Understanding Gallstone Treatment: Surgery, Medication, and Alternative Options

What Are Gallstones and Why Do They Form?

Gallstones are hard, stone-like materials that develop in your gallbladder, usually made of cholesterol or bilirubin. When gallstones block your bile ducts, they can cause sudden and severe pain. They may form as one large stone or as many small gravels; the condition is also known as cholelith.

Types of Gallstones

There are mainly two types of gallstones. They are:

• Pigment gallstones: When your bile contains too much bilirubin, it causes dark brown or black stones.
• Cholesterol gallstones: This is the most common type of gallstone, often appearing yellow. Undissolved cholesterol mainly composes these gallstones but may contain other components.

There is also one more type of gallstone called a mixed gallstone. Some people have a mix of cholesterol and pigment stones. Sometimes, cholesterol stones may accumulate a substantial proportion of calcium bilirubin and other calcium salts, producing mixed gallstones.

What Causes Gallstones?

If bile contains too much cholesterol, too much bilirubin, or not enough bile salts, it may cause gallstone formation. Researchers have not clearly understood why these changes in bile occur. Gallstones can form if the gallbladder does not empty completely or often enough. Some people are more likely to develop gallstones than others due to risk factors for gallstones, including obesity and certain types of diets.

Risk Factors

The following risk factors increase the likelihood of developing gallstones:

• Gender - Women are more prone (twice as likely) to develop gallstones than men.
• Ethnicity - Native Americans have the highest rates of gallstones in this country.
• Obesity - Obesity is a major risk factor for the formation of gallstones, especially in women.
• Estrogen - Increased levels of Oestrogen during pregnancy, hormone replacement therapy, or birth control pills may increase cholesterol levels in bile and decrease gallbladder movement, which can cause the formation of gallstones.
• Age - People over 60 are more likely to develop gallstones.
• Genetic predisposition - People with a family history of gallstones are likelier to develop them.
• Cholesterol-lowering medicines - Intake of medicines that lower cholesterol in the blood can increase the amount of cholesterol secreted in bile, increasing the risk of gallstones.
• Diabetes - People with diabetes usually have high levels of triglycerides, which increase the risk of gallstones.
• Drastic weight loss - Sudden weight reduction causes the liver to secrete extra cholesterol into bile, which can cause gallstones.
• Fasting - If you don't consume food, gallbladder movement decreases. This causes the bile to become over-concentrated with cholesterol.
• Bone marrow or solid organ transplant - Due to immunosuppressive medications and parenteral nutrition after surgery can increase the risk of gallstones.

Ayurvedic Insights into Gallstone Care

In Ayurveda, gallstones are referred to as 'Pittashmari'. 'Ashmari means stone, and Pitta refers to the imbalanced Pitta dosha related to bile in the gallbladder. 

Ayurvedic treatment for gallstones includes cleansing the liver and gallbladder to restore their normal functioning. These methods involve the use of very effective herbs, herbal formulations, and panchakarma detoxification.

Turmeric, Ginger, Garlic, Gale of Wind, aloe vera, Indian Madder, and aloe vera are herbs useful in gallstone treatment.

Panchakarma detox therapies for gallstone removal:

Some panchakarma detox therapies are highly beneficial for gallstone removal. The following therapies are beneficial in managing symptoms of gallstones:

• Vamana or Emesis therapy - Toxins in the form of vitiated Kapha (water element) and Pitta (fire element) are brought to the stomach and duodenum from all over the body by procedures like oil massage and sudation therapy. And then are eliminated through the mouth by inducing therapeutic emesis. You will vomit out the waste products after you take medicine to induce emesis.
• Avagaha Sweda (Ayurvedic Sitz bath) - It is good for pain management. It involves sitting in a bathtub filled with a medicated herbal concoction and relaxing for a while. This therapy will help open the channels and pacify Vata dosha (the air element) to relieve pain.
• Parisheka (Streaming of Medicated Concoction)- This procedure involves continuously streaming a medicated concoction with medicinal herbs on the lower abdomen. It helps pacify Vata (air element) and Pitta (fire element).

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

Surgical Treatment Options for Gallstones

Because gallstones can recur, your doctor will usually recommend surgery to remove your gallbladder. After removing your gallbladder surgically, bile is released directly from your liver into your small intestine instead of being stored in your gallbladder.

You can live without a gallbladder; removing it will not affect your digestion. However, it can sometimes cause diarrhoea, which is usually temporary.

The surgical removal of the gallbladder is called a cholecystectomy. It is a common and safe surgery that usually carries a low risk of complications. In most people, the surgery is done through small incisions.

Types

Depending on your condition, your doctor will advise cholecystectomy surgery. Doctors will use one of the two following surgical approaches. Those two types of surgical procedures are as follows:

• Laparoscopic Cholecystectomy: Laparoscopic cholecystectomy uses very small incisions in your abdomen. This surgery method results in less bleeding and requires a shorter recovery time than open surgery. 
• Open Cholecystectomy: Removal of the gallbladder by making a large abdominal incision. Doctors do not prefer this method when they suspect cancer. 

There is also one more method if the above one is not possible.

• Simple Cholecystectomy: If doctors suspect cancer, they go for simple cholecystectomy. In this type, the surgeon will remove the gallbladder along with some of the surrounding tissue to ensure the complete removal of cancerous tissue. The procedure can be done open or laparoscopically.

Medications for Gallstone Management

Usually, doctors don't prescribe gallstone medicines as they are ineffective. Chenodiol (Chenix) and ursodiol (Actigall) are effective only if the size of the stone is smaller, they are cholesterol-based, and they are free from complications. These medicines may cause mild diarrhoea. It can take months to dissolve the stones, and they often recur.

Sometimes, medications do not help dissolve gallstones. Therefore, gallstones are not usually treated with medications. Doctors prefer medications only when you are ineligible for surgery.

Pain Management

If you have gallbladder stones, you will experience severe pain. So, effective gallstone pain relief is very much necessary. You can apply a warm compress to the affected area. Consuming peppermint tea also helps soothe the pain. But there is not much you can do to relieve the pain because the pain is so intense. If the pain becomes unbearable, you will usually need prescription medication or surgery.

Medication depends on the cause and severity of pain. Your doctor may prescribe the following medicines:

• Pain medication: If you have frequent pain attacks, your doctor may prescribe an analgesic medicine or pain reliever to manage your pain.
• Antibiotics: Your healthcare provider may prescribe an antibiotic if you have an infection that might cause aggravated pain.

Alternative and Natural Treatments

You can use home remedies to treat gallstones and manage related symptoms. But you must contact your doctor for advice before trying any home remedies for gallstones. Your doctor will recommend whether natural remedies are beneficial in your case or whether medication or surgery is necessary.

Dietary Adjustments

Diet plays a significant role in preventing and treating gallstones. Here are some healthy diets for gallbladder health:

Include these in your diet:

• Fiber-rich foods such as fruits, vegetables, beans, pulses, oats and whole grains
• Fresh fruits and vegetables: Beans, citrus fruits, dark, leafy greens, peppers and tomatoes.
• Increase fluid intake: Daily drink at least two litres of water and/or other fluids, such as herbal tea.
• Dairy products: Consume two to three portions of dairy every day and opt for low-fat dairy products. This improves calcium intake, which is essential for gallbladder health.
• Lean protein: Eat lean meat, poultry, and fish, such as sardines, eggs, beans, lentils, nuts, pulses, tempeh, and tofu.
• Healthy fats: Healthy fats include unsaturated fats that come from plant sources. So, consume fats from avocados, nuts and seeds, olives, rapeseed, and sunflower oil.

Try to avoid or limit these in your diet:

• Refined white flour – Avoid pasta and white bread, which contain refined white flour and little to no fibre.
• Sugar - Sugar increases the risk of gallstone formation. Therefore, avoid high-sugar foods, such as cakes, biscuits and other sweet dishes.
• Low-calorie diets - This leads to rapid weight loss, which can worsen symptoms or trigger more gallstones to form.
• Fried foods – Deep-fried foods such as fried meat, chips, nuggets, spring rolls, and spring rolls are high in fat and are not good for your gallbladder.
• Saturated fats – If you consume a diet high in fat, particularly saturated fats and trans fats, it can put too much strain on your gallbladder.

Read more about home remedies here: Dissolve Gallstones Naturally: Herbs & Home Remedies.

Herbal Remedies

Doctors usually recommend medication or surgery for gallstones, but some natural remedies may help prevent gallstones formation. Herbal remedies for gallstones are very effective if used wisely. Here are some herbs which are very effective in treating gallstones:

• Dandelion - Dandelion tea helps to remove gallstones.
• Milk thistle - You can take Milk thistle as a tonic, capsule, or tablet. It may support the liver and gallbladder.
• Picrorhiza (Yellow gentian) - It has a bitter taste and acts as a liver stimulant. It is a particularly recommended Ayurvedic medicine that works on bile.
• Indian Berberi - This relieves bile flow blockage and thereby reduces sharp cutting pain caused by obstruction. With its systematic, controlled, and continuous use, you can dissolve gallstones naturally.
• False Daisy – It acts on the liver and improves its bilious flow. It is an excellent appetizer and liver stimulant.
• Aloe Vera – Regular Aloe Vera juice intake can help dissolve small gallstones.
• Artichoke - Extracts of artichoke stimulate bile production and improve gallbladder and liver functions.
• Castor - Castor oil packs are a popular remedy for improving gallbladder health and reducing pain and discomfort.

Lifestyle Changes

Some lifestyle changes might help improve your condition. Sometimes, this may not reduce the size of the stone, but it may improve your symptoms. You can follow these tips:

• Eat a nutritious diet with more fibre from vegetables, whole grains, and unsaturated fats from nuts, olive oil, and fish.
• Following a vegetarian diet can reduce the risk of developing gallstones. A vegetarian diet lowers the risk of developing gallstones compared with people who eat a non-vegetarian diet.
• Practise regular exercise at least 30 minutes per day.
• Obesity or being overweight can increase the risk of gallstone formation, so maintain a healthy body weight.
• Even though obesity is a risk factor, avoid rapid weight loss. Again, rapid weight loss is also a risk factor for gallstones.
• Be cautious about using hormonal birth control or hormone replacement therapy. Hormonal imbalances, such as low levels of Oestrogen, can increase the risk of gallstones.

Gallbladder Flushes

Gallbladder flushing or cleansing is considered a method of removing gallstones from the body. However, there is no reliable evidence that gallbladder cleanses are useful in preventing or curing gallstones.

Olive oil, some other herbs, and certain fruit juices are consumed for several hours as a method of gallbladder cleansing. According to proponents of this treatment, a gallbladder flush helps break up gallstones and eliminate them through the stool.

Although olive oil may act as a laxative, there is no evidence that it is an effective treatment for gallstones. Gallbladder flushes are not free of side effects. Some people experience nausea, vomiting, diarrhoea, and abdominal pain during a gallbladder flush. Additionally, the ingredients used may present their own health risks.

However, there are no specific gallbladder cleansing techniques that everyone follows, and more research is required to prove the claimed benefits.

When to Seek Medical Attention?

When should you see your doctor about gallstones? If you develop a sudden stabbing type of pain in your upper right abdomen or shoulder, especially after eating, the pain might be due to gallbladder stones. In such conditions, you should immediately seek your doctor's help. If you experience this type of pain, don't expect it to go away on its own. The pain may not go away on its own. Seek a doctor's help who can diagnose the exact cause of your pain and help relieve it.

Similarly, if you have ever had gallstones, see your doctor periodically, even if you don't have symptoms. They can detect them through specific imaging techniques and recommend treatment before they cause further problems.

You should also consult a doctor if you experience symptoms of gallbladder problems, such as abdominal pain that lasts at least several hours, nausea, vomiting, fever, and chills. Also, take advice from your doctor if you are planning to take some natural remedies.

Conclusion

After exploring this blog, you may have come to know several important things related to gallstones. One of them is that you may be suffering from gallstones even if you are not experiencing any symptoms. So, if you are indulging in any of the causes of gallstones mentioned above, like consuming gallstone-causing food or following such a lifestyle or if you are under any of the risk factors, it is time to see your doctor.

Gallstone treatment options range from simple herbal remedies to surgical intervention. Although surgery is the ultimate treatment for gallstones, there is nothing wrong with trying herbal remedies or Ayurvedic Panchakarma treatment. However, you may resort to conventional medicine or surgery in emergencies.

If you have gallstones or suspected gallstone issues, contact Nirva for advice on gallstones. Our expert doctors and other health consultants will listen to your problem and provide the appropriate solution.