Homeopathy

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.

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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 neutralises 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, functionless 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 undiagnosed 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 Homoeopath.

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Published on Jan 10^th, 2005