Non-Surgical Approaches to Treating Gallstones: What Are Your Options?

Understanding Gallstones and Their Impact

What are gallstones?

Gallstones, also known as cholelithiasis, are hardened deposits of bile in your gallbladder. Bile is a digestive fluid produced by your liver and stored in your gallbladder. Abnormal changes in the composition of bile cause it to form tiny crystals that harden into stones, which may range in size from a sand grain to the size of a golf ball. Gallstones are usually asymptomatic until they block the flow of bile into the intestines.

Types of Gallstones

Types of gallstones that may form in your gallbladder include:

1. Cholesterol Gallstones

• These are the most common type of gallstones, constituting about 70% to 80% of gallstones in adults. Cholesterol gallstones are made primarily of undissolved cholesterol with a few other components. It appears yellowish in colour.

2. Pigment Gallstones

• These stones are formed due to too much bilirubin (a yellow substance produced by the breakdown of red blood cells) in the bile. They appear dark brown or black in colour. These stones are most often associated with liver diseases.

Symptoms of Gallstones

Gallstones cause symptoms if they get stuck in a duct and cause blockage. The symptoms include:

• Sudden and severe pain in the upper right or middle abdomen
• Pain in the right shoulder or between the shoulder blades
• Nausea and vomiting
• Indigestion
• Abdominal bloating
• Gas or belching
• Fever and chills
• Yellowish discolouration of the skin and whites of the eyes
• Pale coloured stools

Read more - Guide to Managing Gallbladder Pain: Understanding the Cause and Seeking Relief.

When Non-Surgical Approaches Are Considered

Non-surgical methods to treat gallstones are recommended in the following conditions:

• The stone is not causing any symptoms, such as pain or digestion-related issues.
• The symptoms are mild and do not cause serious discomfort to the patient.
• The patient is elderly or is not able to undergo surgery due to health conditions.
• The gallstone is small and can be dissolved with medications.
• The patient prefers non-surgical methods due to the fear of surgery if the stones are not causing severe symptoms.

Dietary and Lifestyle Changes

Various studies have shown how simple dietary and lifestyle modifications can help support your gallbladder’s health, reducing the risk of gallstones, the symptoms they cause, and the need for surgery to treat them.

Here’s how to adopt a gallstone-friendly diet:

• Eat foods that are rich in fibre, such as fruits, vegetables and whole grains.
• Eat healthy fats (monounsaturated and polyunsaturated fats) like those found in olive oil, avocado, fish, full-fat dairy, nuts and seeds.
• Stay hydrated by drinking plenty of water to support healthy bile production and prevent stone formation.
• Go for low-fat foods such as lean meats. Low fat can reduce the workload on the gallbladder.
• Reduce the intake of refined sugars and unhealthy fats found in fried foods and desserts. These foods may trigger or worsen the symptoms caused by gallstones.
• Nutritional supplements like vitamin C, soy lecithin, and iron may help prevent gallstones.

Read more - 15 Dietary Strategies for Gallbladder Wellness: What to Eat and What to Avoid.

Apart from your diet, other lifestyle changes that can support gallbladder health include:

1. Weight Management

Obesity increases the prevalence of gallstones, and so does rapid weight loss. A study showed that a relative loss of weight greater than 24% of initial body weight, a rate of weight loss greater than 1.5 kg per week, a very low-calorie diet with no fat, or a long overnight fast can increase the risk of gallstones. 

Then what’s the solution? Gradual weight loss is key. Control your weight loss, reduce the length of overnight fasting, and continue to include healthy fats in your diet.

2. Exercise

• Various studies confirm the protective effect of physical activity on the risk of gallbladder disease. Exercise improves your overall well-being and supports the maintenance of a healthy body weight.

Medications for Gallstone Management

Certain medications offer you a chance to avoid surgery and treat gallstones by managing their symptoms and even dissolving them. Gallstones that are small and cause mild symptoms can be effectively treated using medicines.

1. Bile Acid Therapy (Ursodiol or Chenodiol)

This treatment for gallstones involves taking oral bile acids orally. 

How It Works: 
Bile acids reduce the cholesterol content in bile. This makes the bile less saturated by cholesterol, allowing the cholesterol gallstones to dissolve gradually.

Best For: 
Bile acid therapy can be used for treating small, non-calcified cholesterol gallstones.

Duration: 
Taking bile acid pills can provide symptomatic relief in 2 to 3 months. However, for the stone to disappear completely, it may take several years.

2. Pain Management

Mild pain caused by gallstones can be managed using over-the-counter painkillers like ibuprofen or acetaminophen. 
Medications for gallstones have limitations – they are effective for treating only specific types and small-sized gallstones. Once the medicines are discontinued, there is a chance that other new stones may form.

Alternative and Natural Therapies

Alternative therapies provide a gentle and natural way to treat gallstones. Many report relief from gallstone symptoms with the use of different herbal remedies, gallbladder cleanses and acupuncture. Let us explore some of them:

Herbal Remedies for Gallstones

Many herbs have been used since ancient times as remedies for gallstones and other gallbladder-related disorders. Even though their traditional uses are well known, more scientific studies are required to confirm their efficacy.

1. Dandelion Root

• This herb has been used for many centuries as a remedy for gallbladder disorders. The bitter compounds found in dandelion root stimulate your liver to produce bile, which in turn helps with fat metabolism.

2. Milk Thistle

• Extracts of milk thistle have been recognised as remedies for liver and gallbladder disorders.

3. Gold Coin Grass

• This is a herb used in Chinese medicine to treat gallstones.

4. Turmeric

• A 2015 study conducted on mice showed that curcumin (an active component in turmeric) administered along with piperine (an alkaloid present in black pepper) for 4 weeks prevented the development of gallbladder stones.

Read more - Understanding the Root Causes of Gallstones and How Ayurveda Addresses Them.

Gallbladder Cleanses

The gallbladder cleanse is a folk remedy that is said to promote the passage of gallstones. This involves consuming a combination of herbs, olive oil and fruit juices to flush out gallstones. 

Caution:
Gallbladder cleanse is not scientifically proven and may result in complications like a blocked bile duct. Do not try this remedy without consulting a healthcare professional.

Acupuncture

A  study showed that the stimulation of GB21, an acupressure point on the shoulder, reduces gallbladder-related shoulder, back, and stomach pain and reduces the gallbladder volume in cholecystitis (inflammation of the gallbladder) patients.

Shock Wave Therapy (Extracorporeal Shock Wave Lithotripsy - ESWL)

Shock wave therapy for gallstones is a non-surgical alternative which uses sound waves to break down gallstones into small pieces that can pass out easily through your digestive system.

The physician first locates the gallstone using ultrasound and then focuses shock waves on that particular point.

ESWL is used to treat patients with small-sized gallstones and normally functioning gallbladders. It is also very useful in treating cholesterol-based gallstones in patients contraindicated for surgery or refusing to undergo surgery.

However, ESWL has a few limitations: this treatment option is not widely available and may require to be followed up with bile acid therapy to dissolve any remaining gallstone fragments.

Preventing Gallstone Recurrence

Preventing gallstones can be easy – protect your gallbladder with these lasting methods:

Balanced Diet

• Practise healthy eating habits. Stick to a balanced diet rich in whole grains, fruits, vegetables, lean meats, healthy fats, nuts and seeds. Avoid processed, high-fat and excessively sweet foods.

Physical Exercise

• Engage in physical activities. Staying active can help you maintain a healthy body weight and prevent obesity.

Weight Management

• Avoid rapid weight loss treatments or diets as they can increase the risk of gallstones.

Hydration

• Stay hydrated by drinking plenty of water throughout the day. Hydration is the key to the healthy functioning of all body processes. It can prevent the bile from becoming concentrated.

Regular Check-Ups

• Getting regular check-ups done can help in early detection, monitoring the progress to know if they are worsening, and preventing complications.

Wrapping Up

Do you suspect you have gallstones? If you experience severe symptoms, repeated episodes of gallstones, or if you have large or numerous stones, cholecystectomy (surgical removal of the gallbladder) becomes necessary.

Non-surgical options like simple changes in your diet and lifestyle, medications to relieve pain and dissolve stones, and alternative therapies like the use of herbs or acupuncture can be effective in managing the symptoms and discomfort caused by gallstones. 

If you suspect you have gallstones, consult a healthcare provider to diagnose it and plan the best treatment approach for your needs.