Gallstones are hard deposits of bile components that form in the gallbladder or bile ducts. Bile is produced by the liver and flows into the gallbladder to be stored until it is needed to help with the digestion and absorption of fat (Maldonado-Valderrama 2011). Signals from the digestive system after eating trigger the release of bile into the small intestine via the bile ducts. Gallstones may cause dull pain and indigestion due to chronic inflammation of the gallbladder, or acute, often severe, pain if they block bile flow. In rare cases, inflammation of the gallbladder, liver, or pancreas resulting from gallstones can become life-threatening (Zakko 2018; Byrne 2006; Indar 2002; Rangaswamy 2017).
Gallstones are very common in Western societies, and their prevalence is increasing. About 38 million people in the United States have gallstones, and one million new diagnoses are made each year (Zakko 2018; Stinton 2012; Ibrahim 2018). However, as many as 80% of gallstone cases are silent, causing no immediate signs or symptoms (Stinton 2012; Jones, Ghassemzadeh 2018; de Bari 2012).
Gallstones can range in size from a tiny speck to as large as a golf ball (Mayo Clinic 2017; Zakko 2018). Most gallstones are composed primarily of cholesterol, but a small percentage are made mainly of bilirubin and are known as pigment stones. Cholesterol gallstones usually form in the gallbladder, but some pigment stones form in the bile ducts (Shaffer 2018).
Gallstones may be associated with increased risks of gallbladder, pancreatic, and colorectal cancers (Pak 2016). In addition, there is mounting evidence that gallstones are a risk factor for cardiovascular disease and increased mortality (Upala 2017; Shabanzadeh, Sorensen, Jorgensen 2017b; Shabanzadeh, Skaaby, Sorensen, Jorgensen 2017; Zheng 2016).
Silent gallstones are often found incidentally and usually left untreated, but surgery is generally recommended in people with symptoms (Jones, Ghassemzadeh 2018). Cholecystectomy (removal of the gallbladder) is one of the most common surgeries in the United States and is done laparoscopically in most cases (Zakko 2018). In some circumstances, treatment with an oral bile salt that gradually softens and dissolves gallstones is the preferred approach (Goral 2016).
In this protocol you will learn how gallstones form and are diagnosed, the available conventional treatment options, and surgical approaches that are continually being refined. You will also learn about diet, lifestyle, and integrative approaches to reducing the risk of gallstones and their complications. For example, eating a diet that emphasizes fiber, fruits and vegetables, plant proteins, and monounsaturated and polyunsaturated fats can help prevent the formation and growth of cholesterol gallstones (Di Ciaula 2017). Physical activity not only protects against gallstones but can also help prevent silent gallstones from becoming problematic (Shabanzadeh, Sorensen, Jorgensen 2017a; Chuang 2001). Gallbladder function may be improved and the risk of cholesterol gallstones further decreased by integrative interventions such as fish oil (Mendez-Sanchez 2001), vitamin C (del Pozo 2014), soy lecithin (Pakula 1996), curcumin from turmeric (Rasyid 2002), and epigallocatechin gallate (EGCG) from green tea (Shan 2008). Finally, emerging evidence suggests medications targeting metabolic disturbances such as high cholesterol and glucose levels may have a role in preventing cholesterol gallstones (Husain 2015; Liao 2017).