Gall bladder attacks

Gall bladder: How to prevent excrutiatingly painful attacks without resorting to surgery

Around 20 per cent of people over the age of 65 develop gallstones, but only about 4 per cent suffer any symptoms. Most people only find out they have gallstones when one gets stuck in the tube leading to the bile duct (called the cystic duct). If it isn’t quickly dislodged, this can be dangerous and cause spasm and inflammation of your gall bladder; excruciating pains in your upper right abdomen or back that can last for several hours; nausea and vomiting.

The incidence of gallstones increases with age and strikes women, especially obese women, three times as often as men. This is thought to be a result of hormonal changes associated with pregnancy, the birth control pill or hormone replacement therapy (HRT). Increased oestrogen levels encourage your gall bladder to relax – meaning that it can’t contract properly and expel gallstones as they begin to form.

Gallstones form in your gall bladder, a little pear-shaped pouch located under your liver. It is responsible for storing bile and releasing it into your intestine to aid the digestion of food. Bile is made in your liver from cholesterol, bile salts and pigments, and lecithin.

Your body’s only means of getting rid of excess cholesterol is by converting it into bile salts and removing it in your bile. Normally, bile salts keep cholesterol dissolved in the bile, but if there is too much cholesterol it crystallises into little solid specks – which can lead to the formation of gallstones the size of a marble, or even a golf ball!

Lose weight to lower your risk of gallstones… but don’t shed the pounds too quickly

Your chance of developing gallstones doubles if you are just ten pounds overweight, and increases up to six times if you are obese (Am. J. Clin. Nutr. 55: 652-8, 1992). This is because obesity is associated with increased levels of cholesterol in your bile, which can lead to gallstones.

If you need to lose weight, make sure you regulate your weight loss carefully, and are not losing more than two or three pounds a week. Rapid weight loss itself increases the risk of gallstones, because it upsets the production of bile salts, which keep cholesterol soluble (Ann. Intern. Med. 199: 1029-35, 1993).

To prevent gallstones, follow a low-carbohydrate diet, but include plenty of fibre from fresh green vegetables and salads. Including some vegetable protein, for instance from soya beans, will also help keep cholesterol dissolved in your bile (Am. J. Clin. Nutr.

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37:802-4, 1983).

To encourage your gall bladder to empty completely and flush out any solid particles of cholesterol, have a couple of tablespoons of olive oil with your main meal. A high consumption of olive oil has been shown to lower the incidence of gallstones (J. Clin. Nutr. 47: 960-4, 1988).

Could a food intolerance be behind your attacks?

There is a strong link between food allergies and gall bladder attacks (Annals of Allergy 1968;26;83-89). Common dietary culprits include eggs, pork, onions, chicken and turkey, milk, coffee and oranges. It has been suggested that in susceptible people the body reacts to these foods by causing the ducts carrying bile to swell, impeding the flow of bile from the gall bladder.

If you suspect that a food intolerance may be causing your symptoms then the best way of identifying the problem foods is through an elimination diet. This involves avoiding all food likely to cause allergies for at least two weeks, then re-introducing them one at a time.

You should do this under the supervision of a nutritionist, who will assess your nutritional status before you start and monitor your progress. The reason for this is that it can be difficult to detect which foods are causing you problems, as an attack can take up to a few days after the offending food has been eaten to occur. Once you have identified the offending foods, keep them out of your diet. To find a registered nutritionist in your area, contact The British Association of Nutritional Therapy on 0870 606 1284 or visit www.bant.org.uk

Safe, natural alternatives to gallbladder surgery

If you already have gallstones and suffer from ‘gall bladder attacks’ – severe cramping pain accompanied by nausea – your doctor will probably advise you to have your gall bladder removed.

Surgery can involve risks, the most common complication being injury to your bile ducts, which can leak bile and cause a potentially painful and dangerous infection that may require further surgery. Once your gall bladder is removed, bile flows into the small intestine more frequently, which can cause diarrhoea.

The most powerful herbal remedies for gallbladder problems are dandelion and milk thistle. Dried and roasted dandelion root can be used as a healthy substitute for coffee, but to be sure of getting an effective dose of the active ingredients pick a ‘standardised extract’. The standard dose of milk thistle is also based on its main active ingredient, silymarin. Most herbalists recommend a dose of between 75 and 200 mg of silymarin, taken three times a day.

The phospholipid lecithin, and its active ingredient phosphatidyl choline, is an ingredient of bile that helps to protect against gallstone formation. A supplement of around 1,200 mg a day of lecithin helps prevent gallstones and may also be active in dissolving existing stones (Am. J, Gastroenterol. 165: 231-5, 1976).

20.09.2007

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