Gall stones

There are two main types of gall stones: those that are of mixed composition, cholesterol and its derivatives plus varying amounts of bile salts, pigments and salts of calcium, and those that are composed entirely of minerals, principally calcium salts.

Rarely gall stones will consist of pure cholesterol or pure pigment (calcium bilirubinate).

Fats, including cholesterol, are insoluble in water and require emulsification by the bile for complete utilization.

Bile, consisting of bile acids, bilirubin, cholesterol, lecithin and electrolytes, is secreted by the gall bladder to facilitate fat digestion.

For gall stones to form, cholesterol must become insoluble within the gall bladder either by an increase in cholesterol or decrease in bile salts, lecithin or water within the bile.
To prevent this happening the solubility of the bile must be increased. There are several theories as to how to do this.

Addressing the diet is one aspect to look at.

The theory that the main reason for gallstones forming is the consumption of fibredepleted refined foods has a lot of support. Diets high in refined carbohydrates (sugars) and fats and low in fibre, lead to a reduced amount of bile acids being produced by the liver, which in turn reduces the solubility of cholesterol.

Dietary fibre has also been shown to decrease the formation of deoxycholic acid and to promote its excretion from the bowel.
This can be important as deoxycholic acid greatly reduces the solubility of cholesterol in
the bile. Therefore a diet high in fibre, especially those found in vegetables and fruits, and notably the gel-forming fibres such as flaxseed, oat bran, guar gum, psyllium and pectin, are extremely important in the prevention as well as the reversal of gallstones.

There is also evidence that excess dairy proteins are likely to increase the formation of gallstones, whereas vegetable proteins such as soy are more likely to be preventative.
This is because high acidity, caused by high intake of animal proteins, must be buffered by the alkaline reserves of the body, meaning less alkalinity is available for bile secretions. Insufficient alkalinity can cause cholesterol to precipitate, restricting bilary flow and ultimately leading to gallstone formation.

In many cases it is not just the diet that needs to be addressed but also the digestion of the fats in the diet. Avoidance is not a complete answer to the problem. In the digestive process, exogenous lipase enzymes (the ones that digest fats) will aid pancreatic lipase and bile in breaking down dietary fats.
Therefore the use of moderate amounts of supplementary lipase, as well as protease and amylase, will gradually improve the digestion and absorption of dietary fats.

I usually recommend enzyme products which are entirely plant derived, contain an effective dosage of digestive enzymes (including Lipase) and are extremely well tolerated.
Go to On-line shop for Enzyme products.

Other dietary considerations are the possibility of a low level of lecithin in the bile.
In some cases supplementing with 300-400 mg of lecithin daily can increase concentration of lecithin in the bile and in doing so increase the solubility of cholesterol.

Another factor to consider is the fact that most of the bile acids excreted in the bile are re-absorbed through the intestinal mucosa into the blood, where it is transported back to the liver for re-excretion in the bile.
Lactobacillus Acidophilus is the most prevalent bacteria found in the intestines and plays a major part in the recycling of bile components.
Make sure that your bowel is kept healthy with adequate amounts of acidophilus.
See page on Probiotics.

Also food allergies are known to cause gall bladder pain in many instances.
Foods that can induce symptoms in decreasing order of occurrence are likely to be:  egg, pork, onion, chicken, milk, coffee, citrus, corn, beans and nuts.

Other avenues of treatment for gall stones are herbal treatments and Vitamin supplements.
Vitamins usually include vitamins C and E as some experimental studies (in animals) have shown deficiencies of these vitamins to cause gallstones.

Herbal treatments involve the taking of choleretic herbs.
Choleretic herbs are those herbs that stimulate the secretion of bile.
Cholagogues on the other hand being agents that stimulate gall bladder contraction to promote bile flow.
Choleretic herbs are Dandelion Root, St Mary’s Thistle, Globe Artichoke, Greater Celandine and Turmeric. These may need to be used over a long period.
Garlic is also known to reduce cholesterol levels and may help prevent the formation of gall stones.

There are also procedures such as gall bladder flushes, which have been known dissolve gallstones and then allow them to be flushed from the gall bladder.
Not always a pleasant procedure and may possibly be dangerous if there is a large gall stone that may get stuck in the gall bladder duct. There is also conjecture over whether any ‘stones’ passed are truly gall stones.

On the other hand, many patients report feeling better after the procedure but it is
advisable to have a repeat gall bladder scan to verify results.
See page on ‘ Gall bladder Flush’