Introduction

Gallstones will affect about 10% of the population, resulting in biliary colic that appears as pain in upper abdomen, particularly center to right sided, and radiating to the back, especially in the region of the shoulder blade. The pain may come and go, and may be worse after eating fatty foods.

Causes include elevated cholesterol, rapid weight loss, liver dysfunction, and hemolytic diseases.

Standard allopathic treatment for gallstones is removal of the gallbladder.

Naturopathic treatment options include dissolving cholesterol stones and correcting the underlying cause. Non-cholesterol stones require surgical intervention.

Please see conventional, complementary, and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complementary, and Alternative treatments that may be considered include:

Pathophysiology

Hypothyroidism is associated with a thinning of the endothelial lining of the gall bladder, resulting in irritation of the bladder by its contents [Hertoghe1914], [Starr2005, pg 142].

Cholesterol stone formation may be due to production of bile supersaturated in cholesterol, possibly secondary to decreased bile acid or phospholipid production in the liver.

Biliary stasis or impaired gall bladder motility, possibly secondary to spinal misalignment impairing innervation of gall bladder or to disruption of the vagus nerve [Domino2008, pg 264].

Predisposing factors include:

    <&LOCAL_LI hypothyroid.html : Hypothyroidism is associated with a sluggish, congested, and distended gallbladder [Kharrazian2010, pg 11].
  • Obesity [Domino2008, pg 264].
  • Rapid Weight Loss [Domino2008, pg 264].
  • Hyperlipidemia [Domino2008, pg 264].
  • Blood dyscrasia and hemolytic disorders [Domino2008, pg 264].
  • Inflammatory Bowel Disease [Domino2008, pg 264].
  • Cirrhosis (pigment stones) [Domino2008, pg 264].

Differential Diagnosis

  • Cholesterol stones: visible in ultrasound but not in X-ray.
  • Calcium stones: visible in X-ray.
  • A small percentage of hypothyroid patients develop pain in the upper right quadrant that mimics gallstones, but no gallstones are evident. This condition resolves upon treatment of hypothyroidism [Barnes], [Starr2005, pg 142].

Management

Cholesterol Stones

Ursodiol 300mg (ursodeoxycholic acid, Actigall) dosed at 8-10mg/day/Kg body weight in 2 or 3 divided doses often slowly dissolves cholesterol gall stones over a period of several months. However, if the underlying cause of stone formation is not addressed, often stones recur within five years.

ICD-10

References