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Health Protocols

Gallstones

What are Gallstones?

Gallstones are hard deposits formed from bile components in the gallbladder or bile ducts. Gallstones are most commonly formed when there is an excess of cholesterol in the bile, causing it to crystallize. Blockages caused by gallstones can cause moderate to severe pain, and can lead to several complications, including inflammation of the gallbladder and infection of the bile ducts. Gallstones are also linked to increased risk of certain cancers and cardiovascular diseases.

For many, gallstone formation is linked with a typical western diet consisting of high amounts of cholesterol and saturated fats.

Natural integrative interventions like vitamin C and omega-3 fatty acids may help reduce the risk of gallstone formation.

What Increases Gallstone Risk?

  • A western diet high in saturated fats and cholesterol and low in fiber is one of the strongest risk factors.
  • Age
  • Gender – women are more likely than men to develop cholesterol gallstones.
  • Ethnicity – native North and South Americans and Mexican Americans have a higher risk.
  • Genetic predisposition
  • Obesity
  • Rapid weight loss, prolonged fasting, and weight cycling
  • Total parenteral nutrition (TPN, ie, all nutrition is derived intravenously)
  • Medications including female hormones and thiazide diuretics (mainly used to treat high blood pressure)
  • Sedentary lifestyle
  • Other diseases and conditions such as metabolic syndrome, celiac disease, and some liver diseases

What are the Signs and Symptoms of Gallstones?

  • Biliary pain (acute, severe pain in the upper-right or upper-mid region of the abdomen)
  • Biliary pain that lasts more than 24 hours and is accompanied by nausea, fever, or jaundice can indicate a complication associated with gallstones and warrants emergent evaluation.

What are the Conventional Medical Treatments for Gallstones?

  • Gallbladder removal (cholecystectomy)
  • Ursodeoxycholic acid may be an alternative to surgery for small, cholesterol-rich gallstones, but can take years to completely dissolve them.
  • Other interventions including combination procedures to remove stones from the common bile duct, stone fragmentation, and balloon dilation of the bile duct opening.

What Novel and Emerging Therapies Appear Promising for Gallstones?

  • The anti-diabetes medication metformin
  • Cholesterol-lowering medications such as statins and ezetimibe (Zetia)
  • Surgical advances, including natural orifice transluminal endoscopic surgery (NOTES)

What Dietary and Lifestyle Changes Can Help Relieve Gallstones?

  • A diet rich in fiber, plant proteins, fruits and vegetables, and mono- and polyunsaturated fats can protect against gallstone formation.
  • Weight loss reduces the risk of gallstones in obese individuals, but rapid weight loss can increase the risk. Someone who wishes to lose weight to decrease the risk of gallstones should try to control their rate of weight loss by modestly restricting calories and keeping a small amount of fat in their diet.
  • The addition of certain foods, including coffee, tea, nuts, and dietary spices may reduce the risk of gallstones.
  • At least 2‒3 hours of exercise each week can reduce the risk of cholecystectomy by about 20%.

What Natural Interventions May Be Beneficial for Gallstones?

  • Vitamin C. Vitamin C decreases oxidative stress, a contributing factor in gallstone formation. Low vitamin C intake has been linked with increased cholesterol concentration in bile, and a study showed regular vitamin C users were 66% less likely to have gallstones than those who did not use it.
  • Fish oil and omega-3 fatty acids. Fish oils and omega-3 fatty acids may prevent gallstone formation by preventing crystallization. Supplementation with omega-3 fats was also shown to attenuate the risk of developing gallstones due to rapid weight loss.
  • S-adenosylmethionine (SAMe). SAMe has been shown to improve bile flow in people with certain liver diseases. It also may decrease the level of cholesterol in the bile.
  • Curcumin. Curcumin, a polyphenolic compound extracted from turmeric, may reduce the chance of gallstones forming by improving cholesterol and lipid metabolism. It can also reduce postoperative pain following a cholecystectomy. However, people with bile duct obstructions should avoid curcumin because it may promote gallbladder contraction.
  • Other natural interventions that may help reduce the risk of gallstone formation include iron (in those with iron deficiencies), vitamin E, epigallocatechin gallate (EGCG, a flavonoid found in green tea), melatonin, and milk thistle.
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