver inflammation, heartburn, decreased appetite, nausea, elevated blood cholesterol and a decreased white blood cell count. Contact Dissolution Therapy Contact dissolution of gallstones is experimental and is not widely accepted or available. The procedure involves injecting a chemical solvent directly into the gallbladder. The surgeon inserts a thin tube into the gallbladder and connects a pump that delivers small amounts of solvent directly into the organ over a period of hours or days. The procedure can reduce cholesterol stones rapidly, but the risk of complications is high due to the toxic nature of chemical solvents. Homeopathic Treatment & Remedies for Gall Stones or Gall Bladder Stones Consultation Form Gall bladder stones or Gall stones are lumps of hardened bile deposited in the gall bladder. Gall bladder is a small sac present at the right upper abdomen, just under the liver. It stores bile, a liquid produced by the liver, required for digestion of fats. Bile is a thick liquid composed of proteins, water, bilirubin, bile salts, small quantity of copper, cholesterol among other substances.

If this chemical composition is disturbed by the excess of any substance, especially cholesterol, the liquid crystallizes to form small pebble like structures, known as gall stones. The gallstones vary in size, from being as small as a sand grain to as big as a golf ball. Usually they lie idle, but in a few instances they migrate to the connecting ducts and block the passage. This leads to a gall bladder attack and necessitates immediate medical attention. A gall stone is characterized with severe pain in the upper right side of the abdomen, often coupled with vomiting and nausea. At times the pain could be felt under the right shoulder or between the shoulder blades as well. The pain increases progressively for about 30 minutes to a few hours. Other minor symptoms associated with gall bladder attack are abdominal bloating, belching, intolerance for fatty substances and indigestion. Gall bladder stones are caused when the bile retains a high concentration of cholesterol and the chemical balance of the bile is disturbed. It is more common in people suffering from liver cirrhosis, biliary tract infections or a few blood related genetic disorders, like sickle cell anemia. Other risk factors include: Sex: Women are more susceptible than men, especially women bearing many children.

Diet: A high cholesterol and fat laden diet can lead to gall bladder stone formation. Weight: Obesity as well as rapid weight gain can also cause gall stones. High triglyceride levels Bile Duct Stones & Gallstones | Pancreas Diseases | MUSC DDC johnsome@musc.edu What are gallstones? Gallstones, which are created in the gallbladder , form when substances in the bile create hard, crystal-like particles. Cholesterol stones, as the name implies, are made of cholesterol and appear light in color. Eighty percent of gallstones are formed this way. Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile. About twenty percent of gallstones are pigment stones. Risk factors for pigment stones include: cirrhosis of the liver biliary tract infections hereditary blood cell disorders (such as sickle cell anemia) Gallstones can be as small as a grain of salt or as large as a golf ball. The gallbladder may develop many smaller stones, or a single, often large one. It may even develop several thousand stones. What are bile duct stones? Gallstones that move out of the gallbladder can pass into your stomach .

However, a stone may become lodged in your bile duct due to the size of the stone or the anatomy of the biliary tree . Thus, bile duct stones are gallbladder stones that have become lodged in the bile duct. Stones that become stuck in the ducts that lead to the duodenum can be both agonizing and dangerous. What causes gallstones? Advancements have been made in better understanding the gallstone formation process. Gallstones may be caused by: inherited body chemistry gallbladder movement (the gallbladder is a muscular sack that contracts) diet and lifestyle Cholesterol gallstones When the bile contains too much cholesterol and not enough bile salts, cholesterol gallstones may develop. Aside from a high concentration of cholesterol, there are two other factors that seem to be of importance in causing gallstones. Movement of the gallbladder is referred to as gallbladder motility. This small but muscular organ squeezes to force bile into the bile duct. If the gallbladder does not perform as it should, the bile may not be able to makes its way into the bile duct, instead becoming concentrated and forming small crystals. Gallstones may also be created by proteins in the liver and bile.

These proteins may either promote cholesterol crystallization into gallstones. Other factors also seem to play a role in causing gallstones but how is not clear. Obesity Mexican-Americans What are the symptoms of gallstones? A person with gallstones may have what are called "silent stones". Studies show that most people with silent stones may not experience any symptoms at all for awhile, remaining symptom-free for years and requiring no treatment. Silent stones may go undiagnosed until they begin to cause discomfort. For those that are not quite so lucky, the symptoms my include: Acute pain, possibly very severe, that occurs very suddenly. It may last a few minutes, or many hours Pain is usually located behind your breastbone, but may occur in the upper right abdominal area Pain between your shoulder-blades It is not uncommon for attacks to be separated by weeks, months, or even years. What problems can occur? A common complication cause by gallstones is blockage of the cystic duct. Sometimes gallstones may make their way out of the gallbladder and into the cystic duct, the channel through which bile travels from the gallbladder to the small intestine .

An inflammation of the gallbladder ( cholecystitis ) can occur if the flow of bile in the cystic duct is severely impeded or blocked by any gallstones. A less common but more serious problem occurs if the gallstones become lodged in the bile ducts between the liver and the small intestine. This condition, called cholangitis , can block bile flow from the gallbladder and liver, causing pain , jaundice and fever. Gallstones may also interfere with the flow of digestive fluids into the small intestine, leading to an inflammation of the pancreas , or pancreatitis . Prolonged blockage of any of these ducts can cause severe damage to the gallbladder, liver, or pancreas, which can be fatal. How are gallstones diagnosed? CT scan When actually looking for gallstones, the most common diagnostic tool is ultrasound. An ultrasound examination, also known as ultrasonography, uses sound waves to create images of the various abdominal organs … &hel including the gallbladder. If stones are present, the sound waves will bounce off the stones, revealing their location. Ultrasound has several advantages.

It is a noninvasive technique - nothing is injected into or penetrates the body It is painless - there are no known side effects It does not involve radiation Occassionaly, other tests needed to detect small stones, or verify their non-existance, may be required. MRI/MRCP — a painless, magnetic imaging technique endoscopic ultrasound — a minimally invasive procedure that can visualize tissue ERCP — for diagnosis and management of stones in the bile duct Other gallbladder diseases Pain and inflammation of the gallbladder can occur in the absence of gallstones. Acalculus cholecystitis Acalculus cholecystitis, or inflammation of the gallbladder without stones, may occur in conjunction with other severe illnesses. This condition occurs when the gallbladder fluids become infected as a result of being stagnant during a long illness. Biliary dyskinesia Biliary dyskinesia, or disordered function of the gallbladder, describes a condition in which the gallbladder cannot empty properly due to inflammation or spasm of its drainage system (the cystic duct). When you eat a meal, the gallbladder is prompted to contract, and in doing so, bile is forced into the duodenum.

If the gallbladder cannot contract, the pressure exerted on the gallbladder causes pain. A scanning technique, known as an HIDA scan, uses radioactive isotopes to help diagnose both of these conditions. This shows whether the gallbladder is blocked, or cannot drain completely. These conditions are treated in the same way as gallbladder stones. Gallbladder cancer Cancer, which can develop in the gallbladder wall, appears to be more common in patients with gallstones. Unfortunately, it often does not cause symptoms until the cancer has spread to the liver or adjacent bile duct. If technically possible, surgical removal is the recommended course of action. Treatments Cholecystectomy Each year more than 500,000 Americans have gallbladder surgery. This surgery, called cholecystectomy, is the most common method for treating gallstones despite the development of some nonsurgical techniques. There are two types of cholecystectomy: the standard “open” cholecystectomy; and, a less invasive procedure called laparoscopic cholecystectomy .

Open Cholecystectomy The standard cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder through a 5-to-8 inch incision. The person will remain in the hospital for about a week, and convalesce at home for several weeks after. Laparoscopic cholecystectomy Laparoscopic cholecystectomy is a more minimally invasive method of gallbladder removal that accounts for approximately 95% of all cholecystectomies performed. Laparoscopic cholecystectomy requires several small incisions in the abdomen to allow the insertion of surgical instruments and a small video camera. The surgeon is provided with a close-up view from inside the body sent by the camera to a video monitor. He is then able to perform the procedure by manipulating his surgical instruments all while watching the monitor. Laparoscopic cholecystectomy does not require the abdominal muscles to be cut, and thus results in less pain, quicker healing, improved cosmetic results, and fewer complications such as infection. Recovery usually requires only a night in the hospital, and several days recuperation at home. Non-surgical approaches Several methods are available, but are used only in special circumstances.

Patients with acute inflammation of the gallbladder (and acalculus cholecystitis) may sometimes be treated first with "percutaneous drainage". This involves inserting a tube and needle (also known as a catheter) straight into the gallbladder to siphon the harmful fluids. Cholecystectomy is performed after the acute situation has settled. Special medicines can dissolve gallstones which are composed of cholesterol. However, this method works only when there is no blockage, and is usually more practical with smaller stones. However, treatment usually requires many months or years (and stones may return when the treatment is stopped). Thus, it is used only rarely in certain individuals who cannot tolerate surgery. Extracorporeal shockwave lithotripsy (ESWL) is an excellent method for treating stones in the kidneys. However, ESWL often requires several treatments, and has other drawbacks, including the possibility of stone recurrence. As a result, this treatment method is rarely used. ESWL can also be used to break up stones in the gallbladder. Resulting stone fragments usually then pass through into the small bowel. A bile duct stone as seen on ERCP.

Treatment of bile duct stones Approximately 10% of patients with stones in the gallbladder also have stones in the bile duct. These can cause acute blockage to the bile duct with cholangitis, or acute pancreatitis. When blockage can cause life threatening illness, emergency treatment is best applied with ERCP . The gastroenterologistpasses an endoscope down to the bile duct opening, and then releases the stone into the duodenum with a small cutting incision ( sphincterotomy ). Give Us a Call Gallstones Causes - Mayo Clinic By Mayo Clinic Staff It's not clear what causes gallstones to form. Doctors think gallstones may result when: Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones. Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders.

The excess bilirubin contributes to gallstone formation. Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated and this contributes to the formation of gallstones. Types of gallstones Types of gallstones that can form in the gallbladder include: Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components. Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin. Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed May 13, 2013. Understanding gallstones. American Gastroenterological Association. Accessed May 13, 2013. Choi Y, et al. Biliary tract disorders, gallbladder disorders and gallstone pancreatitis. American College of Gastroenterology. Accessed May 13, 2013. Feldman M, et al.

Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. Accessed May 13, 2013. What are the risk factors for gallbladder cancer? American Cancer Society. Accessed May 17, 2013. Products and Services Gallstones | NIDDK Gallstones Gallstones What are gallstones? Gallstones are hard particles that develop in the gallbladder. The gallbladder is a small, pear-shaped organ located in the upper right abdomen—the area between the chest and hips—below the liver. Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can develop a single large gallstone, hundreds of tiny stones, or both small and large stones. Gallstones can cause sudden pain in the upper right abdomen. This pain, called a gallbladder attack or biliary colic, occurs when gallstones block the ducts of the biliary tract. What is the biliary tract? The biliary tract consists of the gallbladder and the bile ducts.

The bile ducts carry bile and other digestive enzymes from the liver and pancreas to the duodenum—the fi rst part of the small intestine. The liver produces bile—a fl uid that carries toxins and waste products out of the body and helps the body digest fats and the fat-soluble vitamins A, D, E, and K. Bile mostly consists of cholesterol, bile salts, and bilirubin. Bilirubin, a reddish-yellow substance, forms when hemoglobin from red blood cells breaks down. Most bilirubin is excreted through bile. The biliary tract The bile ducts of the biliary tract include the hepatic ducts, the common bile duct, the pancreatic duct, and the cystic duct. The gallbladder stores bile. Eating signals the gallbladder to contract and empty bile through the cystic duct and common bile duct into the duodenum to mix with food. What causes gallstones? Imbalances in the substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. Scientists do not fully understand why these imbalances occur.

Gallstones also may form if the gallbladder does not empty completely or often enough. The two types of gallstones are cholesterol and pigment stones: Cholesterol stones, usually yellow-green in color, consist primarily of hardened cholesterol. In the United States, more than 80 percent of gallstones are cholesterol stones.1 Pigment stones, dark in color, are made of bilirubin. Who is at risk for gallstones? Certain people have a higher risk of developing gallstones than others:2 Women are more likely to develop gallstones than men. Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form. Women may have extra estrogen due to pregnancy, hormone replacement therapy, or birth control pills. People over age 40 are more likely to develop gallstones than younger people. People with a family history of gallstones have a higher risk. American Indians have genetic factors that increase the amount of cholesterol in their bile. In fact, American Indians have the highest rate of gallstones in the United States—almost 65 percent of women and 30 percent of men have gallstones. Mexican Americans are at higher risk of developing gallstones.

Other factors that affect a person’s risk of gallstones include2 Obesity. People who are obese, especially women, have increased risk of developing gallstones. Obesity increases the amount of cholesterol in bile, which can cause stone formation. Rapid weight loss. As the body breaks down fat during prolonged fasting and rapid weight loss, the liver secretes extra cholesterol into bile. Rapid weight loss can also prevent the gallbladder from emptying properly. Low-calorie diets and bariatric surgery—surgery that limits the amount of food a person can eat or digest—lead to rapid weight loss and increased risk of gallstones. Diet. Research suggests diets high in calories and refi ned carbohydrates and low in fi ber increase the risk of gallstones. Refi ned carbohydrates are grains processed to remove bran and germ, which contain nutrients and fiber. Examples of refi ned carbohydrates include white bread and white rice. Certain intestinal diseases. Diseases that affect normal absorption of nutrients, such as Crohn’s disease, are associated with gallstones. Metabolic syndrome, diabetes, and insulin resistance. These conditions increase the risk of gallstones. Metabolic syndrome also increases the risk of gallstone complications.

Metabolic syndrome is a group of traits and medical conditions linked to being overweight or obese that puts people at risk for heart disease and type 2 diabetes. More information about these conditions is provided in the NIDDK health topic, Insulin Resistance and Prediabetes . Pigment stones tend to develop in people who have cirrhosis—a condition in which the liver slowly deteriorates and malfunctions due to chronic, or long lasting, injury infections in the bile ducts severe hemolytic anemias—conditions in which red blood cells are continuously broken down, such as sickle cell anemia What are the symptoms and complications of gallstones? Many people with gallstones do not have symptoms. Gallstones that do not cause symptoms are called asymptomatic, or silent, gallstones. Silent gallstones do not interfere with the function of the gallbladder, liver, or pancreas. If gallstones block the bile ducts, pressure increases in the gallbladder, causing a gallbladder attack. The pain usually lasts from 1 to several hours.1 Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night.

Gallbladder attacks usually stop when gallstones move and no longer block the bile ducts. However, if any of the bile ducts remain blocked for more than a few hours, complications can occur. Complications include infl ammation, or swelling, of the gallbladder and severe damage or infection of the gallbladder, bile ducts, or liver. A gallstone that becomes lodged in the common bile duct near the duodenum and blocks the pancreatic duct can cause gallstone pancreatitis—in flammation of the pancreas. Left untreated, blockages of the bile ducts or pancreatic duct can be fatal. When should a person talk with a health care provider about gallstones? People who think they have had a gallbladder attack should notify their health care provider. Although these attacks usually resolve as gallstones move, complications can develop if the bile ducts remain blocked.

People with any of the following symptoms during or after a gallbladder attack should see a health care provider immediately: abdominal pain lasting more than 5 hours nausea and vomiting fever—even a low-grade fever—or chills yellowish color of the skin or whites of the eyes, called jaundice tea-colored urine and light-colored stools These symptoms may be signs of serious infection or infl ammation of the gallbladder, liver, or pancreas. How are gallstones diagnosed? A health care provider will usually order an ultrasound exam to diagnose gallstones. Other imaging tests may also be used. Ultrasound exam. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care provider’s offi ce, outpatient center, or hospital, and a radiologist—a doctor who specializes in medical imaging—interprets the images. Anesthesia is not needed. If gallstones are present, they will be visible in the image. Ultrasound is the most accurate method to detect gallstones. Computerized tomography (CT) scan. A CT scan is an x ray that produces pictures of the body.

A CT scan may include the injection of a special dye, called contrast medium. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. An x-ray technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed. CT scans can show gallstones or complications, such as infection and blockage of the gallbladder or bile ducts. However, CT scans can miss gallstones that are present. Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the body’s internal organs and soft tissues without using x rays. A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed, though people with a fear of confi ned spaces may receive light sedation. An MRI may include the injection of contrast medium.

With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines allow the person to lie in a more open space. MRIs can show gallstones in the ducts of the biliary system. Cholescintigraphy. Cholescintigraphy—also called a hydroxyl iminodiacetic acid scan, HIDA scan, or hepatobiliary scan—uses an unharmful radioactive material to produce pictures of the biliary system. In cholescintigraphy, the person lies on an exam table and a health care provider injects a small amount of unharmful radioactive material into a vein in the person’s arm. The health care provider may also inject a substance that causes the gallbladder to contract. A special camera takes pictures of the radioactive material as it moves through the biliary system. A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed. Cholescintigraphy is used to diagnose abnormal contractions of the gallbladder or obstruction of the bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP).

ERCP uses an x ray to look into the bile and pancreatic ducts. After lightly sedating the person, the health care provider inserts an endoscope—a small, flexible tube with a light and a camera on the end—through the mouth into the duodenum and bile ducts. The endoscope is connected to a computer and video monitor. The health care provider injects contrast medium through the tube into the bile ducts, which makes the ducts show up on the monitor. The health care provider performs the procedure in an outpatient center or hospital. ERCP helps the health care provider locate the affected bile duct and the gallstone. The stone is captured in a tiny basket attached to the endoscope and removed. This test is more invasive than other tests and is used selectively. Health care providers also use blood tests to look for signs of infection or in flammation of the bile ducts, gallbladder, pancreas, or liver. A blood test involves drawing blood at a health care provider’s offi ce or commercial facility and sending the sample to a lab for analysis. Gallstone symptoms may be similar to those of other conditions, such as appendicitis, ulcers, pancreatitis, and gastroesophageal refl ux disease.

Sometimes, silent gallstones are found when a person does not have any symptoms. For example, a health care provider may notice gallstones when performing ultrasound for a different reason. How are gallstones treated? If gallstones are not causing symptoms, treatment is usually not needed. However, if a person has a gallbladder attack or other symptoms, a health care provider will usually recommend treatment. A person may be referred to a gastroenterologist—a doctor who specializes in digestive diseases—for treatment. If a person has had one gallbladder attack, more episodes will likely follow. The usual treatment for gallstones is surgery to remove the gallbladder. If a person cannot undergo surgery, nonsurgical treatments may be used to dissolve cholesterol gallstones. A health care provider may use ERCP to remove stones in people who cannot undergo surgery or to remove stones from the common bile duct in people who are about to have gallbladder removal surgery. Surgery Surgery to remove the gallbladder, called cholecystectomy, is one of the most common operations performed on adults in the United States. The gallbladder is not an essential organ, which means a person can live normally without a gallbladder.

Once the gallbladder is removed, bile flows out of the liver through the hepatic and common bile ducts and directly into the duodenum, instead of being stored in the gallbladder. Surgeons perform two types of cholecystectomy: Laparoscopic cholecystectomy. In a laparoscopic cholecystectomy, the surgeon makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magni fied image from inside the body to a video monitor, giving the surgeon a close-up view of organs and tissues. While watching the monitor, the surgeon uses instruments to carefully separate the gallbladder from the liver, bile ducts, and other structures. Then the surgeon removes the gallbladder through one of the small incisions. Patients usually receive general anesthesia. Most cholecystectomies are performed with laparoscopy. Many laparoscopic cholecystectomies are performed on an outpatient basis, meaning the person is able to go home the same day. Normal physical activity can usually be resumed in about a week.3 Open cholecystectomy.

An open cholecystectomy is performed when the gallbladder is severely infl amed, infected, or scarred from other operations. In most of these cases, open cholecystectomy is planned from the start. However, a surgeon may perform an open cholecystectomy when problems occur during a laparoscopic cholecystectomy. In these cases, the surgeon must switch to open cholecystectomy as a safety measure for the patient. To perform an open cholecystectomy, the surgeon creates an incision about 4 to 6 inches long in the abdomen to remove the gallbladder.4 Patients usually receive general anesthesia. Recovery from open cholecystectomy may require some people to stay in the hospital for up to a week. Normal physical activity can usually be resumed after about a month.3 A small number of people have softer and more frequent stools after gallbladder removal because bile fl ows into the duodenum more often. Changes in bowel habits are usually temporary; however, they should be discussed with a health care provider. Though complications from gallbladder surgery are rare, the most common complication is injury to the bile ducts. An injured common bile duct can leak bile and cause a painful and possibly dangerous infection.

One or more additional operations may be needed to repair the bile ducts. Bile duct injuries occur in less than 1 percent of cholecystectomies.5 Nonsurgical Treatments for Cholesterol Gallstones Nonsurgical treatments are used only in special situations, such as when a person with cholesterol stones has a serious medical condition that prevents surgery. Gallstones often recur within 5 years after nonsurgical treatment.6 Two types of nonsurgical treatments can be used to dissolve cholesterol gallstones: Oral dissolution therapy. Ursodiol (Actigall) and chenodiol (Chenix) are medications that contain bile acids that can dissolve gallstones. These medications are most effective in dissolving small cholesterol stones. Months or years of treatment may be needed to dissolve all stones. Shock wave lithotripsy. A machine called a lithotripter is used to crush the gallstone. The lithotripter generates shock waves that pass through the person’s body to break the gallstone into smaller pieces. This procedure is used only rarely and may be used along with ursodiol.

Eating, Diet, and Nutrition Factors related to eating, diet, and nutrition that increase the risk of gallstones include obesity Gallstones - Health & Wellbeing Gallstones by ABC Health & Wellbeing Gallstones are stones that form in a small pear-shaped sac situated under the liver called the gallbladder. [Image source: iStockPhoto] More info The gallbladder stores bile; a greenish brown thick liquid made by the liver. It is composed of water, cholesterol, fats, bile salts, proteins, and bilirubin (a waste product from the breakdown of red blood cells). When food enters the small intestine, a signal is sent to the gallbladder which then contracts. Bile is discharged from the gallbladder down the bile duct and into the small intestine where it helps break down and emulsify fats so they can be more easily absorbed into the bloodstream. After emptying, the gallbladder slowly fills up again with bile which it concentrates and stores ready for another mealtime. But there's a snag. As the bile becomes concentrated, depending on its composition, the bile can form gallstones (also known as biliary calculi). Gallstones can sit in the gallbladder for years and not cause problems.

However, if they move and block the drainage duct from the gallbladder (called the cystic duct), they can cause pain, inflammation and infection in the gallbladder (cholecystitis) or the bile ducts. Top Who is at risk? Gallstones are common; around 15 per cent of people aged 50 years and over have them. They are more common in women than men; in people who are overweight, and people with a family history of gallstones. Why do people get them? No-one knows. It's thought that people who have gallstones may have  for unknown reasons  undergone changes in the composition of their bile; or perhaps because their gallbladder has failed to empty normally, making it easier for bile to stagnate and form into stones. Ranging in size from grains of sand (known as gallbladder 'sludge') to stones 2-3cm or more in diameter, they are made of the various constituents of bile: cholesterol, bile pigments and salts. They are traditionally classified into three main types; Mixed stones  the most common type. They occur in batches and are made up of cholesterol and salts.

Cholesterol stones  comprised mainly of cholesterol, a fat-like substance that is crucial to many metabolic processes. Cholesterol stones can grow to significant sizes, large enough to block bile ducts. Pigment stones  bile is greenish-brown in colour, due to particular pigments. Gallstones made from bile pigment are typically small but numerous. Top Types of gallbladder disease As we've mentioned earlier, many people with gallstones have absolutely no symptoms. However when gallstones move out of the gallbladder and into the drainage ducts, they can cause symptoms of pain as the smooth muscles of the gallbladder and the ducts contract against the stone(s). Infection can result when stones block the exit of the gallbladder or lodge in the bile ducts. Biliary colic The most common symptom of gallbladder disease is intermittent pain caused by the smooth muscle contracting against the stones in the gallbladder or ducts. The presence of stones in the gallbladder is called cholelithiasis. The pain is called biliary colic and is felt as intermittent 'colicky' pain in the mid or right part of the upper abdomen, or into the chest.

The pain is often severe, may last between 30 minutes and several hours, and may be associated with vomiting. Acute cholecystitis When gallstones move out of the gallbladder they may lodge in the cystic duct and block normal gallbladder emptying. The bile that is trapped in the gallbladder can then become infected with bacteria. The symptoms are similar to those of biliary colic but are more persistent and severe. Pain in the upper right abdomen can last for days. The pain may radiate around to the back or be felt under the shoulder blades, behind the breast bone, or on the left side. As well, there may be signs of infection with fever, chills, nausea and vomiting. It's a very serious condition; if left untreated it can progress to gangrene, perforation of the gallbladder and peritonitis. Chronic cholecystitis This is similar to acute cholecystitis, in that gallstones cause mild inflammation, but the process occurs over months or years, causing the gallbladder to become scarred and stiff. This causes symptoms of pain, diarrhoea, abdominal discomfort, and bloating after meals.

The symptoms are vague and similar to those of other conditions like irritable bowel syndrome. Stones in the bile ducts (Choledocholithiasis) Gallstones can escape the gallbladder but become lodged in one of the ducts along the pathway from the liver to the small intestine. These include: the hepatic ducts, which carry bile out of the liver; the common bile duct, which takes bile from the cystic and hepatic ducts to the small intestine. The symptoms of stones in the bile ducts are similar to those of stones in the gallbladder, but if they remain blocked, they may become inflamed and infected as well (cholangitis) and there is also the danger of infection travelling up the ducts into the liver. People with cholangitis will frequently become jaundiced (the whites of the eyes become yellow), and have fever and shivering as well as pain over the liver. Jaundice occurs because of build up of bile in the blood, because it is unable to travel past the blockage in the bile ducts. Pancreatitis Sometimes gallstones become stuck in the lower part of the common bile duct as it passes through the pancreas.

The pancreas discharges powerful hormones into the small intestine to aid with digestion of food. But if it's exit is blocked, the enzymes can escape causing acute pancreatitis, an extremely serious condition requiring urgent medical attention. Top Diagnosis Generally speaking, vague abdominal complaints like belching, feeling unusually full after meals, bloating, heartburn or acid reflux or regurgitation are unlikely to be caused by gallbladder disease but by something else, possibly peptic ulcer, gastroesophageal reflux disease, or irritable bowel syndrome. If your doctor suspects gallstones, they will take your medical history and do a physical examination. Symptoms are often vague and can be caused by many conditions, so further tests are almost always needed to make the diagnosis of gallbladder disease. They may include blood tests and plain X-rays but the most useful tests are those that look specifically at the gallbladder and the ducts. They include: Ultrasound  this simple, easy and cheap test detects the presence of gallstones using sound waves. HIDA scan  this is a nuclear scan that can tell how well (or poorly) the gall bladder empties.

Magnetic Resonance Cholangiopancreatography (MRCP)  this is a Magnetic Resonance Imaging or MRI scan of the liver, biliary and pancreatic system. It is non-invasive and does not involve X-rays. Endoscopic retrograde cholangiopancreatography (ERCP). In this test, an endoscope is passed down through the oesophagus and stomach and into the top of the small intestine. A fine plastic catheter is then inserted into the opening of the common bile duct, and dye is injected. X-rays show the path of the dye and any stones in the ducts are highlighted. If stones are lodged in the common bile duct, they can be removed at the same time. Top Treatment Just because someone has gallstones, it doesn't mean they need to be treated. If the person is not having symptoms the gallstones can be safely left alone. However if they are causing biliary colic, cholecystitis or pancreatitis then they may need to be treated, to relieve symptoms, or prevent complications. The mainstay of treatment is surgery to remove the gallbladder (cholecystectomy). About 80 per cent of cases are treated by surgery.

Most gall bladder operations are performed via 'keyhole' (laparoscopic) surgery where the gall bladder is removed through a small incision in the abdomen. This type of surgery is quick to heal and leaves a smaller scar than traditional open surgery. Less frequently, the gall bladder is removed at an open operation via a larger incision in the upper abdomen (laparotomy). Acute inflammation of the gall bladder (acute cholecystitis) is ideally treated by surgical removal of the gallbladder within a week of onset of symptoms. Removing the inflamed gallbladder early after presentation, usually results in a shorter period of time in hospital than delaying the operation. Sometimes other non-surgical approaches are tried (though these tend to be less successful than surgery). Lithotripsy involves the use of a special machine that generates soundwaves that are focused on stones and can shatter them. It's most suitable for small and soft stones but is rarely used. Some medications can dissolve gallstones but they are only sometimes successful and have side effects. Note: The presence of asymptomatic gallstones has been associated with gallbladder cancer.

Because gallbladder cancer is rare, and the prevalence of asymptomatic gallstones in the community is high, there are no recommendations to remove the gallbladder purely to prevent the risk of gallbladder cancer. All operations have risk, and these risks must always be balanced against the potential benefit. Top Life after surgery If you end up having your gallbladder removed, you won't need to alter your diet or take medications. You can live perfectly well without your gallbladder  and the treatment is a permanent cure for the pain of gallstones. Reviewed by Clinical Associate Professor Simone Strasser, chair of the Digestive Health Foundation, an initiative of the Gastroenterological Society of Australia. Updated: 10/12/2013 Gall Stones and Gall Bladder Surgery Gall Stones and Gall Bladder Surgery Although gall bladder surgery brings in significant revenue for hospitals and physicians, the research clearly shows that simple dietary changes can result in dramatic and immediate health improvements for people with gall stones. All of this without the risks and side effects of gall bladder surgery. Unfortunately, once gall stones have been diagnosed by a physician, the research on the effectiveness of dietary interventions is not conveyed to the patient.

Information for this article was located from the University of Florida, Medical Library in Gainesville, Florida. and researched by Richard Pressinger (M.Ed.) and Jerry Abraham (M.B.A) CHEM-TOX.COM The Gall Bladder - What does it do? The Gall Bladder is a small pear-shaped sac that stores and concentrates bile. It is connected to the liver (which produces the bile) by the hepatic duct. When food containing fat reaches the small intestine, the hormone cholecystokinin is produced by cells in the intestinal wall and carried to the gall bladder via the bloodstream. The hormone causes the gall bladder to contract, forcing bile into the common bile duct. A valve, which opens only when food is present in the intestine, allows bile to flow from the common bile duct into the duodenum (upper intestine) where it functions in the process of fat digestion. Sometimes the substances contained in bile crystallize in the gall bladder, forming gallstones. These small, hard concretions are more common in persons over 40, especially in women and the obese. They can cause inflammation of the gall bladder, a disorder that produces symptoms similar to those of indigestion, especially after a fatty meal is consumed.

If a stone becomes lodged in the bile duct, it produces severe pain. Cholecystitis (Gallstone Inflammation) Evidence of an Environmental Disease The local Melbourne physician said she would die without the surgery. He said removal of her gallbladder was the only way we could stop the painful attacks in her upper abdomen. The patient was the 80 year grandmother of a close friend of mine in Melbourne Beach, Florida. She was suffering pains on a regular basis, however the research shows the risk of her dying from the anesthesia alone was over 1% - too great as far as we were concerned. What other options did we have with this common disease known as Cholecystitis? To find out as much as we could regarding gallstones and the gallbladder removal epidemic, we spent four days at the University of Florida Medical Library researching the medical journals for information. The first thing which shocked us is how common this disease really is: Each year over 500,000 people are admitted into hospitals for gallbladder disease. Two-thirds of them are treated surgically.

In studies of 60-90 year people, 60% of the women and 30-50% of men were found to have gallstones. The other surprising factor was how the incidence of the disease differs dramatically among populations. A large study in India found North Indians had gall stones seven times higher than South Indians. The only difference between the two groups was that the North Indians were found to consume 8-19 times more saturated fats in their diet. South Indians were found to use unsaturated fats and consume larger amounts of rice. What you're about to read may surprise you, in fact, physicians rarely convey this information, as it would create significant doubt with the patient and among family members. However, by implementing the strategies you're about to read - the 80 year old grandmother was 90% symptom free after 1 week and completely cured of her gallstones and gallbladder problems within two weeks. She never had a return of any gallbladder problems after beginning this diet. Another 55 year old man by the name of Dennis who resided in Vero Beach, Florida also used these strategies after being diagnosed with a serious gallstone problem. He too was symptom free within one week.

If you decide to try the gallbladder - gallstone correction interventions below, let us know your results. As you'll see, the information simply "makes sense" and is information that needs to reach the public and is why we have spent hundreds of hours on this project and are providing the information at no cost. We only ask that after your symptoms disappear upon beginning the strategies outlined by the researchers, please share your experience with us so that we can post it on this site. This way you will be helping thousands of other patients who would have otherwise been pushed into unnecessary and dangerous surgery. Inflammation of the Gallbladder - Cholecystitis Inflammation of the gallbladder (also called cholecystitis) is caused by stones forming in the gallbladder. It occurs in two phases. In the first phase, stones become lodged in the cystic duct (this is the duct which carries bile from the gallbladder to the intestine). The gallbladder contracts against this obstruction, resulting in "biliary colic," a steady epigastric pain. If the obstruction continues, the second phase begins. The gallbladder then becomes inflamed, causing a steady pain localized in the upper right quadrant.

A blockage of the bile to the intestine can also cause a rise of bilirubin in the blood, resulting in jaundice (since the bilirubin can't escape into the bile for excretion). Why do Gallstones Form? The research indicates that 80-90% of all gallstones are cholesterol gallstones. They form in the gallbladder because the liver begins secreting bile that is unusually saturated with cholesterol (Proceedings of the Nutrition Society, 1985:44). The cholesterol then crystallizes to form stones while in storage in the gallbladder or cystic duct. The specific mechanisms in the body which cause the bile to reach these high cholesterol levels are not entirely known. However, the liver appears to play a large part in this process since it is the source for making bile from which gallstones form. Other evidence, which we'll discuss later, shows that stones can form because the amount of bile acids and bile lecithin are low. Bile acids and lecithin act as an emulsifier in the bile within the gallbladder. Therefore, any inefficiency in this emulsifying process would accelerate the formation of stones.

Upon understanding this, to correct the problem without surgery would suggest we need to find a way to make the liver operate more efficiently so it can produce bile that is less concentrated with cholesterol and more concentrated with the emulsifying bile acids and lecithin. Dietary Differences Increase Gallstone Formation While investigating the gallbladder research at University of Florida's medical library, we found several studies which pinpointed dietary factors as the primary reason for gallstone formation. In research published in 1983 from the University Department of Medicine, the scientists stated, "Bile is significantly more saturated with cholesterol after 6 weeks on a refined carbohydrate diet (white flour and sugar) than after a similar period on an unrefined carbohydrate diet (whole wheat and grains)." The effect of the refined carbohydrate diet might then be expected to increase the risk of cholesterol gallstone formation. In this study, the percentage of chenodeoxycholic acid (a bile acid known to be capable of lowering bile cholesterol saturation) was not significantly different in the two diets. This suggests that the reduction in gallstones from eliminating white flour and white sugar comes from some other mechanism besides the bile acid dissolving potential.

Another study, published in the 1983 journal Experientia, investigated the effect of Pectin and Cellulose in the ability to actually dissolve stones in test animals. The results indicated that cellulose (found in crisp fruits and vegetables) is able to "slightly" decrease the rate of gallstone formation. It was not, however, able to reduce the size of pre-established gall stones. Pectin (found mainly in apples) has a greater effect in stopping gallstone formation and of great interest, was found to dissolve pre-established stones as well!!! Administration of diets including fat emulsion resulted in an increase in phospholipid concentration in the blood and liver (Lecithin is an example of a phospholipd). Therefore, phospholilpds (lecithin) may reduce the stone forming condition in the bile. (Surgery, 1980:88). Another dietary factor found to lower cholesterol levels in the gallbladder includes basic "wheat bran." (American Journal of Surgery, 1978). In a study published in the British Medical Journal, it was shown that vegetarian women had a much lower incidence of gallstones than non-vegetarian women.

Of the 632 non-vegetarians, overall occurrence of gallstones was 25%. Vegetarians had only half as many problems, with only 12% being found to have gallstones. A 1979 dietary survey reported in the American Journal of Clinical Nutrition, found whole wheat flour intake was low in the diet of subjects with gallstones. A study strongly linking diet and gallstone formation was published in the journal Lipids. Researchers studied the direct effects of meat and vegetable proteins on gallstone formation in test animals. Gallstone incidence was greater among animals fed meat proteins. "Bile acid concentrations within the vegetable protein fed groups were significantly higher than within the meat protein fed groups. The meat protein fed animals showed a significantly higher percentage of cholesterol in the bile fluid. As the percentage of cholesterol increased in the bile, the percentage of bile acids was found to decrease....

"Upon administration of a diet containing vegetable protein (in the form of soybeans), gallstones were dissolved." SUMMARIZING THE RESEARCH To summarize the results of the previous studies investigating the causes of gall stone formation, it strongly suggests the following interventions should be tried before opting for surgery: 1) Consume Whole Grains (unrefined) 2) Increase Vegetable Protein (especially soy products ) 3) Consume foods containing Pectin (Apples) 4) Consume foods containing Cellulose (Celery and Crisp Fruits & Vegetables) 5) Reduce (eliminate) Saturated Fat intake 6) Reduce (eliminate) Animal Meat intake 7) Eliminate all White Flour Products Immediately 8) Eliminate (at least reduce substantially) Drinks and Foods Containing White Sugar An additional note: Since maximum liver function is essential for proper bile formation, it is also important to reduce chemical stress upon the liver (remember, the liver produces the bile which must have proper levels of cholesterol, bile acids and lecithin and synthetic chemicals are well known for weakening liver function).

Therefore, it is important you look carefully at your lifestyle habits and eliminate as many chemical sources as possible that may compromise proper liver function. This may include chemicals in the home or job such as solvents, gasoline, paints, fingernail polish, hair sprays, facial cosmetic products, vinyl products, pesticides, artificial food additives (a very important factor) such as artificial colors, artificial flavors and preservative chemicals such as sodium benzoate and others. In other words, begin eating natural based foods, rather than foods containing petroleum based products used to enhance flavors and shelf life. Lets save the petroleum products for our automobiles...... That's it, the above 8 suggestions are the main points brought out by the scientists in the previously mentioned research articles. In our situation, the doctor said my friend's grandmother would "die" if she didn't get the surgery (he didn't tell us the figures show she had over a 1% chance of dying with surgery since she was over 80 years old). She didn't die, and after one week on the above diet she never had another gallbladder pain again.

So when your doctor suggests you remove your gallbladder with this over $2000 surgery, we strongly suggest you tell him you would first like to get a "second opinion" - this will give you enough time to try these thoroughly researched dietary changes for one week, and is usually all the time needed to stop the gallbladder pain and begin the healing process. We apologize for any loss of income to physicians whose livelihood depends on gallbladder removal, but these techniques are just too effective and important for people currently experiencing gallstone problems. Gallstones-Cause Gallstones Credits Gallstones develop when cholesterol and other substances in the bile form crystals that become hard stones in the gallbladder . The gallbladder is a small sac located just under the liver . Gallstones can occur when your gallbladder does not empty properly or if you have too much cholesterol in your bile. Too much cholesterol in your bile is not caused by eating too much cholesterol or having high cholesterol (in the blood ). Most doctors believe that even microscopic gallstones in the gallbladder can cause symptoms. These tiny stones can form a type of sediment called biliary sludge that often can be seen on an abdominal ultrasound .

For more information on an abdominal ultrasound, see the Exams and Tests section of this topic. WebMD Medical Reference from Healthwise This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.© 1995-2015 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Next Article Gallstones Picture, Types, Causes, Risks, Symptoms, Treatments Problems with your gallbladder Diet Bile can be part of the problem. Your body needs bile, but if it has too much cholesterol in it, that makes gallstones more likely. It can also happen if your gallbladder can’t empty properly. Pigment stones are more common in people with certain medical conditions, such as cirrhosis (a liver disease) or blood diseases such as sickle cell anemia. Am I at Risk? You're more likely to get gallstones if: You're obese. This is one of the biggest risk factors. Obesity can raise your cholesterol level and also make it harder for the gallbladder to empty completely.

You take birth control pills, hormone replacement therapy for menopause symptoms, or are pregnant. The extra estrogen is the problem. It can increase cholesterol and make it harder for the gallbladder to empty. You have diabetes. People with this condition tend to have higher levels of triglycerides (a type of blood fat), which is a risk factor for gallstones. You take medicine to lower your cholesterol. Some of these drugs boost the amount of cholesterol in bile, which may increase your chances of getting cholesterol stones. You lost weight too quickly. Your liver makes extra cholesterol, which may lead to gallstones. You’re fasting. Your gallbladder may not squeeze as much. Gallstones are also more likely if they run in your family, and they're likelier among women, older people, and some ethnic groups, including Native Americans and Mexican-Americans. Continued What Are the Symptoms? You might not notice anything, or even know you have gallstones, unless your doctor tells you. But if you do get symptoms, they usually include: Pain in your upper belly and upper back that can last for several hours Nausea Other digestive problems, including bloating, indigestion and heartburn, and gas How Do Doctors Diagnose Them?

If your doctor thinks you may have gallstones, he'll give you a physical exam. You may also get: Blood tests to check for signs of infection or obstruction, and to rule out other conditions. Ultrasound. This quick procedure is done in your doctor’s office, and it makes images of the inside of your body. CT scan. Specialized X-rays allow your doctor to see inside your body, including your gallbladder. Magnetic resonance cholangiopancreatography (MRCP). This test uses a magnetic field and pulses of radio-wave energy to make pictures of the inside of your body, including the liver and the gallbladder. Cholescintigraphy (HIDA scan). This test can check on whether the gallbladder squeezes correctly. Doctors inject a harmless radioactive material, which makes its way to the organ. The technician can then watch its movement. Endoscopic ultrasound. This test combines ultrasound and endoscopy to look for gallstones. Endoscopic retrograde cholangiopancreatography (ERCP). The doctor inserts an endoscope through your mouth down to the small intestine and injects a dye to allow the bile ducts to be seen.

He can often then remove any gallstones that have moved into the ducts. What’s the Treatment? Many people with gallstones get surgery to take out the gallbladder. There are two different kinds of operations. Laparoscopic cholecystectomy. This is the more common procedure. The surgeon passes instruments, a light, and a camera through several small cuts in the belly. He views the inside of the body on a video monitor. Afterward, you spend the night in the hospital. Open cholecystectomy. The surgeon makes bigger cuts in the belly to remove the gallbladder. You stay in the hospital for a few days after the operation. If gallstones are in your bile ducts, the doctor may use ERCP to find and remove them before or during gallbladder surgery. Continued Can You Treat Gallstones Without Surgery? If you have a medical condition and your doctor feels you shouldn't have an operation, he may prescribe the medications chenodiol (Chenix), ursodiol (Actigall), or both. These drugs work by dissolving cholesterol stones. Mild diarrhea can be a side effect.

The downside of using either medication is that you may have to take it for years to completely dissolve the stones, which may come back after you stop taking the drug. WebMD Medical Reference Reviewed by David T. Derrer, MD on February 27, 2016 Sources

Question: What substance crystallises in the gall bladder to form gall stones?
Answer: CHOLESTEROL