Gallbladder Disease

Gallbladder disease is swelling of the gallbladder a pear-shaped organ under the liver that secretes bile a fluid that helps with digestion. Gallbladder disease often occurs with gallstones. You can have gallstones and never have any symptoms although if the stones are large they can be painful and require treatment.

Signs and Symptoms

• Pain mostly on the upper right side of the abdomen
• Pain following meals intolerance of fatty foods
• Nausea vomiting
• Loss of appetite

What Causes It?

A gallbladder attack is caused by inflammation of the gallbladder. This usually happens because a stone is blocking a passageway in the gallbladder. Gallstones develop in the gallbladder when substances in bile form hard particles. They can be as small as a grain of sand or as large as a golf ball.

What to Expect at Your Provider's Office

If you are having a gallbladder attack you will feel tenderness when the upper right side of your abdomen is touched. Jaundice (yellowing of the skin) occurs when the bile duct (a tube between the liver and gallbladder) is also blocked. If your health care provider thinks you have a gallstone you will probably have an ultrasound. During an ultrasound sound waves take pictures of your gallbladder. This test is painless and can be performed quickly which is important if you are in a lot of pain.

Treatment Options

Treatment Plan

There are drugs that can help to dissolve your gallstones. It may take as long as two years for a stone to dissolve. Painful gallbladders are usually removed. Most gallbladder surgery today is performed with a laparoscope. A laparoscope shows the surgeon pictures of your gallbladder as it is being removed. You will have less pain a smaller scar and a shorter hospital stay than with traditional surgery.

Drug Therapies

Prescription

The following drugs can help to dissolve stones avoiding the need for surgery.

• Oral bile acids can dissolve cholesterol stones that are quite small (less than 15 mm in diameter). It works for 40 percent of people within two years. There are two types of oral bile acids: chenodeoxycholic acid—side effects include diarrhea and possible liver damage and ursodeoxycholic acid—few side effects
• Methyl tert-butyl ether—a strong solvent; 95% of mass dissolves in 12.5 hours

Over the Counter

N/A

Complementary and Alternative Therapies

It is important to see your provider for tests before you start any alternative treatment so that you will use the remedies that are right for the size of your stone and your condition.

Nutrition

• Decrease total fat intake especially saturated fats (meat and dairy products).
• Eliminate food allergens. Eggs in particular may irritate the gallbladder.
• Eat more fiber. Consider fiber supplements such as flax meal (1 tsp. one to three times per day). Combine 1 heaping tsp. of flax meal in 8 oz. of apple juice for a drink high in fiber and pectin.
• Lecithin (1 000 to 5 000 mg per day) for cholesterol excretion
• Choline (1 000 mg per day) and lipase (10 000 NF units with meals) stimulate gallbladder function.
• Vitamin E (400 to 800 IU/day) and vitamin C (1 000 mg two to three times per day) promote bile production.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

• Choleretic herbs stimulate bile production and increase bile solubility. Especially useful are milk thistle (Silybum marianum) dandelion root (Taraxecum officinalis) greater celandine (Chelidonium majus) globe artichoke (Cynara scolymus) and turmeric. (Curcuma longa). Use these herbs singly or in combination as a tea or tincture (15 to 20 drops) two to three times per day before meals.
• Enteric-coated peppermint oil may help dissolve stones (0.2 to 0.4 ml three times a day between meals).

Homeopathy

Some of the most common remedies are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Colocynthis for colicky abdominal pains that are lessened by pressure or bending double
• Chelidonium for abdominal pain that moves to right shoulder area
• Lycopodium for abdominal pain that is worse with deep breaths

Physical Medicine

Castor oil pack. Apply oil directly to skin cover with a clean soft cloth (such as flannel) and plastic wrap. Place a heat source (hot water bottle or heating pad) over the pack and let sit for 30 to 60 minutes. For best results use for three consecutive days. Apply to abdomen especially the gallbladder area to help reduce swelling.

Acupuncture

Acupuncture may prove especially helpful in pain relief reducing spasm and easing bile flow and proper liver and gallbladder function.

Following Up

Early surgery usually ends symptoms and recurrence; stones may recur in the bile duct however.

Special Considerations

If you have diabetes or are pregnant there is a higher chance of complications from gallbladder attacks. If you are pregnant use choleretic herbs with caution. Milk thistle and dandelion rootare safe in pregnancy. Talk with your health care provider before you take any medication or supplement.

Supporting Research

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:422 427 465

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:118 139 230.

Murray MT Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin Calif: Prima Publishing 1998.

Sabiston DC Lyerly HK. Textbook of Surgery. 15th ed. Philadelphia Pa: WB Saunders 1998

Weiss RF; Meuss AR trans. Herbal Medicine. Medicina Biologica; 82–89 94–97.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.