Talk:Gallstone

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[edit] Gallstones

Gallstones are stones that form in the gallbladder and are usually one of two types: cholesterol stones or pigment stones.

Cholesterol stones are made primarily of hardened cholesterol, yellow-green and account for about 80% of gallstones. Pigment stones are darker and made of bilirubin.

Gallstones can vary in size from sand grain size to golf ball size.

A common medical student memory aid for the most likely category of people to get gallstones are the four (five?) Fs: Fat, Female, Fertile, Forty, Flatulent.

Gallstones can be asymptomatic or symptomatic. Gallstone 'attacks' often occur after a fatty meal - this is because the gallbladder responds to cholecystokinin (a hormone released by the stomach) and contracts to release bile into the duodenum to emulsify the fat in the food so it can be broken down by pancreatic lipase and absorbed.

Gallstones can cause obstructive jaundice (if a small stone goes down and blocks the bile duct), porcelain gallbladder and gallstone ileus.

The usual treatment for gallstones is surgical removal of the gallbladder - cholecystectomy. Laparoscopic cholecystectomy is a routine operation nowadays.


Note: Unsure if I can use any of this as possible information in the Gallstone entry but it is information I found lacking during my ordeal when i was searching for answers, that I now have a more complete understanding of. --- I have had a recent ordeal with gallstones. the first few times, I woke up with pain in the middle of the night that went away only after eating a certain food or drinking milk, and lasted a few hours of intense pain. after the 3rd such attack, i had one that would not go away and went to the ER for where it was misdiagnosed as Gas, and I left in more pain than I arrived. eventually it went away, after eating a sandwich i made as soon as i got home. I had another attack and not as willingly this time went to the ER again, this time i got a decent prescription for pain pills, but still left in more pain and with no clear diagnosis. the third ER visit they performed xrays after having me drink liquids containing contrast, and ct scans, finally an ultrasound which diagnosed the gallstones. I later had another attack where it was also diagnosed, but the blood tests were apparently indicative of hepatitis so that was put on the release form beside gallstones. this time, i was released with instructions to go see a specialist but due to insurance problems, i never saw anyone and the pain actually lasted 2 weeks before it went away on its own. this was a couple years after the first time it occured. I thought that the stones had passed (mistakenly as they don't pass apparently), and didnt have another case for over a year. a year and a half later, on vacation, i had another case, this time hepatitis was believed because I waited 4 days before going to the hospital, apparently long enough for my bilirubin count to reach 4.9 (normal 0.0-1.0), SGPT/ALT to 668(nor 30-65), ALKP 285 (nor 50-136). even some references I found online show that far off of blood test results to be otherwise unreachable from gallstones alone. They gradually decreased over time, with the largest single decrease (and the simultaneous largest improvement in condition, lessening of pain, etc) coinciding with the ERCP which opened up my bile duct. however the next time I had a gallstone attack, I went to the hospital immediately and the bloodtests showed normal liver function, thus pointing to the gall bladder having caused the high numbers in the previous attack. removal of the gall bladder via laparoscopic means was impossible due to the gall bladder being quite swollen, so a regular open surgery was performed.

I'm not sure if you should be posting this on such a public forum. Your experience is quite consistent, and the abnormal lab values are simply due to cholestasis (high pressure on the bile duct causing liver dysfunction). I think the abnormal liver enzymes should have been linked to gallstones much earlier, but that's my professional opinion. Colic + abnormal LFTs = gallstones until proven otherwise. JFW | T@lk 09:03, 28 Jan 2005 (UTC)

[edit] extracorporeal shock wave lithotripsy

No mention is made of extracorporeal shock wave lithotripsy as an alternative treatment.

Because this treatment is illogical for GALL stones. No serious/sane physician would recommend this option.

Here's my explanation as to why lithotripsy is not recommended, but feel free to research this on your own.

As we know, ultrasonic bombardment in the context of lithotripsy seeks to fracture large stone masses into smaller ones, thereby allowing these to pass out of the body. While this is a nice idea for kidney stones, it is a bit more interesting with gall stones since their way out of the body is a bit more involved. See, debris from disintegrated and partially-disintegrated gallstones would likely collect in the gall bladder first and then eventually flush down the biliary tree in probably fairly decent amounts, depending on initial mass of source material, of course. This would significantly increase the patient's risk of gall stone obstruction in the tree/ducts. There would be no guarantee that the ultrasonic bombardment could create a debris-field fine enough to completely void the tree/ducts, and even if you could guarantee a fine grit, the resulting bile-effluence would probably become rather viscous (re : sludgy) and could effectively curtail movement of bile in similar fashion as an outright stone blockage.

In short, you're running a risk here which might be unacceptable, even though it is possible that some patients would do well with lithotripsy. There is also some issue as to whether gall stones (cholesterol-precipitate usually) would respond in the same fashion as kidney stones in vivo. I'm not sure if this has been tested on live patients.

More promising alternatives than hypothetical lithotripsy include in-situ dissolving of the gallstones via injection of solvent directly into the gall bladder. Regarding this, there is (or was) at least one serious case-study in Massachusetts (since 2002) which is (or was) still ongoing. If it pans out (and all known results look great so far), it would likely signal the end of most surgical interventions for gall bladder disease. These interventions are big money makers for small-to-medium-sized hospitals (at least in USA). If we were to assume a cynical bent, this study might be ongoing forever (never to be seen), simply due to politico-economic issues. —Preceding unsigned comment added by 67.34.98.154 (talk) 06:45, 2 March 2008 (UTC)

[edit] Gall bladder flush

Gall bladder flush should not be reinserted without a reference and without a clear statement that it is not standard treatment and favoured by alternative practicioners. JFW | T@lk 17:29, 15 December 2005 (UTC) ya well try haveing them weh your 10 years old and over five feet and 60 puonds they killed

I'm not sure what the previous statement refers to, but I have left a comment in the actual article, I'm sorry if I don't know proper protocol for introducing problems with the text. But I feel if someone goes on here and says "many sources on the web say the gallstone flush is a hoax" they should really provide sources, period. And putting it on here doesn't help people as putting a note on the main page that tells them this. All I reccomend is someone link to a source that shows why they, or the medical community, think the flush is not effective, and is perhaps harmful.

The following web page [1] supports the view that the gall bladder flush works. It says "The argument against this position is that, if there were truth to the saponification theory, every time you did the flush you'd get the same results with the discharge the next morning of these green saponified artifacts. The experience of people who have done this flush is quite the contrary -- the first few times produce gall stones, and when they are gone, they are gone. Thus, the green sludge is not being chemically created each time you do the flush." If other first-hand testimony can be found to back this up then it may be worth adding to the article. Madda 14:21, 1 August 2006 (UTC)

I'm no gastroenterologist, but if gastric juice were a component of a chemical reaction forming the stones, couldn't this be explained by the body's adaptation to the fasting that precedes the gallbladder flush? (I.E., as you fast repeatedly, the stomach learns to quickly stop producing acid that won't be used in the foreseeable future.) -Seventh Holy Scripture 18:27, 5 November 2006 (UTC)

In contrast, an article in The Lancet Volume 365, Number 9468 16 April 2005 (available from http://www.thelancet.com (requires login) or from http://curezone.com/forums/m.asp?f=476&i=798#i) seems to provide sound scientific evidence that these green 'stones' are not gallstones but are formed by the olive oil, lemon juice and the gastric process. Madda 15:04, 1 August 2006 (UTC)

Thanks Madda, but I'm not sure we should keep it as a judge for yourself, here are both sides issue. We have one side, a respected peer-reviewed journal, and the other that has a disclaimer at the bottom: "FungusFocus does not practice medicine. The information herein is intended to help you with greater awareness. If you are ill and need treatment, seek out a qualified healthcare professional. Please see our Legal page for our disclaimer." Maybe this should be put on the front page? Do we not have a responsibility to be ahead of the curve and look out for the population? If this flush is out there, and people come here for information, I think we should really be able to point them to more serious places for information because those Alt. Medicine sites are certainly not the greatest sources. Not that wikipedia is the best, but its maybe better. I mean, this flush could be harmful, and I don't think we should say on the frontpage that it certain aspects are painless. That sounds like too much of an endorsement.

I am a Gall Bladder Patient out of the Dallas, Texas area and have to say that a Gall Bladder/Liver flush does in fact get stones out without any weired slug. Please see...http://www.curezone.com/cleanse/liver/huldas_recipe.asp for the flush I do, I am still on the road to recovery and am looking for other "alternative" ways to help with that process but am confident that I can do this without surgery. ~ Creativebug

[edit] Signs/symptoms?

It might be helpful it someone added some signs that a person may have gallstones or symptoms that would occur.

The symptoms part contains a lot of unreferenced material. This article is related to medicine/surgery. I think it might be better to have just very less information on these matter but all of the information must be cited and refereced properly. Thanks.--Eukesh 22:20, 22 July 2007 (UTC)

[edit] Cholecystectomy

I had my gall bladder surgically removed two years ago, and have had a lot of problems after that. My doctor says cholecystectomy has 90% chance of eliminating the recurrence of cholelithiasis, not 99% as said here. Cyborg 10:40, 30 March 2006 (UTC)

I also had my gall bladder removed. No issues afterwards. Interestingly; my doctor did mention that gall stones can continue to be produced in a small percentage of people even without a gall bladder. In these few cases, removal of the gall bladder may not remove the symptoms since the stones are produced in the liver itself and generally caused by a liver parasite contracted by eating raw fish. I did mention my love of Sushi, and he said that was an unlikely source of the parasite since Sushi grade fish in North America is treated (flash frozen) to kill such things. Fracture98 17:23, 24 August 2006 (UTC)

[edit] Homeopathic options

"By drinking water, you reduce your body's need to produce this bile."

In what way is this homeopathic, and why would drinking water alter the active secretion of bile? --Coroebus 19:35, 31 March 2006 (UTC)

In my opinion this is not homeopathy. May be it could be defined as an alternative to taking a medicine. Also, the effect of drinking water is already cited above. And it is a temporary solution, but not a cure. I am removing this part. Miguel Andrade 16:04, 12 April 2006 (UTC)

I think there is strong scientific evidence that homeopathy and drinking water, save for the placebo effect, are equivalent. Fracture98 17:26, 24 August 2006 (UTC)
There's one important difference: Water's a lot cheaper. Bruce Tindall (talk) 22:00, 20 December 2007 (UTC)

[edit] Unsourced information added by 63.198.115.166

Yesterday I deleted this large quantity of unsourced and poorly integrated information added to the article by an anonymous editor, but in retrospect I should have moved it here. Doing that now! -Seventh Holy Scripture 18:27, 5 November 2006 (UTC)

Many report that gallstones are green, varying from light green to dark green. This green color is from the bilyrubin in the bile.
Gallstones are also commonly thought of as occuring in the gallbladder. Cases of gallstones do occur in people who have had their gallbladder removed, proving that gallstones are formed in the liver (as well as possibly elsewhere). It is suggested by some that most gallstones actually form in the liver and may deposit in the gallbladder over time.
Gallstones in younger people (under 50) may be as large as a grean pea, garbanzo bean or even a grape, yet be somewhat soft (like candle wax at various stages of hardening) so soft in fact that they will not show up in an ultrasound or CT scan. It is presumed that by age 70 or so, unflushed gallstones become calcified, which increases the intesity of the pain associated with them, and, also makes them easier to detect with ultrasound and CT scan.
There appears to be a misconception that gallstones are typically found in one or two or three and each are very painful, so much so that hospitalization is required. However, reports indicate that the severity of the pain is often not that high, yet the quantity of stones is orders of magnitute higher, such as 300, 400, 500 or more. (Such quantities require recurring treatements.)
When gallstones build up in the liver and gallbladder, feelings of bloatedness may be accompanied by unusually large amounts of flatulation. Problems (pain & bloatedness) with sitting cross legged and bending slightly forward are also indicative of gallstones (but could also be other problems).
And then there are those that are in between - neither intensly painful, nor without pain or discomfort - painful yet tolerable. There is a common misconception that gallstone pain is either very severe, or, nonexistant. In fact, it stands to reason that the level of pain could also be anywhere in between. Such pain can be hard to diagonse, and it is helpful to know if there is a family history of gallstones.
Gallstones can be formed in the liver and make their way to the gallbladder. Such stones can be felt as they travel along the "gallstone highway", which goes from the middle of the back just slightly to the right of the spine then further towards the right side then toward the front and then drops into the gallbladder. Passing of these stones from the liver to the gallbladder causes back pain and side aches. Pain may be felt over a series of days, starting in the back, then felt at the side, and later in the gallbladder.
Another problem with gallstones is that they can harbor bacteria, that is, when they become blocked or a number of them builds up in the gallbladder, the gallbladder becomes unable to totally flush itself. This allows bacteria to build up, and, can cause symptoms similar to diverticulits. These symptoms are direct pain, other odd feelings of weakness in the gut. Further, general irritation of the right side of the abdomen that occurs particularly just prior to bowel movement may indicate presence of stones in the gallbladder. Bacteria are a particular problem for those who are experiencing their first gallstone problems of life.
When the gallbladder starts getting full of gallstones, one might experience repeated contractions just to the right of the navel. This is an attempt by the gallbladder to flush itself and some stones. These contractions will appear generally in the middle of the night. If the gallstones are also harboring bacteria, then additional abdominal discomfort, such as weakness or burning felt near the navel or just to the left of it, may be associated with the contractions.
(following paragraphs concern gallbladder flushes) Some report that the only necessary ingredient is the oil, preferably organic olive oil.
Prior fasting appears to contribute to less stomach upset during treatment, lessening the possibilty of vomiting during treatment. (However, it seems that even after vomiting during treatment still results in passing of stones.)
Success in flushing some stones has been reported with as little as 5 oz of oil. Doses can range from 5 to 12 oz, though some report as much as 16 oz being used. The oil is consumed 1 to 2 oz at a time with water first and after as necessary. Lemon or grapefruit juice is also good to cut the taste of the oil, and, may have an antibacterial effect as well. Also oil of oregano tablets or garlic fresh or tablets may provide antibacterial properties. The magnesium an optional ingrediant for muscle relaxation, with some taking it before the oil, and some taking it the next day after. Some reports suggest drinking a beer or two for relaxation as an alternative to magnesium.
At first time treatment one should be on the lookout for bacterial infection.
Multiple treatments will most likely be required before the stones are all gone. Treatment should not occur more than 1 or 2 times a month, since it is very hard on the body, and gives a hangover like feeling for the following day. The first bowel movement after may appear normal. Subsequent bowel movements should take on a lite greyish color indicating a lack of bile; these should be interspersed with stones.
Treatment should not be repeated until bowel color has returned to normal. It may take more than a dozen treatments (over the course of a year) to completely shed the built up stones. Note that the bulk of the stones are probably coming out of the liver, and just take up temporary residence in the gallbladder as they pass through.
(added at end of paragraph on gallbladder removal) This is presumably because of the gallstones yet remaining in the liver.

Personal accounts: I went to a naturapath for a back treatment, after suffering symptoms of headaches, back ache and pains, esp around the right shoulder blade and around the side into the breastbone, and vomiting when bending over. He said " I think you may not have a bad back, but a bad liver, and I think you may have gallstones." I had to go easy on citrus juices, caffeine and dairy. I also did a gallstone cleanse by missing my evening meal, drinking a quarter cup of olive oil, mixed with a quarter cup of lemon juice, then taking a natural laxative tablet before going to sleep. Next day I got rid of large plastacine-like stones, and doing another cleanse about a week later, I removed dozens of green stones of all sizes, that seemed like they had been harder. 2 more cleanses over the next months removed more of these types of stones, in lesser quantities. My symptoms were gone, maybe because of a stricter diet for my liver (the effect took less than a week) maybe because of the gallstone cleanse. We gave the recipe to a woman with a heart condition who was shown by scansto have at least onelarge gallstone causing her much pain. Doctors at that time wanted to remove them surgically but did not want to operate because of her heart condition. She did the cleanse, said she had never felt better, and took them in a jar to the doctor. She was over the moon, and didn't have a need to have anything surgically removed. Although doctors may be sceptical, I am absolutely convinced they were gall-stones that came out in both instances, or at least something that certainly should not have been there, whether they come from the gallbadder or the liver. (shood) - —The preceding unsigned comment was added by Novhood (talk • contribs) 18:25, 19 April 2007.

Unfortunately, personal accounts and anecdotes aren't reliable sources. Did the woman's doctor write a case report on her? If further medical examination proved that her gallbladder flush had been effective, I'd be quite surprised if he hadn't; this would have been an unprecedented event in the medical literature, as far as I know. -Seventh Holy Scripture 03:00, 20 April 2007 (UTC)

[edit] Effects of Surgury

<snip> - Nevermind, I found a reference. The Mayo Clinic should count as a decent medical reference. Xaa (talk) 12:45, 26 May 2008 (UTC)