Gallstones

However, sometimes the pain is not exactly where the organ is located. That’s why I prepared a comparison to show some presumptive diagnoses according to the area where the patient refers to the pain.

Carlos Castillo, Own work Carlos Castillo, Own work

Gallstones are solid deposits of minerals that form in the gallbladder. Their presence causes pain and difficulty in digestion. The gallbladder is an organ located below the liver that serves as a reservoir for bile salts, the substance responsible for aiding in the digestion of fats. When a fatty food must be digested, the gallbladder receives a signal and squeezes itself to discharge bile salts into the duodenum then begins the process of emulsifying them so that digestion is smooth. When there are stones in the gallbladder, this process is not carried out normally because when the gallbladder makes the movement to expel the bile salts, the stones do not allow it to empty completely.

Bruce Blaus, Own work, CC BY-SA 4.0

a) Symptoms

Gallstones usually occur in women between the ages of 20 and 50. Sometimes the disease is asymptomatic and is diagnosed by chance in a routine evaluation. When it does present with symptoms, the main one is pain in the right hypochondrium, at the level of the gallbladder. The pain is characteristic of this disease and is called biliary colic. Colic is a type of pain that starts suddenly and increases in intensity until it reaches a maximum point from which it decreases until it is completely eliminated. This symptom is typical of hollow organs, such as the intestines or ureters. In the case of the gallbladder, the pain becomes very intense and lasts between 15 minutes and half an hour. In addition to the pain, the patient with gallstones has abdominal bloating when eating high-fat or high-carbohydrate foods and a feeling of fullness after eating any amount of food.

It is important to mention that those people who undergo bariatric surgery greatly increase the risk of suffering from gallstones. Some bariatric surgery teams have a protocol of removing the gallbladder during the surgery itself. If you are planning to have bariatric surgery, you should ask your surgeon about this since you would have a very high chance of having to have surgery again in a couple of years to remove the gallbladder.

b) Treatment

Treatment of gallstones is surgical and consists of removing the gallbladder. Currently this procedure is performed by laparoscopic surgery with minimal complications. It is one of my favorite procedures. There are some natural preventive treatments that help maintain and improve gallbladder health. In scientific research over the years, however, there is no clear evidence that treatments serve to dissolve or eliminate gallstones once they have formed. Ursodeoxycholic acid is the only treatment that has been shown to dissolve specific types of cholesterol stones. The acid dissolves the cholesterol from the stones already formed and decreases the amount of cholesterol in the bile so that no new ones are formed. The treatment is long, between eight months and one year. Ursodeoxycholic acid 250mg, Dosage: 7mg/lb. (Example: If your body weight is 150 pounds, you have to take 1 gram of Ursodeoxycholic acid, or 4 tablets) for at least 6 months. The patients I have seen with this type of treatment return to having gallstones sometime after ending the treatment. However, it can be a good tool if there is no possibility of operating in the immediate future.

Dr. Maybell Nieves operating a laparoscopic The pain is treated with common painkillers such cholecystectomy with her surgical team as Paracetamol or Ibuprofen. Honey and turmeric are natural anti-inflammatories that can help improve the pain of biliary colic.

c) How Can I Prevent Gallstones?

Eating foods that naturally stimulate gallbladder activity is beneficial in keeping the bile ducts working properly. Olive oil, artichokes, and foods with fiber, such as brown rice and quinoa, are some of the best options. One of the recommendations that I personally use and that works very well both for the digestive system and to reduce inflammation and fluid retention is apple cider vinegar mixed with half a cup of water. I mix the water with two spoonfuls of organic apple cider vinegar on an empty stomach, and it has helped me eliminate heartburn and improve digestion. Eating regularly, without too much fat or carbohydrates, helps the body keep its cholesterol levels under control, thus decreasing the chance of cholesterol stones forming. Gold coin grass is a plant widely used in Eastern medicine. It is said to have anti-inflammatory properties and to soften gallstones. It is important to remember that these types of herbs should be boiled enough to concentrate into an infusion. Between one and two hours is enough to prepare the infusion; it can be taken hot or cold. You should use two liters of water for every 30 grams of the product. Many people have websites with recipes for biliary cleansing. I particularly find that it is not necessary and that all these preparations have a lot of olive oil, which can be harmful to many. I do not recommend them.

d) When Should I Worry?

When, in addition to the pain, there is a fever, an infectious process may have begun that requires evaluation by a specialist. Jaundice, the yellow color of the skin and mucous membranes, is a warning sign since it means that one of the gallstones is obstructing the exit of the bile. To examine for jaundice, it is important to look at the sclera of the eyes. Sometimes in a darkskinned or very light-skinned patient, it is difficult to distinguish it. If jaundice is really present, the eyes will look yellow as well as the mucous membrane of the lower eyelid. This is a medical emergency; the patient must be evaluated by a gastroenterologist and a surgeon.

Bruce Blaus, Own work, CC BY-SA 4.0