Many patients undergo gallbladder surgery to relieve pain and avoid potentially serious conditions caused by gallstones. In fact, the function - in this case, acholecystectomy, i.e. removal of the gallbladder— is the most common form of treatment for gallstones. But the fact that surgical removal of gallstones requires removal of the entire organ has led to a growing interest in non-surgical treatment of gallstones.
Why is gallstone treatment necessary?
In addition to relieving symptoms, treatment of gallstones is necessary to prevent progression that can lead to serious conditions such as acute cholecystitis, a condition in which stones block the ducts of the gallbladder, causing inflammation and infection. gallbladder. Patients with acute cholecystitis are usually hospitalized and given antibiotics, pain medication, and often surgery.
If you have no symptoms, the most common treatment is to "wait and see," as the risks outweigh the benefits of both medical and surgical treatment. If you havegallbladder symptoms, surgical treatment is preferred unless you are at high risk, in which case drugs can be used.
"If someone has symptoms, we recommend that patients have their gallbladder removed," he saysNikhil Kumta, Ph.D. ιατρ, school studentgastroenterologistat Mount Sinai Hospital in New York. “[Gallbladder surgery] is minimally invasive, thereforerisk of complicationsis low. But if people can't have surgery, if someone is too old or too sick, there are different treatment options."
Here are seven alternatives to surgery:
1. Bile thinners can dissolve gallstones
In some cases, gallstones can be treated with medication.
Certain chemicals, such as asursodiol orenodiol, which have been shown to dissolve some gallstones, are available in oral bile acid tablets. These drugs work by thinning the bile, which allows the gallstones to dissolve.
Although these pills can be effective and are generally well tolerated by patients, medical treatment for gallstones is limited to people whose stones are small and composed of cholesterol. Butto Mount Sinai, these drugs may take two years or more to work, and gallstones may return after treatment ends.
"Bile cholesterol reduction can dissolve (some gallstones), but it's not effective enough that we don't refer patients to surgery," says Dr. Kumta.
2. Small gallstones can be broken up by shock waves
Another non-surgical treatment for which gallstones must meet certain criteria is extracorporeal shock wave lithotripsy (ECSWL). Although it is most often used forkidney stone treatment, can also be used for gallstones. The goal of the treatment is to break or fragment the gallstones by sending shock waves through the body's soft tissue.
This method is only effective on isolated gallstones that are less than 2 centimeters in diameter, so less than 15 percent of patients are eligible for ECSWL. ONEcase report published in 2017International Journal of Surgical Casesfound a low success rate for ECSWL patients with multiple gallstones. Even when the stones are fragmented, the diseased gallbladder may not expel the fragment.
Accordingresearch published in the October-December 2014 issue of the journalJournal of the Indian Association of Pediatric Surgeons, children are probably the best candidates for this form of treatment.
3. Gallstones can be dissolved by injection of MTBE
This non-surgical treatment option involves injecting a solvent known as methyl tertiary butyl ether (MTBE) into the gallbladder to dissolve the gallstones. Accordingresearch published in June 2015 in the journalCase reports in surgery, MTBE quickly dissolves gallstones — but it can cause serious side effects, such as severe burning pain. MTBE produces vapors and if not properly applied in a ventilated area, can cause severe burns to the patient and operators and even cause an electrical fire. Ask about your doctor's level of experience in performing this procedure before receiving this form of treatment.
4. Endoscopic drainage follows the natural course of the gallbladder
Endoscopic drainage mimics the healthy path of bile from the gallbladder to the small intestine. Endoscopic transurethral therapy involves accessing the cystic duct with a camera through the mouth and down the neck. A wire is then placed through the duct into the gallbladder. It is coiled to mimic the path of bile through the small intestine, the same process as a healthy gallbladder. Kumta says this form of treatment allows the gallbladder to resume normal bile storage.
5. Percutaneous cholecystostomy is best for critically ill patients
This is a non-surgical treatment option, but is more effective if followedgallbladder removal. Percutaneous cholecystostomy (PC) is usually reserved for critically ill patients who cannot tolerate immediate surgery. The procedure involves using a needle to remove fluid from the gallbladder and then inserting a catheter through the skin to drain the fluid. The catheter is left in place for several weeks, after which surgery is performed to remove the gallbladder to prevent recurrence.
6. Transmural drainage decompresses the enlarged gallbladder
"Transmural drainage creates a new pathway directly through the stomach to the gallbladder," says Kumta. An inflatable metal stent is then placed to allow the gallbladder to drain into the small intestine. "This allows the gallbladder to decompress."
With this approach, astudy published in March 2016 in the journalTherapeutic advances in gastroenterologyfound high success rates, with only one in 16 patients experiencing complications during the stenting procedure.
7. Acute cholecystostomy, ultrasound-guided drainage
For patients who haveacute cholecystitistheinflammation of the gallbladderand cannot undergo surgery, an endoscopic stent may be placed between the gallbladder and digestive tract to drain the infection in a procedure called acute cholecystoenterostomy (ACE). ANDmeta-analysis published in April 2018 in the journalSurgical endoscopyfound that ACE was as effective, if not more effective, than percutaneous cholecystostomy in pain control and reoperation rates in acute cholecystitis.
“Sometimes surgeons choose to do this before surgery when the gallbladder is inflamed. We give the patient antibiotics and drain the gallbladder so that it is not hot, sticky and inflamed during the operation,” says Kumta.
When considering treatment options, talk to your doctor
As a gastroenterologist, Kumta always refers people to a surgeon if they experience pain in their right abdomen so they can learn the pros and cons of having their gallbladder removed.
However, Kumta says obesity is associated with gallstone formation and that patients canchanges in diet,lose weight if they are obeseand choose a low-fat diet.
If you choose to change your diet, take a "wait and see" approach, be aware of the factors that predispose you to gallstones: you cannot control age, gender (women are more prone to gallstones) or your genes.
If you have gallstones, knowing what is available to remove or treat them can help you make treatment decisions. Discuss these treatment options with your doctor and find the one that works best for you.
Additional reporting by Calley Nelson
FAQs
Can gallstones be treated nonsurgically? ›
Extracorporeal shock wave lithotripsy (ESWL) is a nonsurgical alternative to manage gallstones. You can receive this treatment as long as your gallbladder is functioning normally and your stones are small. You do not need anesthesia for ESWL, and the procedure may be performed as an outpatient.
Can gallstones be treated without removing the gallbladder? ›Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. The gallbladder isn't removed during this procedure, so any stones in the gallbladder will remain unless they're removed using other surgical techniques.
What are non-surgical approaches to gallstone treatment? ›The main modalities for nonsurgical treatment of gallbladder stones include oral dissolution therapy with bile acids, and percutaneous cholecystostomy and stone extraction. Extracorporeal shock wave lithotripsy (ESWL) is used in rare situations.
Do gallstones always have to be surgically removed? ›If you feel comfortable managing mild and infrequent gallstone attacks, and if your doctor thinks that you aren't likely to have serious complications, it's okay not to have surgery. Most doctors recommend surgery if you have had repeated attacks.
Are gallstones easily treated? ›Most cases of gallstone disease are easily treated with surgery. Very severe cases can be life-threatening, especially in people who are already in poor health. However, deaths from gallstone disease are rare in the UK.
What can dissolve gallstones? ›Ursodiol is used to dissolve gallstones in people who do not want surgery or cannot have surgery to remove gallstones. Ursodiol is also used to prevent the formation of gallstones in overweight people who are losing weight very quickly.
Why don t doctors just remove gallstones? ›That's because there's no evidence that people who have gallstones that don't cause symptoms actually benefit from gallbladder removal. Since up to 70% of people don't have any symptoms from their gallstones, that means most people can skip surgery.
Can gallstones dissolve on their own? ›Gallbladder stones are usually harmless and dissolve on their own. But, they may pose to be life-threatening if these stones block any duct or cause an infection.
What is the new gallstone removal method? ›Lithotripsy, or shock wave dissolution of gallstones, is a new technique that uses a highly focused sound wave to break the stones up into tiny particles that can then pass through the cystic duct into the common duct and out into the intestine.
Is gallbladder surgery the only option? ›If you feel comfortable managing mild and infrequent gallstone attacks, and if your doctor thinks that you aren't likely to have serious complications, it's okay not to have surgery. Most doctors recommend surgery if you have had repeated attacks.
What happens if you wait too long for gallbladder surgery? ›
You may wonder how long can you put off gallbladder surgery. We don't want to scare you. However, if not managed in time, it can cause severe issues, like sepsis, jaundice, or cancer. Our team will complete a thorough consultation and develop a treatment plan to meet your needs.
What happens if you refuse gallbladder surgery? ›If you choose not to have this procedure, symptoms related to your gallbladder/gallstones may continue, deteriorate or cause life-threatening complications. This includes pain, infection and inflammation, jaundice and pancreatitis.
What size of gallstones need surgery? ›However, some patients with high risk of gallbladder cancer such as porcelain gallbladder, stones associated with gallbladder polyps larger than 10mm, stones larger than 25mm, etc., need to apply gallstone surgery.
Is it OK to live with gallstones? ›If your gallstones aren't causing symptoms, you may live the rest of your life without any problems. If you do experience symptoms, your doctor may want to remove your gallbladder. You don't need your gallbladder to live.
Can drinking lots of water dissolve gallstones? ›Natural Ways to Dissolve Gallstones
A very effective way to dissolve gallstones naturally is by staying hydrated. Drinking at least six to eight glasses of water per day helps in keeping the bile production smooth.
- meat pies.
- sausages and fatty cuts of meat.
- butter, ghee and lard.
- cream.
- hard cheeses.
- cakes and biscuits.
- food containing coconut or palm oil.
- fruits, vegetables, beans, and peas.
- whole grains, including brown rice, oats, and whole wheat bread.
Furthermore, this probiotic treatment exhibited a marked gallstone dissolution effect. Hosomi et al also reported infestation of Clostridium butyricum Miyairi No. 588 in the intestine enhanced the excretion of bile acids and inhibited gallstones formation in mice.
Can walking dissolve gallstones? ›Studies have found that exercise can help reduce the risk of gallbladder problems. However, no scientific evidence shows that exercise can help remove gallstones, but it may help you manage the pain.
How long does it take for gallstones to leave your body? ›Alternatively, gallstones can sometimes be dissolved with drugs, such as bile acids (ursodeoxycholic acid), taken by mouth. Such a drug, taken two or three times daily, can dissolve tiny stones in 6 months. Larger stones may take up to 1 to 2 years.
Does apple cider vinegar treat gallbladder stones? ›
Although there is limited evidence to suggest that apple cider vinegar does have some health benefits, no studies support its use as a treatment for gallstones.
Can I buy ursodiol over the counter? ›This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Capsule. Tablet.
How do you unclog a clogged bile duct? ›The goal of treatment is to relieve the blockage. Stones may be removed using an endoscope during an ERCP. In some cases, surgery is required to bypass the blockage. The gallbladder will usually be surgically removed if the blockage is caused by gallstones.
What is the gold standard treatment for gallbladder stones? ›Biliary colic and acute cholecystitis are common indications of laparoscopic cholecystectomy, while endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy and stone extraction is the gold standard for the treatment of common bile duct (CBD) stones.
How can I save my gallbladder naturally? ›- Keep the bile fluid and keep it moving - ie. prevent bile stasis and bile sludge.
- The best foods and herbs for the gallbladder. ...
- Keep your bowel moving and avoid constipation.
- Take the right nutrients necessary for healthy bile.
- Reduce cholesterol.
- Avoid problem foods and fix your digestion. ...
- Eat the right fats.
- Avocados. Eating foods rich in fibre and healthy fats is ideal for a healthy gallbladder. ...
- Turmeric. Turmeric is a popular superfood. ...
- Coffee. ...
- Beans. ...
- Green leafy vegetables. ...
- Flaxseeds. ...
- Whole grains. ...
- Oranges.
Surgery is not the only way to deal with gallstones. These natural and easy ways will help you dissolve gallstones. Drinking enough water is one of the safest and hassle-free ways to dissolve gallstones without any possible side effects.
What breaks up gallstones naturally? ›In most cases, a gallbladder cleanse involves eating or drinking a combination of olive oil, herbs and some type of fruit juice over several hours. Proponents claim that gallbladder cleansing helps break up gallstones and stimulates the gallbladder to release them in stool.
Does cranberry juice help with gallstones? ›The goodness of dietary fibre in cranberry juice aids in diminishing the cholesterol levels in the system, thus averting the formation of cholesterol gallstones. And for pigment stones, the acidic nature of the juice will assure that bile flows via the system to avert build-up.
What should you not drink with gallstones? ›Sugar and carbonation in soft drinks impede your gallbladder's normal function. Water is your best beverage option for its many health benefits and because it detoxifies impurities that impact your gallbladder.
Is yogurt good for gallstones? ›
Other good dairy choices for people with gallbladder issues are low-fat milk and yoghurt and sour cream.
How long is too long for gallstones? ›It may take 10 to 20 years for gallstones to grow large enough to cause an obstruction.
What makes gallstones worse? ›Foods high in saturated fat include: meat pies. sausages and fatty cuts of meat. butter, ghee and lard.
What vitamins help dissolve gallstones? ›Nutritional supplements that might help prevent gallstones include vitamin C, soy lecithin, and iron. In addition, a mixture of plant terpenes (Rowachol) has been used with some success to dissolve radiolucent gallstones.