What are Gallstones?

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Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that’s released into your small intestine.

Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.

People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don’t cause any signs and symptoms typically don’t need treatment.

Symptoms

Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:

• Sudden and rapidly intensifying pain in the upper right portion of your abdomen
• Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
• Back pain between your shoulder blades
• Pain in your right shoulder
• Nausea or vomiting

Gallstone pain may last several minutes to a few hours.

If you are suffering from any pain in the above areas, or anywhere please consult with your doctor.

Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as:

• Abdominal pain so intense that you can’t sit still or find a comfortable position
• Yellowing of your skin and the whites of your eyes (jaundice)
• High fever with chills

Causes

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, contributing 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. 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.

Risk factors

Factors that may increase your risk of gallstones include:

• Being female
• Being age 40 or older
• Being a Native American
• Being a Mexican-American
• Being overweight or obese
• Being sedentary
• Being pregnant
• Eating a high-fat diet
• Eating a high-cholesterol diet
• Eating a low-fiber diet
• Having a family history of gallstones
• Having diabetes
• Having certain blood disorders, such as sickle cell anemia or leukemia
• Losing weight very quickly
• Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
• Having liver disease

Complications

Complications of gallstones may include:

• Inflammation of the gallbladder. A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.
• Blockage of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Severe pain, jaundice, and bile duct infection can result.
• Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct. A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.
• Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.

Prevention

You can reduce your risk of gallstones if you:

• Don’t skip meals. Try to stick to your usual mealtimes each day. Skipping meals or fasting can increase the risk of gallstones.
• Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week.
• Eat more high-fiber foods. Include more fiber-rich foods in your diet, such as fruits, vegetables, and whole grains.
• Maintain a healthy weight. Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet, and continuing to exercise.

Diagnosis

Endoscopic retrograde cholangiopancreatography (ERCP)Open pop-up dialog box

Tests and procedures used to diagnose gallstones and complications of gallstones include:

• Abdominal ultrasound. This test is the one most commonly used to look for signs of gallstones. Abdominal ultrasound involves moving a device (transducer) back and forth across your stomach area. The transducer sends signals to a computer, which creates images that show the structures in your abdomen.
• Endoscopic ultrasound (EUS). This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. During EUS your doctor passes a thin, flexible tube (endoscope) through your mouth and through your digestive tract. A small ultrasound device (transducer) in the tube produces sound waves that create a precise image of surrounding tissue.
• Other imaging tests. Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.
• Blood tests. Blood tests may reveal infection, jaundice, pancreatitis, or other complications caused by gallstones.

Treatment

Laparoscopic cholecystectomyOpen pop-up dialog box

Most people with gallstones that don’t cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing.

Your doctor may recommend that you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment.

Treatment options for gallstones include:

• Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. You don’t need your gallbladder to live, and gallbladder removal doesn’t affect your ability to digest food, but it can cause diarrhea, which is usually temporary.
  Medications to dissolve gallstones. Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way, and gallstones will likely form again if treatment is stopped. Sometimes medications don’t work. Medications for gallstones aren’t commonly used and are reserved for people who can’t undergo surgery.

Alternative Treatments

Although there is no reliable evidence that these remedies work, the following treatments are popular natural alternatives to medical interventions.

One of the most common treatments for gallstones is a gallbladder cleanse. Proponents of this method claim it breaks down the gallstones and flushes them from the body. A 2009 paper states that although scientific evidence to support a gallbladder cleanse is minimal, anecdotal reports indicate it may be helpful for some people.

A gallbladder flush involves consuming a blend of apple juice, herbs, and olive oil for 2 to 5 days. Recipes vary, and some procedures allow a person to eat food while others do not.

This diet may be unsafe for people with diabetes or blood sugar problems, who do not consume solid food during the cleanse.

2. Apple cider vinegar with apple juice

Some people believe that apple juice softens gallstones, allowing them to be excreted from the body with ease.

One cleanse involves mixing apple cider vinegar into the apple juice before drinking it. Although there is limited evidence to suggest that apple cider vinegar does have some health benefits, no studies support its use as a treatment for gallstones.

Furthermore, people with diabetes, stomach ulcers, and hypoglycemia should be wary of consuming large amounts of fruit juice.

According to the National Center for Complementary and Integrative Health, dandelion has been used historically to treat gallbladder, liver, and bile duct problems. Supporters believe that the bitter roots may stimulate bile production in the gallbladder.
People usually drink dandelion teas or coffees to remove their gallstones. However, there is no evidence to suggest this is beneficial. Furthermore, people with gallstones, gallbladder problems, or kidney problems should speak with a doctor before consuming dandelion.

4. Milk thistle

Milk thistle has been used medicinally to detoxify the liver for centuries. While it may support the liver and gallbladder, there are no studies evaluating its effects on gallstones.

A person can take milk thistle as a tonic or in a capsule or tablet form. People with diabetes, ragweed allergies, or a history of hormone-sensitive cancers should discuss the use of milk thistle with their doctor.

5. Lysimachia herba
Lysimachia herba or gold coin grass is a popular traditional Chinese remedy for gallstones. Research suggests it may be beneficial for treating or preventing cholesterol gallstones.

The supplement is available as a powder or liquid.

6. Artichoke

Extracts of artichoke have been shown to stimulate bile production and aid both gallbladder and liver function. However, there is no research specifically on the effects of artichoke on gallstones. Globe artichokes can be cooked and prepared in various ways. However, the research is based on artichoke extract supplements, which are more potent than vegetables.

It is essential to speak with a doctor before taking artichoke extract because it may cause a gallbladder attack if a bile duct is obstructed.

7. Psyllium husk

Psyllium is a soluble fiber derived from the seeds of the Plantago ovata plant. Research has shown it to benefit the heart, pancreas, and other areas of the body.

A very old study found that psyllium husks protected hamsters from the formation of cholesterol gallstones. A more recent study, from 1999, supports these findings.

8. Castor oil pack

Castor oil packs are a popular remedy among naturopaths and natural living enthusiasts for a wide variety of complaints.

To apply a castor oil pack, soak a cloth in warm castor oil and place it on the abdomen. Cover with a towel. Some people choose to place a heat source, such as a hot water bottle or heating pad, on top. Leave the pack on the abdomen for up to an hour.

There are no scientific studies to support the use of this treatment for gallstones.

9. Acupuncture

Acupuncture may relieve gallstone symptoms, although the research is very limited.

In one study on 60 people with cholecystitis (gallbladder inflammation), acupuncture was found to alleviate back pain, stomachache, and nausea, while also regulating the volume of the gallbladder.

It should be noted that this research does not look specifically at gallstones, and it may only relieve symptoms, rather than helping people to pass the stones.

10. Yoga

Some yoga poses are said to cure gallstones, although no studies support this claim. The following poses are believed by some to be beneficial for people with gallstones:

• Bhujangasana (Cobra Pose)
• Dhanurasana (Bow Pose)
• Pachimotasana (Seated forward bend)
• Sarvangasana (Shoulderstand)
• Shalabhasana (Locust Pose)

Medical treatments

natural remedies do not treat gallstones effectively, then a person might want to consider medications or surgery.

Medication

Smaller gallstones may be treated with bile acids such as ursodeoxycholic acid and chenodeoxycholic acid.

Potential disadvantages of these medications include:

• The time they take to work (up to 2 years)
• The potential for gallstones to return once medication use is stopped

Surgery

Gallstones are often treated by removing the gallbladder. This ensures that the gallstones cannot re-form.

Gallbladder removal surgery or cholecystectomy is one of the most common operations performed on American adults. There are minimal side effects of gallbladder removal.

Can diet prevent gallstones?
Women who eat more fruits and vegetables are less likely to have their gallbladders removed than women who eat very little fresh produce, according to a 2006 study. Also, other sources of fiber such as the psyllium husks mentioned earlier may be beneficial for the gallbladder.

Foods that may cause gallbladder problems include:

• high-fat foods
• eggs
• sugar

Weight management

As obesity increases the risk of gallstones, those who are overweight should aim to achieve and maintain a healthy weight.

However, following a diet that is very low in calories (500 per day) can be a risk factor for gallstone formation, according to a 2013 study. However, those who ate between 1200 and 1500 calories a day for 12 weeks lost weight but were much less likely to get gallstones.

People who suspect they have had a gallbladder attack should contact a doctor without delay to reduce the risk of future complications.

Thank you for reading

Michael

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