What is the gallbladder?
Some gallstones may dissolve and go away with intervention while others need more extensive treatment.
The gallbladder is a small pear-shaped organ located below the liver on the right side of the abdomen. The main function of the gallbladder is to store bile, a substance secreted by the liver that is required for digestion. The bile contents may sometimes crystallize and form gallstones. They may be as small as a grain of salt or as large as a tennis ball causing symptoms like severe belly pain, heartburn, fever, nausea and vomiting.
Can gallstones go away on their own?
If there are no symptoms, a regular follow-up would suffice. Natural remedies and medical management may prevent worsening of the condition. Treatment is necessary if the stones cause pain or swelling of the gallbladder. Surgery may be required if nonsurgical treatments fail or there is a high risk of complications.
Complications of gallstones may include
- Inflammation of the gallbladder: Gallstones can block ducts inside the gallbladder or the neck of the gallbladder, causing the gallbladder to become inflamed or infected. This is called cholecystitis. Cholecystitis can cause severe pain and fever.
- Blockage of the common bile duct: A gallstone may pass out of the gallbladder duct and into the main bile duct, leading to bile duct infection that can eventually cause swelling of the biliary structures (cholangitis). This causes severe pain, jaundice and infection.
- Blockage of the pancreatic duct: The pancreatic duct is a tube that connects the pancreas to the common bile duct just before the opening into the duodenum. The flow of pancreatic juices, which aid in digestion, gets blocked if the pancreatic duct is blocked by gallstones. This leads to inflammation of the pancreas (pancreatitis). It causes intense, constant abdominal pain and requires hospitalization.
- Gallbladder cancer: Though extremely rare, having a history of gallstones may increase the risk of gallbladder cancer.
Nonsurgical treatment options for gallstones
The following nonsurgical treatments are provided by a doctor
1. Medication
In the early stages of gallstones, medications like ursodiol or chenodiol can dissolve some gallstones. They are available as oral bile acid pills. These medications cause thinning of bile, helping gallstones dissolve. Medication to decrease cholesterol levels in the bile may help dissolve certain types of gallstones, but they are not very effective. These medications usually take years to work and do not prevent a recurrence.
2. Extracorporeal shock-wave lithotripsy (ECSWL)
This nonsurgical treatment uses shock waves to break down/fragment the gallstones if they are less than 2 cm in diameter. The shock waves are sent through the soft tissue of the body. This is also used to treat kidney stones.
3. Methyl tertiary-butyl ether (MTBE) Injection
This nonsurgical treatment involves injecting a solvent called methyl tertiary-butyl ether (MTBE) into the gallbladder to dissolve the gallstones. A side effect could be severe burning pain.
4. Endoscopic drainage
This treatment involves passing a thin tube attached with a camera and light (endoscope) through the mouth, down the throat and into the gallbladder. A wire is passed through the duct and into the gallbladder. This treatment allows the gallbladder to resume normal bile drainage.
5. Percutaneous cholecystostomy (PC)
This is a nonsurgical treatment option, but it’s most effective when followed by gallbladder removal. Percutaneous cholecystostomy (PC) is ideal for seriously ill patients who are not fit for surgery. The procedure involves using a needle to withdraw fluid from the gallbladder followed by inserting a catheter through the skin to drain the fluid. The catheter is usually left in place for a few weeks, after which gallbladder removal surgery may be performed to prevent recurrence.
6. Transmural drainage
Transmural drainage involves creating a new tract that goes through the stomach and into the gallbladder and a metal stent is placed. This allows the gallbladder to drain into the small intestine.
7. Acute cholecystostomy, an ultrasound-guided drainage procedure
In patients with acute cholecystitis, cholecystostomy may be performed for those who are unable to undergo surgery. An endoscopic stent is placed between the gallbladder and intestine to drain the infection.
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Natural remedies for gallstones
There is no reliable scientific evidence to prove the effectiveness of natural remedies in the treatment of gallstones. They may be used after consulting with a doctor and can be taken alongside medical interventions.
1. Gallbladder cleanse
This involves fragmentation of the gallstones and flushing them from the body. Consuming a combination of apple juice, herbs and olive oil for 2 to 5 days can help in a gallbladder cleanse.
2. Apple cider vinegar with apple juice
Apple juice is believed to soften gallstones, allowing them to be excreted easily.
3. Dandelion
Dandelion has been used historically to remove gallstones.
4. Milk thistle
This is believed to detoxify the liver and gallbladder, but it may not have an effect on gallstones.
5. Lysimachiae herba
This is an ancient Chinese remedy for gallstones.
6. Artichoke
Artichoke extracts have been found to stimulate bile production and promote gallbladder and liver function.
7. Psyllium husk
Psyllium is a soluble fiber believed to benefit the heart, pancreas and other organs.
8. Castor oil
Applying a warm castor oil pack on the abdomen may help.
9. Acupuncture and exercise
Acupuncture and yoga may relieve gallstone symptoms, such as pain.