Optimizing Digestive Wellness: Holistic Strategies for a Healthier System

According to estimates, the gallbladder fills up with gallstones in every tenth German citizen. Gallstones can cause painful biliary colic. Then the gallbladder has to be removed entirely, or if there are stones in the bile ducts, the stone has to be removed from the bile duct endoscopically, crushed or dissolved.

A stony gallbladder can be painful.

The pear-shaped gallbladder is an appendage of the liver. It lies between the main trunk of the bile ducts leading out of the liver and the bile duct that opens into the duodenum. The gallbladder’s job is to store the bile produced by the liver for fat digestion. The gallbladder wall contracts – controlled by nerves and hormones – and releases the bile into the duodenum if necessary.

 In addition to a high-calorie, carbohydrate-rich diet with high cholesterol intake and being overweight, risk factors for gallstones are also fasting cures and radical diets. If no food is eaten, the gallbladder does not empty itself regularly, and the bile slowly thickens. A low-fibre diet is also unfavourable because more cholesterol is absorbed from the intestine.

 

When to remove the gallbladder?

Stones in the gallbladder and those that have migrated into the bile ducts can cause pain. Biliary colic, for example, occurs when a stone enters the bile ducts and causes the bile duct wall to constrict erratically.

If there are stones in the gallbladder and biliary colic has lasted more than 15 minutes, the gallbladder should be removed using minimally invasive gallbladder surgery (cholecystectomy). This is a minimally invasive, i.e. without abdominal incision, laparoscopic removal of the gallbladder. But don’t worry; humans can live without a gallbladder.

Even if gallstones are not a problem, the procedure is necessary if there are polyps in the gallbladder. They can lead to gallbladder cancer.

The gallbladder is also removed for gallstones that are already larger than three centimetres or for a so-called porcelain gallbladder with an increased risk of cancer. A porcelain gallbladder occurs when the gallbladder wall has hardened due to chronic inflammation. If the indication for the operation is correct, over 85 per cent of the operated patients benefit from the procedure.

Surgery is only sometimes necessary.

 Gallbladder surgery is not necessary if the ultrasound incidentally discovers gallstone debris or small gallstones that do not cause pain. Anyone who has gallbladder stones and complains of symptoms such as a feeling of fullness, flatulence and pressure in the upper abdomen but has not yet had biliary colic can first try low-dose ursodeoxycholic acid after consulting a doctor.

Ursodeoxycholic acid is a bile acid that, even in low doses, has an anti-inflammatory effect on the gallbladder wall, inhibits stone formation, promotes emptying of the bladder and promotes bile flow. Complaints such as upper abdominal pain and flatulence then occur less frequently.

 

When gallstones travel up the bile ducts

Small stones often migrate out of the bile ducts on their own if the opening of the bile duct into the duodenum is widened with a small incision. If there are larger stones in the bile ducts, they can be removed endoscopically using a kind of basket.

External shock waves can also shatter gallstones (extracorporeal shock wave lithotripsy, ESWL for short). It is possible to “shoot” up to three stones at once. A prerequisite for ESWL is a free bile duct so the fragments can be excreted via the intestine. Pure cholesterol stones less than five millimetres in size in the gallbladder can also be dissolved with medication (lipolysis). However, this process takes three months to two years and has a success rate of about 40 per cent.

Gallstones often reappear after three to five years, especially after ESWL. However, changing your diet to “lower in fat and cholesterol” and reducing weight can prevent the formation of new cells. Drinking coffee also has a positive effect.