GALLBLADDER DISEASE

THE OLD FASHIONED APPROACH to gallbladder disease was to ignore the pain until it was so severe the patient couldn’t stand it any longer and then operate to remove the gallbladder. Once upon a time this made a certain kind of sense, but today there are other alternatives.

The truth is that I’ve been seeing fewer and fewer patients with gallbladder disease, probably because diet plays such an important role m preventing it and in general my patients are conscious of eating a healthy diet.

The disease typically causes symptoms including regular or occasional digestive distress, bloating, gas and nausea, usually after a fatty meal, which result from the irritation and spasms of the gallbladder. Sometimes these symptoms are ignored until the patient experiences intense abdominal pain, a result of passing a gallstone. Sometimes there are no warning symptoms-just the intense pain that some people confuse with appendicitis or duodenal ulcer. You may have an irritated gallbladder with or without stones. The symptoms and treatment will be identical.

The gallbladder is a pear-shaped organ located just under the liver and behind the bottom right rib. Bile, a substance produced by the liver, is stored in the gallbladder for release into the gut to help digest fat. When you eat fatty foods, the bile becomes saturated with cholesterol, one of the components of bile. Eventually, the excess cholesterol separates from the bile and begins to calcify, forming stones. Gallstones can be formed from substances other than cholesterol, but in the United States about 80 percent of them are composed primarily of cholesterol (about 2.0 percent are formed from minerals, particularly calcium salts).

The stones themselves may not be the problem. In fact, many people without symptoms are surprised to learn from an ultrasound sonogram or x-ray that they have gallstones. By age forty nearly 2.5 percentage the population has gallstones. The problems begin when the stones begin to move from the gallbladder into one of the small bile ducts leading to the liver. The pain of a gallstone attack comes when the stone blocks the duct and the duct contracts, most commonly after a fatty meal.

Of the gallbladder patients I have treated in the past, Lucille comes to mind immediately. From an English background, nearly sixty pounds overweight, she was a typical gallbladder victim. Gallbladder disease strikes women twice as often as men and is most common among Asians, Latin Americans, Indians, and the English.

Lucille had regularly suffered from indigestion, but the day she came to see me she had awakened with a severe pain in the upper right-hand corner of her abdomen-a much sharper and more powerful pain than any she had experienced before. An ultrasound sonogram revealed gallstones.

Lucille thought that her only option following her gallbladder attack was surgery. But as recovery from gallbladder surgery is often painful and as many people never have subsequent attacks, I thought that in Lucille’s case it was worth trying a natural approach. Her health was suffering from the very factors that were causing her gallstones: obesity and a very high cholesterol count. Lucille followed the recommendations outlined below, and six years later she still has her gallstones but is free of the symptoms of gallbladder disease.

Gallstones are much easier to prevent than to cure. If you have a history of gallbladder disease in your family and/or if you have had some mild symptoms of a gallbladder problem such as regular indigestion, bloating, and gas following a fatty meal, you should immediately adopt these guidelines, which might well keep you free from ever developing full-blown gallbladder disease.

Gallbladder disease, including gallstones and an inflamed gallbladder, is closely connected with a Western diet: high in refined carbohydrates and animal protein and low in fiber. The first step-in avoiding gallstones, and preventing an attack if you already have them, is to eliminate aggravating (fatty) foods. In order to digest them, your gallbladder will go into overdrive and might force a stone into the duct, causing a gallbladder attack.

There’s been a great deal of research that indicates a low-fiber diet is a primary cause of gallbladder disease. Increasing the fiber in your diet is also critical in avoiding gallstones. Water-soluble fiber such as that found in vegetables and fruits, pectin, arid oat bran is the most important.

There’s another interesting theory that links food allergies and gallbladder attacks. In 1948, Dr. J. C. Breneman began using a very successful regime to prevent gallbladder attacks based on his work with food allergies. Dr. Breneman holds that eating allergy-causing foods stimulates the swelling of the bile ducts. The swelling reduces the flow of bile from the gallbladder and causes the pain and other symptoms connected with a gallbladder attack. In one study, 100 percent of gallbladder patients were totally free from symptoms when they followed a basic allergy-elimination diet. The foods that most commonly produced symptoms in decreasing order of occurrence include eggs (93 percent of the patients reacted to eggs), pork, onions, fowl, milk, coffee, citrus, corn, beans, and nuts. Lucille found that eggs, corn, and citrus gave her symptoms anti eliminated them entirely from her diet. The connection between food allergy anti gallbladder attacks could account for the numerous people who have gallbladder surgery and are then dismayed to find that their symptoms are still a problem: Though the stones have been removed, the allergy-causing foods promote the swelling of the ducts and the symptoms.

If you have symptoms of gallbladder disease, you should definitely try going on an allergy-elimination diet to see if it will eliminate your symptoms. As you gradually reintroduce foods to your diet, watch carefully for reactions. It could well be that once you find the offending foods and cut them your diet, you’ll be entirely free from symptoms.

If you: are overweight, your chance of developing gallstones soars. If you are 20 percent overweight you double your susceptibility to gallstones. The proper diet for preventing gallstones-a low-fat, high-fiber diet-is also a diet that will help you lose weight. I must stress that recent research has shown that a very-low-calorie diet-a crash diet arid in particular the “protein” power diets-can actually promote the formation of gallstones, so be sure that you are on a sensible weight reduction program.

A minor but potentially significant step is to be sure to drink six to eight glasses of water each day. This fluid is necessary to maintain the water content of the bile and help prevent the formation of stones.

Interestingly, it has been found that women who skip breakfast or have only coffee have a much greater incidence of gallstones.

There is also evidence that taking aspirin can prevent the formation of gallstones. In one study, all tile regular users of NSAIDs avoided a recurrence of gallstones compared with 32 percent who did not use aspirin regularly. I tell my gallstone patients to take one baby aspirin a day for this reason.

There is one nutritional supplement that can help gallstone sufferers. lecithin has been recognized as a substance that will promote the ability of bile to keep cholesterol in solution and may prevent stones from forming

NATURAL PRESCRIPTION FOR GALLBLADDER DISEASE

• Eliminate any possible food allergies (see Food Allergy, page 146).
• Avoid aggravating foods, including all fatty and fried foods. See Blueprint for Health, page xvii, for more information on eliminating fat from the diet.
• Increase your fiber intake, particularly more of the following foods: fruits, vegetables, whole grain breads and cereals, and oat bran.
• If you are overweight, lose weight on a sensible diet. Do not go on an extremely low-calorie diet, as this can exacerbate gallstones.
• Be sure to drink six to eight glasses of water daily.
• Eat a healthy breakfast daily.
• Avoid caffeine.

IN ADDITION TO YOUR DAILY SUPPLEMENTS, TAKE:

• Lecithin: 500 mg. three times a day,

IN ADDITION: Surgery is the traditional route for gallstones that are persistent and troublesome. But there are some new techniques that are being used in lieu of conventional surgery: a drug that dissolves stones; a new surgical technique using laparoscopic (microsurgical) instruments that require small incisions; a shock wave lithotripsy that “crushes” the stones. These techniques have their advantages and disadvantages and should be discussed with your doctor.

Recent reports in Lancet, a respected British medical journal, made a connection between gallstones and fair-skinned people who suntan. In general, people who enjoy sunbathing have twice the risk of gallstones; fair-skinned people who sunbathe arc at twenty times more risk than non-sunbathers of developing gallstones. This research is in its preliminary stages, but it could be significant for fair-skinned sun lovers.