Lecture Notes on Gallstones

Overview

• Discussion on the first symptom of gallstones.
• Information on the fastest way to dissolve a gallstone.

Asymptomatic Gallstones

• 80% of cases: No symptoms present when a person has gallstones.
• Symptoms may arise when gallstones get lodged in a duct, causing:
  • Distension
  • Pressure

Symptoms of Gallstones

• Common symptoms include:
  • Fullness, tightness, or pain under the right rib cage.
  • Pain in the right rhomboid area (between scapula and mid-spine).
  • Pain radiating to the side of the face.
  • Other symptoms:
    • Nausea
    • Vomiting
    • Bloating
    • Belching
    • Jaundice: due to gallstone blocking bile duct, leading to bile backup in the liver and skin.
    • Dark urine and pale stool.

Causes of Gallstones

• Misconception: High fat and cholesterol intake solely causes gallstones.
• Real Causes:
  1. High cholesterol levels in the body.
  2. Lack of bile salts: Essential for keeping cholesterol dissolved and eliminating it from the body.

Role of Bile

• Bile is crucial for fat digestion and absorption of fat-soluble nutrients (A, D, E, K1, K2, omega-3).
• Without a gallbladder, bile is not concentrated, leading to possible digestive issues.
• Cholestasis: Condition characterized by bile sludge, potentially causing pain similar to gallstones.

Post-Surgery Complications

• Up to 40% of patients may experience complications post-gallbladder removal, often related to cholestasis.

Risk Factors for Gallstones

• Pregnancy: Increased estrogen levels can lead to higher risk.
• Birth control pills: Associated with estrogen.
• Obesity and Type 2 diabetes: Higher insulin levels can increase risk.
• Liver disease: Impairs bile salt production.
• Constipation: Linked to bile deficiency.
• Low folate levels: Folate is necessary for converting cholesterol to bile salts.
• Statin medication: Reduces cholesterol, affecting bile production.
• PPIs (Proton Pump Inhibitors): Can interfere with bile release.
• High carbohydrate diet: Increases insulin levels.
• Low-fat diet: Insufficient fat intake can reduce bile release triggers.

Solutions for Gallstone Issues

1. Take purified bile salts with probiotics:
   • Helps dissolve stones over time.
2. Dietary recommendations:
   • Include fermented foods (sauerkraut, kimchi, kefir).
   • Incorporate more salads for fiber to bind cholesterol.
   • Increase folate intake.
3. Manual massage: Gently massage the area under the right and left rib cage to alleviate pain and push sludge through.
4. Decrease insulin levels:
   • Implement intermittent fasting.
   • Adopt a low-carb diet.

Manual Flushing Techniques

• Importance of learning and performing manual flushing to relieve symptoms associated with gallstones.