Crash course in physiology: in order to absorb fat (which isn’t water soluble – if you don’t believe me, just dump some oil in water), your body has to produce bile salts, which are cholesterol-based. Your liver produces bile, but because you may need more of it for a given meal than the liver can produce in one sitting, your gallbladder hangs off your liver and acts as a receptacle for the extra bile (just in case you have a supersized fast food meal or something. Which I don’t recommend, for the record).
Bile ought to be liquid, but too much of any given constituent in the bile will make it precipitate out of solution and form stones. (If you add sugar to water by the tablespoon, for instance, eventually you’ll add so much that the water is saturated, and the sugar will just collect at the bottom of the glass in solid form again. Same thing.)
Gallstones come in several varieties. By far the most common type are cholesterol stones. The other relatively common type are those made of bilirubin (breakdown products of red blood cells), and these form when red blood cells are being destroyed (hemolytic anemia) or when the liver isn’t doing its job (as in cases of cirrhosis). Sometimes gallstones can even form as a result of local bacterial infections.
Traditionally recognized risk factors include rapid weight loss, pregnancy (this slows down gallbladder emptying), liver or bile duct infections, diabetes, hemolytic anemia (again, that’s destruction of red blood cells), estrogen (including hormonal birth control), certain ethnic descents (Hispanic, Native American, and fair-skinned Europeans), and age – gallstones are more common over 40.
Unless they’re causing an obstruction, gallstones are frequently not associated with any symptoms, and may be found incidentally on imaging.
Once the stone causes an obstruction, the typical treatment involves surgical removal of the gallbladder. After surgery, many patients may experience chronic diarrhea, due to the lack of extra bile to absorb fat.
Some patients are not good candidates for surgery, and these will more often undergo lithotripsy– that is, breaking up the stone with sound waves.
Prior to this, some medications can be given to dissolve the stones – but these take two years or longer to work, and they don’t address the reason for the stones in the first place. Therefore the stones are likely to recur.
THE NATUROPATHIC APPROACH
There are a few other risk factors to consider – among them a high fat diet, low antioxidant or B vitamin status, food allergies (especially a few in particular), low stomach acid, constipation, and proton pump inhibitors (including omeprazole). Of course, we will need to determine which, if any, of these are factors and address them.
In the meantime, for chronic cholesterol-based gallstones (acute is a different story), the philosophical approach involves stimulating the gall bladder to move bile more freely, supporting the liver in its detoxification process, encouraging cholesterol excretion and reducing stone formation. There are a number of tricks we can use in order to do this, but most of them involve a low fat diet full of fiber and gallbladder-stimulating foods (calledcholegogues), slow and steady weight loss, botanicals and nutrients specific for the liver and gallbladder, and some home hydrotherapy treatments.
Want to keep your gallbladder where it is? Make an appointment for a consultation!
MY SUITE OF SUPPLEMENTS FOR GALLBLADDER SUPPORT
Click on each product for a description and dosing recommendation.