Cholelithiasis (Gallstones)

Latest Edit: Iva Lloyd, ND 2017-10-12 (EDT)

Gallstones, or cholelithiasis' are hard stony deposits that form within the gallbladder. Cholecystitis refers to inflammation of the gallbladder. The gallbladder is a small organ located just underneath the liver. It receives, stores and concentrates bile made in the liver and sent to the gallbladder through a small tube called the cystic duct. During digestion the bile is sent to the intestines to help break down the fat in food. Gallstones are more common in women, Indigenous populations and Hispanics, with risk increasing over age 40.

Naturopathic Assessment

Article	Nutritional Approaches to Prevention and Treatment of Gallstones , Alt Med; 2009;Vol14(3)

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With Gallstones, the causes are variable and include lifestyle and Social factors. A detailed assessment is required to determine which factors are contributing to gallstones.

Lifestyle

• Dietary factors include:

• Diets high in fatty foods, fried foods and processed food.
• Eating large meals and eating too close to going to bed.
• Diets low in fiber.
• Food allergies and food intolerances especially to eggs and dairy

• Both obesity and rapid weight loss are associated with increased risk of gallstones.

• Exercise

• A sedentary lifestyle is associated with increased risk of gallstones.

Social

• Stress

• Stress, especially when the emotion is anxiety, irritability or frustration is associated with gallstones.

Environmental

• Parasitic Infections

• Gallstone formation may follow a parasitic infection.

• Environmental Toxins

• Gallstone formation is increased with high heavy metal exposure especially to aluminum, mercury, lead, cadmium and nickel.

External

• Smoking

• Smoking increases a person risk of gallstones.

• Breathing

• Chest breathing can increase the risk of gallstone formation.

Medical Interventions

• Prescription Medications

• The following medications can contribute to increased risk of gallstones:, Tamoxifen, oral contraceptives and estrogens, cephalosporin ceftriaxone, octreotide, HMG CoA reductase inhibitors and potentially other lipid-lowering drugs.

Genetics

• Family History

• There is a strong family history to gallstones.

• Sex

• Women are four times form likely than men to get gallstones, especially is they are overweight and over the age of 40.
• With advancing age, the rate of gallstones becomes equal between males and females.

Common Questions

• Where is the pain?
• Does the pain travel?
• When does it occur?
• Does the pain ever wake you during the night?
• How do you feel after consuming a meal high in fat?

Diagnostic Testing

Several tests are used to diagnose gallstones including:

• Abdominal exam often shows a positive Murphy's Sign

• Blood tests including liver function tests

• Imaging Studies include: abdominal ultrasound, cholecystogram - a type of xray procedure, Endoscopic Retrograde Cholangiopancreatography (ERCP)

Related Symptoms and Conditions

Conditions that are commonly associated with gallstones or that increase a person's risk of gallstones include:

• Obesity
• Cholecystitis, or inflammation of the gallbladder
• Cholangitis, or infection of the common bile duct
• Choledocholithiasis, or presence of at least one gallstone within the common bile duct
• Pancreatitis, or inflammation of the pancreas
• Type II Diabetes
• Metabolic Syndrome
• Increased levels of estrogen|
• Cirrhosis
• Hiatus hernia
• Musculoskeletal symptoms that are persistent
• Hemorrhoids
• Rapid weight loss like that which happens after bariatric surgery can increase risk.

Characteristics

There are four main types of gallstones:,

1. cholesterol stones are the most common. They occur when there is an excess of cholesterol present in the bile.
2. pigment stones are formed from excess bilirubin in the bile.
3. mixed
4. mineral

Common Symptoms

This condition is asymptomatic in about 20% of the cases, or it can present with any of the following symptoms:

• Pain in the upper right quadrant or upper middle area of the abdomen

• Pain may radiate to the right scapula (shoulder blade) or the right shoulder
• Pain may also present as pain or numbness in the right elbow, arm or hand or the left hip
• Neck pain and headaches
• Pain may be intense

• Intolerance to fatty foods

• Attacks of pain follow fatty meal

• Bloating
• Belching
• Indigestion
• Heartburn
• Abdominal cramping
• Jaundice
• Nausea and/or Vomiting
• Clay coloured stool

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. If an individual is experiencing acute pain due to gallstones it is always advisable to seek medical care as gallstones can cause serious health risks.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

• Manage stress levels
• Avoid getting dehydrated. Ensure that you drink adequate water, especially when exercising, also limit sunbathing and avoid getting burnt.

Lifestyle

Lifestyle recommendations include:

• Dietary recommendations:

• Consume a diet that focuses on whole unprocessed foods (whole grains, legumes, vegetables, fruits, nuts and seeds.
• Focus on increasing intake of fibre.
• Eliminate the intake of food allergens and food intolerances especially milk, eggs, onions, and chocolate.
• Reduce intake of saturated fats, cholesterol, sugar, and animal proteins. Eliminate fried foods.
• Drink at least 6 - 8 glasses of water daily to optimize water content of bile.
• A few tablespoons of apple cider vinegar a day may be beneficial.

• Exercise

• Regular exercise is important.

• Posture

• Address any postural constrictions, especially any associated with the mid-back.

• Breathing

• Proper breathing ensures that the gallbladder and liver are pumped on a consistent basis which can aid in the proper movement of bile.

• Time Outside

• Sunlight exposure can assist in converting the excess cholesterol reserves stored in the skin to Vitamin D2 which can then be converted by the liver to Vitamin D3

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for Gallstones include:

• Nutritional Foods include:

• Vegetables, Roots,Nuts & Gourds such as corn silk.

• Clinical Nutritional Supplementation includes

• Vitamins such as Vitamin C, Vitamin E, Folic Acid, Vitamin B12, Vitamin B3
• Amino Acids such as Methionine
• Other supplements such as such as Flaxseed oil, Omega-3 Fatty Acids, Lecithin, Water soluble fibre, choline, phosphatidylcholine, Betaine HCL, Digestive Enzymes, Red yeast rice.

• Herbs such as Dandelion ("Taraxacum officinale"), Milk thistle (Silybum marianum), Globe Artichoke (Cynara cardunculus), Turmeric (Curcuma longa), Greater celandine (Chelidonium majus) and Peumus boldo.Wild Yam (Dioscorea villosa)

• Herbs which have cholagogue actions are commonly used.
• Peppermint Oil (Mentha piperita) can be effective in dissolving gallstones.
• Castor Oil Packs over the liver for 5 to 7 days may be helpful. With gallstones the addition of heat with the castor oil packs is often not advised.

• Gemmotherapies such as Alnus glutinosa

• Homeopathy

• Classical homeopathics: such as Carduus marianus, Chelidonium, Colocynthis. Other remedies include: Calc carb, Lycopodium, Veratrum album
• Complex homeopathics can be helpful in the treatment of acute and chronic gallstones.

• Traditional Chinese Medicine & Acupuncture

• Acupuncture alone or in combination with herbs can be very effective in the treatment of gallstones.,
• The focus of TCM is to increase the flow of liver Qi. Patterns often associated with gallstones include: Liver Qi stagnation, Damp Heat in the Gallbladder, Damp Heat in the Liver.

• Hydrotherapy

• Constitutional hydrotherapy may be helpful in the treatment of chronic gallstones.

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]