Gallstones 24 August 2009
Gallstones occur in 10 to 15% of the Australian population. The gall bladder sits underneath the liver and is the storage bag for bile. Bile is secreted by the liver to aid in the digestion of fat and the absorption of fat soluble nutrients. Gallstones occur when chemicals within the bile solidify. The two main types of stones are cholesterol and pigment stones. Cholesterol stones are the most common. Stones occur either because the chemicals are too concentrated or the gall bladder fails to empty properly on contraction. Risk factors for gallstones include:
- High cholesterol levels
- Overly-acidic diet
- Food sensitivities
- Chronic intestinal and liver parasites
Gall bladder pain occurs when the stones get stuck in the ducts that travel from the gall bladder to the small intestine (cystic duct and common bile duct). Surgery to remove the gall bladder is necessary if one of the stones get stuck and cannot be dislodged, because of the risk of pancreatitis and infection of the gallbladder. However surgery is usually done only because of recurrent attacks of pain. There is no medical evidence that gallstones which are not causing problems should be removed to “prevent” complications.
Alternatives to non-emergency surgery are:
- Keep your gallstones but prevent the stones causing pain when they obstruct a duct. To do this you need to be tested for food sensitivities. Food sensitivities usually precipitate gall bladder pain. Eliminating the sensitivities almost always eliminates the gall bladder pain attacks and therefore the need for surgery. Food sensitivities are best detected by having a blood test looking for IgG, IgM and IgA antibodies. That’s why the pain disappears on admission to hospital- all foods are stopped and intravenous fluids are started.
- Flush the stones out of the gallstones. This is a controversial technique. For more information, click here.
If the gallbladder has previously been removed then the absorption of the fat soluble nutrients- vitamins A, D, E and K plus some essential fatty acids will be reduced. Bile still gets to the intestines from the liver but not in adequate amounts (the storage bag has been removed). To increase their absorption, it is a good idea to take a bile salt supplement after any meal containing fat or oil.