Are there alternative medicine options for gallstones?
23/02/13 15:19 Gallbladder | Author - Dean Spilias
In response to a question on healthshare.com.au
For most people, surgery is the most reliable treatment for gallstones. There are, however, alternative treatments that are used on occasion.
Ursodeoxycolic acid is a bile salt that can dissolve some gallstones, in particular the ones that are associated with excess cholesterol production by the body (eg. rapid weight loss) or the inability of the body to produce, excrete or reabsorb the bile salts that are normally produced by the liver. (Conditions that cause this include removal of part of the small bowel called the terminal ileum, and a liver disorder called primary sclerosing cholangitis). Ursodeoxycolic acid was once obtained from bear bile but is now produced synthetically. It is expensive; it does not work for all types of gallstones; the effect is temporary; and it is usually only prescribed by specialist gastroenterologists or hepatobiliary (liver and gall bladder) surgeons. It is only subsidised by the Australian Pharmaceutical Benefits Scheme for use in primary sclerosing cholangitis.
People with “silent” or asymptomatic gallstones do not need to have surgery; if the gallstones are not causing any pain or any health problems, it is quite reasonable to treat them with a low-fat diet, with gradual weight loss, and with the inclusion of small amounts of olive oil in the diet.
Gall stones can occasionally pass out of the body by themselves; for example it was fount that about a third of stones in the bile duct (not the gall bladder) were cleared by the body in this 2004 research study: http://www.ncbi.nlm.nih.gov/pubmed/14685097?dopt=AbstractPlus
However, completely clearing stones from the gall bladder is much less common, to the point that individual cases are considered worthy of publicaiton in medical jounals: http://onlinelibrary.wiley.com/doi/10.1002/bjs.1800610206/abstract For some perspective on how rare this is, approximately two million Australians are thought to currently have gallstones.
Because fatty meals cause the gall bladder to contract, and because olive oil slightly increases the solubility of cholesterol-rich gallstones, olive oil flushes are sometimes recommended by alternative health advisors. I haven't been able to find any good research studies that show olive oil flushes to be an effective treatment. As a surgeon, I of course only see patients for whom this treatment has failed, but my impression is that it is a treatment that does not work for the majority of people; my general practitioner and gastroenterologist colleagues certainly don't report any sort of consistent success from their patients who have tried olive oil flushes.
The reports of gallstones being passed into the toilet after these treatments and floating in the toilet bowl are, to the best of my knowledge, false; every gallstone I have removed sinks in the specimen container, unlike the floating “stones” passed by some people using these treatments. The explanation for the stones seems to be that olive oil is liquid in an acid environment (eg. in its natural un-oxidised state, or when mixed with vinegar or lemon), but begins to saponify and solidify into a soap and glycerine mixture when it comes into contact with an alkaline substance - such as pancreatic juice in the intestine.
Good luck with your decisions! Keep in mind that surgery and bile salt tablets are the only proven treatments for gallstones, with surgery being the most effective treatment once symptoms have begun.
For most people, surgery is the most reliable treatment for gallstones. There are, however, alternative treatments that are used on occasion.
Ursodeoxycolic acid is a bile salt that can dissolve some gallstones, in particular the ones that are associated with excess cholesterol production by the body (eg. rapid weight loss) or the inability of the body to produce, excrete or reabsorb the bile salts that are normally produced by the liver. (Conditions that cause this include removal of part of the small bowel called the terminal ileum, and a liver disorder called primary sclerosing cholangitis). Ursodeoxycolic acid was once obtained from bear bile but is now produced synthetically. It is expensive; it does not work for all types of gallstones; the effect is temporary; and it is usually only prescribed by specialist gastroenterologists or hepatobiliary (liver and gall bladder) surgeons. It is only subsidised by the Australian Pharmaceutical Benefits Scheme for use in primary sclerosing cholangitis.
People with “silent” or asymptomatic gallstones do not need to have surgery; if the gallstones are not causing any pain or any health problems, it is quite reasonable to treat them with a low-fat diet, with gradual weight loss, and with the inclusion of small amounts of olive oil in the diet.
Gall stones can occasionally pass out of the body by themselves; for example it was fount that about a third of stones in the bile duct (not the gall bladder) were cleared by the body in this 2004 research study: http://www.ncbi.nlm.nih.gov/pubmed/14685097?dopt=AbstractPlus
However, completely clearing stones from the gall bladder is much less common, to the point that individual cases are considered worthy of publicaiton in medical jounals: http://onlinelibrary.wiley.com/doi/10.1002/bjs.1800610206/abstract For some perspective on how rare this is, approximately two million Australians are thought to currently have gallstones.
Because fatty meals cause the gall bladder to contract, and because olive oil slightly increases the solubility of cholesterol-rich gallstones, olive oil flushes are sometimes recommended by alternative health advisors. I haven't been able to find any good research studies that show olive oil flushes to be an effective treatment. As a surgeon, I of course only see patients for whom this treatment has failed, but my impression is that it is a treatment that does not work for the majority of people; my general practitioner and gastroenterologist colleagues certainly don't report any sort of consistent success from their patients who have tried olive oil flushes.
The reports of gallstones being passed into the toilet after these treatments and floating in the toilet bowl are, to the best of my knowledge, false; every gallstone I have removed sinks in the specimen container, unlike the floating “stones” passed by some people using these treatments. The explanation for the stones seems to be that olive oil is liquid in an acid environment (eg. in its natural un-oxidised state, or when mixed with vinegar or lemon), but begins to saponify and solidify into a soap and glycerine mixture when it comes into contact with an alkaline substance - such as pancreatic juice in the intestine.
Good luck with your decisions! Keep in mind that surgery and bile salt tablets are the only proven treatments for gallstones, with surgery being the most effective treatment once symptoms have begun.