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  • Q&A with Australian Health Practitioners

    Are there alternative medicine options for gallstones?

    I am very wary of taking medications and am frightened at the possibility of having my gallbladder removed. Are there alternative medicine options for treating gallstones?
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  • 5

    Thanks

    Dr Salena Ward

    Bariatric (Obesity) Surgeon, General Surgeon, Upper GI Surgeon (Abdominal)

    I am a specialist Upper Gastrointestinal (gut) Surgeon, who performs surgery for weight loss, tumours of stomach and oesophagus, reflux, hiatus hernia and gallstones. I … View Profile

    I presume you mean alternative medicine to dissolve the gallstones or prevent their symptoms.

    In Western medicine we believe/know that gallstones will not dissolve, and if having caused symptoms then they are likely to continue.  If they are not causing any symptoms then generally we do not remove the gallbladder, however if your doctor thinks the gallstones are causing your problems and symptoms, the evidence is they are likely to continue to do so and this is when we recommend having surgery to remove the gallbladder.

    Some people ask about blasting the stones into tiny pieces. This is NOT advocated and is more dangerous, as the tiny pieces could then come out of the gallbladder into the bile duct and block or infect it which can be a very nasty condition (actually small stones could already do this if you have small stones).

    If your are ‘fit enough’ for surgery, and do not have a nasty infection currently, then the likelihood is your operation will be successful without major problems (95%) and if you have not had major abdominal surgery before, is likely to be able to be done laparoscopically (keyhole) (95%).  However in this situation (without other major health problems or previous operations) there is a 5% risk of complications, and probably 0.5% risk of a nasty complication.

    Every decision in medicine is a balance of risks and benefits.  You should have a frank discussion with your surgeon about this.

    The basic answer is NO, there are not alternatie medicine options for gallstones.

  • 3

    Thanks

    Mr Dean Spilias

    Upper GI Surgeon (Abdominal)

    Dean graduated from the University of Melbourne in 1997 and went on to surgical training at the Royal Melbourne Hospital. During his residency he had … View Profile

    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.

    Dean Spilias
    http://uppergi.net

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