Gallstones – Tombstones of digestion
No one can digest ‘indigestion’. Gallstones are often blamed as a cause for indigestion. Actually, gallstones are formed in the gall bladder due to indigestion or a defective digestive process. The liver excretes (bile pigments) and secretes (bile salts) as yellowish green bile in a continuous process and drains it through the hepatic duct into the small intestine. Most of the bile gets back into the gall bladder (for storage) via the cystic duct due to closure of the sphincter in the intestinal wall. The gall bladder is a small, pear-shaped pouch or sac present adjacent and under the liver surface for storing the bile. The stored bile is concentrated in the gall bladder to about 10 times and poured into the duodenum by periodical contraction of the gall bladder i.e. after ½-1 hour of food intake or when required, through the common bile duct. The gall bladder can store 50-60 ml of bile. Normally, bile flows at the rate of 40-50 ml/hour. The bile stagnation or its composition ratio difference or an infection in the gall bladder can cause stone formation i.e. gallstones.
Bile secreted by the liver is alkaline in nature (pH – 7.5-8.5) and it is mostly composed of 97 per cent water and rest of it consists of conjugated bile salts (sodium and potassium salts of bile acids), cholesterol, lecithin (phospholipids), bilirubin (pigment), and electrolytes. Bile neutralizes the acid food which comes from the stomach and also helps to alkalinise the intestine. It plays a major role in emulsification, absorption and digestion of the fat and oil of our foods. It is a very good natural laxative for the colon. So, only in the case of obstructive common bile duct or liver disorders will there be constipation. The bile salts are important for removal of cholesterol from our body. It combines with lecithin and cholesterol to form micceles which is excreted normally in the stool. Sometimes, bile crystallises in the gall bladder, due to various reasons, forming gallstones.
Incidence of gallstones – The incidence of gallstone
formation is increasingly seen in the fourth decade of life, especially in
women of obese constitution with high cholesterol level. Also women under
contraceptive pills, sedentary lifestyle, multi-para women, and people
suffering from chronic ulcerative colitis are major victims. The increased
dietary intake of fast foods, pastries, oily, spicy foods can cause gallstones
more. Even though it can occur in men, its incidence is more commonly seen in
fat, fertile, flatulent and women in their forties. Gallstones are mostly seen
in the body of the gall bladder rather than in the common bile duct or in the
pouch in the neck of the gall bladder.
Gallstones are usually soft and vary in size, shape, number and types.
·
Size of the stone – varies from 5 mm to 2 cm
·
Shape varies from round, oval to irregular
·
Number of stones may vary from single or
solitary to tiny 100s
· Types – The stone types can be classified by two methods, one by its composition and another by its origin. Mostly, it is classified as septic stones and septic stones.
Aseptic
stones are
Pigment stones – dark green in colour, small in size, usually
multiple and irregular in shape. They are usually seen inside the gall bladder
and rarely in the common bile duct. They are formed due to blood disorders like
haemolytic jaundice, chronic myeloid leukemia (blood cancer) and other chronic
infections which maintain the erythrocyte sedimentation rate (ESR) at a high
level. These conditions, due to blood destruction, cause increased serum
bilirubin level. These bilirubins are trapped in the liver and excreted in the
bile. If the bile doesn’t flow properly, these pigments accumulate as sediment
and form stones.
Cholesterol stones are yellow in colour and usually
seen in singles. It is oval in shape, soft in consistency and smooth. This type
of stone is usually seen in the hartmann’s pouch in the neck of the gall
bladder since these types of stones usually float.
Septic stones are more than aseptic stones.
Mixed stones are brown in colour, large in size, usually
multiple and irregular in shape. These types constitute 70-80 per cent of
stones. These stones are composed of cholesterol, pigments, salts and other
chemicals. Since it is somewhat larger in size, it is usually seen in the body
of the gall bladder as it cannot escape into the intestine and outweigh the
risk of blockage in the common bile duct.
Causes of gallstones – Mainly, stagnation of bile in
the gall bladder or duct for a prolonged time evokes stone formation as the
outcome of precipitation or sediment. It may also be due to variation in
concentration ratio of cholesterol with bile salts (normal it is 1:20-1:30) in
the bile. In general, routine causes are
·
Functionless gall bladder i.e. thick walled gall bladder
with no contraction at all
·
Untimely, unconditioned diet and starvation often. Also
reduced food intake can reduce the secretion of bile acids from the liver. This
causes difference in composition ratio of bile salts and cholesterol, which
finally results in cholesterol stones.
·
Prolonged use of drips, by avoiding oral foods in case of
hospital stay
·
Fatty, flabby belly and pregnancy can relax the gall
bladder and thus cause stones
·
Malfunctioning of liver which secretes less bile with
less bile salts
·
Infection of gall bladder (acute or chronic
cholecystitis)
·
Injury in the gall bladder area which causes inflammation
of gall bladder
·
Taking non-veg foods, fast foods, pastry, oily and spicy
foods often.
·
Increased blood cholesterol level
·
Diseases of the intestines – for example, ulcerative
colitis, crohn’s disease, irritable bowel syndrome, etc. Here, absorption of
bile salts from the intestine or recycling of bile salts is interrupted, so the
liver secretes bile containing very low bile salts. These lowered bile salts
can’t maintain the cholesterol in solution, forming cholesterol gallstones.
Symptom of gallstones
Even though many gallstones are silent or symptom-less,
its presence can be gauged from:
·
Intermittent or constant uneasy feeling or fullness in
the right upper quadrant of the abdomen
·
Pain occurring just below the centre of the right lower
rib pointing to the gall bladder area
·
Vague pain after eating in the right upper quadrant of
abdomen. The pain is more while bending or moving (since the rib presses the
gall bladder) or due to infection
·
Pain may radiate to the right back or just below the
right shoulder blade or right shoulder
·
Fever in case of infection or obstruction Bilious symptom
complex – headache, nausea, constipation and abdomen discomfort. These
complaints are usually better after vomiting.
·
Indigestion, gas trouble, eructation or heartburn and
vomiting
·
Mostly stone pain arises at night as small stones block
the neck of the gall bladder while the person is in a horizontal position.
·
Enlarged and thick-walled gall bladder
·
Constipation or diarrhoea
·
Heart arrythmias – Increased heart beat since irritable
gall bladder or gallstones may stimulate the vagus nerve.
In case of gallstones blocked by common bile duct
·
Colicky pain when gall bladder contracts more – to
overcome the obstruction
·
Jaundice – due to back up of bile into the blood
·
Constipation
Effects & complications of gallstones – Gallstones can cause constipation, infection of gall bladder
(cholecystitis), thickening of gall bladder wall, function less gall bladder
and fibrosis of gall bladder i.e. shrunken and contracted gall bladder.
Finally, but rarely, gall bladder cancer can also be a complication.
Gallstones can get stuck in the bile duct or neck of the gall bladder,
obstructing the bile flow, causing obstructive jaundice which may call for
emergency surgical manipulation. Also the constant infection (acute and chronic
cholecystitis) of the gall bladder can spread the same infection to the
pancreas or peritoneum, causing a serious condition like pancreatitis and
peritonitis. Untreated, irritable gallstones often induce vagal reflex and
cause cardiac arrythmias which may reduce coronary blood flow of the heart and
induce angina pain.
Get alert and beware When you get jaundice (i.e.
yellowishness of skin, pale stool, vomiting and body itching, etc.) When you
get sharp abdomen pain with fever (acute cholecystitis) When you get increased
heartbeat
Diagnosis of gallstones
In this era of ultrasound, routine
scanning or master health check-up often reveals the silent gallstones.
Although many silent gallstones are un diagnosed in many people, pay attention
to analysis and treatment from the very beginning. Diagnosis needs ultimate
ultrasound scanning irrespective of history, signs and symptoms of gallstones.
Then liver function test is also a must to check whether the liver works
efficiently or not. Raised value of serum bilirubin and alkaline phosphatase
give a clue for diagnosis. CT and MRI scans are also very useful for giving
value-added diagnosis, including information about bile ducts and stones. ERCP
procedure (through endoscope) is used to diagnose or remove the gallstones in
the bile ducts. Mostly, gallstones are small and radiolucent so that they
cannot be diagnosed by means of X-rays. But radio-opaque large stones can be
seen in X-rays.
Prevention and precaution – Mostly unconditioned, untimely
and unplanned diet will lead to all illnesses. Prevention techniques
also include preventing pain in case of presence of gallstones.
Avoid
·
Sedentary lifestyle
·
Stress and strain
·
Starving often
·
Drastic weight reduction
·
Oily, spicy, fatty, heavy and large meals while having
gallstones
·
Cheese, pastry, fast foods, sweets and chocolates while
having gallstones
·
Hard diet like meat, chicken, etc., while having
gallstones
·
Drinking aerated drinks often.
Take
·
Fibre-rich diet – vegetables and fruits
·
Food rich in calcium, magnesium, potassium and minerals
to keep the body-alkaline
·
Good protein diets (for example – soya foods or drinks)
·
Plenty of fluids – water and juices (especially lemon and
apple)
·
Timely, small, easily digestible meals while having
gallstones
·
Balanced diet, low in carbohydrates
Treatment of gallstones – This depends on the size and
place of the gallstone. These days, people keep worrying about their health and
go in for surgery unnecessarily. Even for minor ailments they get admitted to a
hospital. In the case of gallstones, the allopathic mode of treatment mostly
concentrates on a course of antibiotics with analgesics during the infective
and painful condition i.e. for temporary palliation – painkillers, avoiding
oral food, giving drips and advising complete bed rest. Or they simply plan for
elective surgery to avoid an emergency surgery.
Surgery – Allopathy system mostly removes the gall bladder as a treatment
for gallstones. The advantageous laparoscopic surgery with minimal scar and
minimal hospital stay makes every patient opt for removal of the gall bladder.
Some do this in extremely painful cases. It is of two types, i.e. one opting
for removal of gallstones, and another one for removing the entire gall bladder
(Cholecystectomy) with stones to avoid risk of recurrence of stones and
eliminate the risk of cancer. The risk of gall bladder cancer is very remote
compared to other organs. It is very sure that digestive difficulties will not
disappear with the operation. There are studies showing that gall bladder
removal can increase the chances of pancreatic problems or colonic problems or
cancer due to constant flowing of bile into the intestine.
Homeopathic approach
Gallstones are a result of digestive disorders. The removal of stones or
removal of the gall bladder will not lead to better digestion. Removing stones
or the gall bladder is not eliminating the disease but only the effects of
the disease. So, the stone-forming tendency will be there and the disease will
move or proceed to other places.
The best way is to treat the condition for preventing the formation of
gallstones. Homeopathy makes a way for the liver to work more efficiently so
that it can produce good quality bile and make the gall bladder function in
well for concentrating bile and pouring it out by good contraction so that
normal digestion can be recovered. Homeopathy strongly suggests that gall
bladder removal is an unnecessary one. In most instances, gallstones can be
dissolved completely by Homeopathy treatment.
Homeopathy is not against surgery when it is really needed, but unnecessary
surgery can be avoided. The Homeopathic system of medicine is proved on human
beings and known to be very effective in acute and chronic conditions. It
treats the disease from the root and provides good health without any
side-effects.
Homeopathic medicines commonly used for treating gallstones are Belladonna,
Beri Beri Vulgaris, Bryonia, Borax, Calcarea Carbonica, Carbo Veg, Cardus.M,
Chelidonium, China, Cholestrinum, Colocynthis, Fel tauri, Hydrastis,
Lycopodium, Nat Sulph, Nux Vom, Pulsastilla, Mag phos, etc. These Medicines
should be taken under the advice and diagnosis of a qualified Homeopath.
for new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer: The contents of this column are for
informational purpose only. The content is not intended to be a substitute for
professional healthcare advice, diagnosis, or treatment. Always seek the advice
of healthcare professional for any health problem or medical condition.)