All You Ever Wanted To Know About Gallstone Disease

Did you know that around 10 in 100 Indians could have gallstone disease?

If you catch 100 people walking on the road and subject them to an Ultrasound examination of the abdomen, you will find at least 10 of them having gallstones without even being aware.

The gallbladder is a small pouch-like organ situated just below the liver with a capacity of about 60 to 80 ml.

The function of the gallbladder is to receive, store and concentrate by about 50 times, the bile secreted by the liver and release this concentrated bile at an appropriate time when partially digested food from the stomach arrives at the first part of the intestine.

Bile is alkaline in nature and neutralizes the acid mixed with food which helped partially digest the food in the stomach. In simple terms, this bile primes the partially digested food to be acted upon by the pancreatic enzymes for it to be properly digested.

However, there are times when the biliary system does not function as smoothly and gall stones are formed in the gall bladder. This happens when the bile turns unhealthy because of the imbalance in the concentration of cholesterol and other pigments in it.

There may be one large stone or several of them. Mostly these stones are asymptomatic and are incidentally detected. However, in some cases, the gall stones announce their existence by causing pain, some times excruciating, in the upper abdomen.

What’s the Link Between Your Diet and the Risk of Gallstone Formation?

There are several risk factors that may contribute to the formation of gallstones. The medical students are taught a one liner for that, which is, Fatty Fertile Female of Forty with a Family history of gallstones. But, this only underscores the slightly increased risk in this group as compared to the general population

Diets that are high in fat and cholesterol and low in fiber appear to play a significant role. You may not be able to do much about other risk factors enumerated above, but you can certainly influence and modify your diet accordingly. If you are overweight, try and shed those extra kilos, but very gradually because studies have shown a link between a crash diet induced quick weight loss and gallstone formation.

The foods that can be certainly recommended for the gallbladder health are:

• Fresh fruits and vegetables
• Whole grains
• Low-fat dairy products
• Lean meat, poultry, and fish

There are anecdotal references about certain foods having been studied for the potential to prevent gallbladder stones but they are at best only preliminary reports with no solid evidence backing them.

It has been said that drinking coffee lowers the risk of gallstones in both the genders. Drinking moderate amounts of alcohol has also been linked to a reduced incidence of gallstones.

What to Do Once You Know You Have Gallstones

People with gallstones and who are asymptomatic must avoid fried foods and highly processed refined carbohydrates, high-fat dairy and fatty red meat.

There is a talk in every culture regarding gallbladder cleansing. This is based on the premise that the gallbladder contracts very vigorously to flush out its contents including the sludge and small gallstones after taking the ‘cleanse.’

The cleanse has olive oil as one of its constituents, which is the strongest known stimulant for gallbladder contraction. The scientific evidence to support a gallbladder cleanse is very minimal. On the contrary, during the process of flushing small gallstones may get stuck in the common bile duct and cause jaundice and severe pain which is generally caused by an inflamed pancreas due to the stuck stone.

Other alternative methods to treat gallbladder disease are dandelion, milk thistle and our very own Isabgole which in an animal study has been shown to protect hamsters from the formation of cholesterol gallstones.

A very large body of research suggests that the only treatment for gallstone disease is the removal of the gallbladder surgically.

It is usually done only when the patient has symptoms, especially the pain suggestive of gallstone disease. Remember that the bile secreted by the liver continues to flow into the small intestine, so that the process of digestion goes on even when the gallbladder is removed, although it is less efficient because bile no longer is as concentrated as is required for digestion.

In the immediate post-operative period it is best to avoid diets with high-fat content and chocolates etc.

(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavor is to help people lead a healthy life without medication. He can be reached at [e-mail])