Gallstone:

A gallstone, also known as a biliary calculus or cholelith, is a calculus formed in the gallbladder or biliary passages.

Gallstone formation is a common disorder of the biliary tree, and it is unusual for the gallbladder to be diseased in the absence of gallstones. The incidence of gallstones in developed countries is increasing and often occurs at an early stage. In India, the incidence of gallstones is less.

Gallstones are classified into cholesterol and pigmented stones.

Gallstones are hardened deposits that form in the gallbladder, often remaining asymptomatic. However, when they block a bile duct, they can trigger biliary colic sharp pain in the abdomen and lead to serious complications like infection or inflammation. Treatment options vary based on severity. Pain management with medications can provide relief during episodes.

Dietary changes, such as reducing fatty foods, may help prevent stone formation or symptom flare-ups. In more severe cases, surgical removal of the gallbladder (cholecystectomy) is common, as it effectively eliminates the source of gallstones. Alternatively, nonsurgical methods like medication to dissolve stones or procedures to remove them may be considered for those unsuitable for surgery.

Early diagnosis is key to avoiding complications, so consult a doctor if symptoms arise. Combining medical guidance with lifestyle adjustments, including a balanced diet and regular exercise, supports gallbladder health and overall well-being.

1. Cholesterol Gallstones:

• The most common type, found predominantly in developed countries and often appears yellow.
• Patients with cholesterol gallstones have gallbladder bile that forms cholesterol crystals more rapidly than equally saturated bile from patients who do not form gallstones.
• Bile contains chemicals that can dissolve the cholesterol excreted by the liver. However, if the liver excretes more cholesterol that cannot be dissolved, excess cholesterol may form gallstones.

2. Pigment Gallstones:

• Brown crumbly pigment stones are almost always the consequence of bacterial or parasitic infections in the biliary tree. These dark brown or black stones form when bile contains too much bilirubin and are common in the Far East.

Symptoms:

At the initial stage, there are often no symptoms. Gallstones may be observed during routine X-rays or abdominal surgeries. When gallstones cause blockage, the following symptoms may occur:

• Asymptomatic in 80% of cases.
• Biliary colic.
• Yellowing of the skin.
• High fever with chills.
• Pain, typically sudden and lasting about 6 hours if the gallstone becomes impacted in the cystic duct.
• Pain is usually felt in the epigastrium or right upper quadrant and may radiate to other regions.

Risk Factors:

• Obesity
• Cirrhosis of the liver
• Crohn’s Disease
• IBS

Herbs to Treat Gallstones:

• Rosemary: Stimulates bile production and helps eliminate blockages in the bile duct.
• Milk thistle seeds (Silymarin): Useful in treating gallstones.
• Green tea extract: Stimulates fat digestion in the gallbladder and prevents gallstone formation.
• Cinnamon: Eugenol present helps to break down gallstones and flush them from the body.
• Peppermint: Menthol component helps treat gallstones.
• Artichoke leaves: Increases bile production and prevents gallstone formation.

Natural Home Remedies:

• Turmeric powder: ¼ teaspoon daily.
• Apple juice: Daily consumption.
• Carrot juice: Daily consumption.
• Low-fat foods and dairy.
• Alfalfa: Beneficial.
• Ginger root: Use in food items.
• Fennel seeds: Help clear obstructions in the liver, gallbladder, and spleen.

Tests Required:

• Bilirubin Test
• Liver Function Test

Investigations:

• Ultrasound: The investigation of choice for diagnosing gallstones. Most stones are diagnosed by transabdominal ultrasound, which has a >92%  sensitivity and 99% specificity for Gallbladder stones.

• CT and MRCP (Magnetic Resonance Cholangiopancreatography): Excellent modalities for detecting complications of gallstones.

Though I have mentioned the quantity of ingredients in some natural home remedies, consult an Ayurvedic Physician for the quantity and usage before taking them.

FAQs on Gallstones: Symptoms, Pain Relief, and Treatment

1. How can I stop gallstone pain quickly?
To relieve gallstone pain fast, apply a warm compress to the upper right abdomen to relax muscles and improve blood flow. Over-the-counter pain relievers like ibuprofen may help reduce inflammation. Avoid fatty foods, stay hydrated, and rest in a comfortable position. Seek medical attention if pain persists.

2. Can I treat gallstones without surgery?
Yes, nonsurgical treatments include medications like ursodeoxycholic acid to dissolve small cholesterol stones over months. Dietary changes, such as low-fat meals, can prevent symptom flare-ups. Procedures like endoscopic retrograde cholangiopancreatography (ERCP) can remove stones. Consult a doctor to assess suitability.

3. How long will gallstone pain last?
Gallstone pain (biliary colic) typically lasts 30 minutes to a few hours. If a stone blocks a bile duct, pain may persist longer or recur until resolved. Severe or prolonged pain (over 6 hours) may indicate complications like cholecystitis, requiring urgent medical care.

4. What is the best medication for gallstone pain?
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are commonly recommended for gallstone pain relief due to their anti-inflammatory effects. In severe cases, doctors may prescribe stronger analgesics or antispasmodics. Always consult a healthcare provider before taking medication.

5. How can I stop a gallbladder attack while it is happening?
During a gallbladder attack, lie on your side with knees drawn up to reduce pressure on the abdomen. Apply a warm compress and take an over-the-counter NSAID if safe. Avoid eating, sip water, and seek medical help if pain escalates or lasts over a few hours.

6. What are gallstone symptoms in females?
In women, gallstone symptoms include sharp pain in the upper right abdomen or under the right shoulder, nausea, vomiting, bloating, and indigestion, especially after fatty meals. Women are at higher risk due to hormonal factors like pregnancy or oral contraceptives, which can promote stone formation.

7. What are gallstone treatments without surgery?
Nonsurgical options include medications (ursodeoxycholic acid) to dissolve cholesterol stones, ERCP to remove stones, or shock wave lithotripsy to break them up. A low-fat diet and weight management can reduce symptoms. These methods suit small stones and patients unfit for surgery.

8. Which size of gallbladder stone is dangerous?
Stones larger than 2 cm pose higher risks, as they’re more likely to block bile ducts, causing complications like cholecystitis, pancreatitis, or infection. However, even smaller stones can be dangerous if they obstruct ducts. Imaging tests help assess stone size and risk.

9. What is the fastest way to relieve gallbladder pain?
The fastest relief comes from applying a warm compress to the abdomen, taking NSAIDs like ibuprofen, and avoiding food intake during an attack. Staying hydrated and resting in a comfortable position can help. Seek immediate medical care for severe or persistent pain.

10. What are the first signs of a bad gallbladder?
Early signs include intermittent pain in the upper right abdomen, nausea, vomiting, bloating, or indigestion after fatty foods. Other symptoms may include fever, chills, or jaundice (yellowing skin/eyes) if complications like infection or bile duct blockage occur.

11. What are three treatments for gallstones?
Three common treatments are: 1) Cholecystectomy (surgical gallbladder removal), effective for recurrent stones; 2) Medications like ursodeoxycholic acid to dissolve small cholesterol stones; 3) ERCP, a procedure to remove stones from bile ducts. Treatment depends on symptoms and patient health.

12. What dissolves gallbladder stones fast?
Ursodeoxycholic acid can dissolve small cholesterol-based gallstones over months, not instantly. For faster results, ERCP or lithotripsy may be used to remove or break up stones. A low-fat diet supports dissolution by reducing gallbladder stress. Consult a doctor for tailored options.

Author:

Dr. Veena Deo