Gallstones

Question:
"I went to my chiropractor today because of pain in my right shoulder. Despite receiving an adjustment, the pain did not go away. He thinks I may have gallstones. How can I confirm this and, if I do have stones, is there anything I can do to resolve them without surgery?"

our Health Coach Answer:
This is a problem I deal with frequently. From an anatomical standpoint alone it is counterintuitive that someone might experience shoulder pain in the setting of gallbladder disease. However, based on a more thorough understanding of neuro-anatomy, that is a common presentation for a sick gallbladder.

Gallbladder disease almost always means gallstones, particularly if your cholesterol is high and you have recently lost weight and or made significant dietary changes. Altering normal bile flow with sudden weight loss can result in the synthesis of more gallstones. A high fat or spicy meal is the typical final precipitating factor that makes gallstones symptomatic. Fat triggers the release of cholecystokinin the hormone responsible for making the gallbladder contract. If the contraction is forceful enough, a stone of approximately the same diameter as the opening of the common bile duct is thrust into it and may ultimately cause a blockage requiring emergency surgery. That is precisely how famed country western singer Tammy Wynette died, due the inevitable ensuing infection.

If you think you may have gallstones or gallbladder disease, your physician can order a gallbladder ultrasound, the most sensitive and safest test available. If no stones are present and yet you still are having food related symptoms, then insist on a HIDA scan which is just a fancy name for a nuclear medicine scan designed to test gallbladder function, not just gallbladder anatomy.

While dissolving gallstones has been tried with various preparations, most are ineffective or so slow as to not be practical. One method that has gained a lot of traction among many alternative medicine practitioners is known as the gallbladder flush. I first read about the gallbladder flush more than 30 years ago in Jethro Kloss's book, Back to Eden. Proponents of the flush claim that it can quickly and safely cause the gallbladder to discharge gallstones, which are then eliminated with a bowel movement. This sounds appealing at first blush until you realize that it all comes down to mathematical probability. The greater the number of stones multiplied by the number of fatty meals a person consumes over time equals a much greater likelihood that one of the stones will lodge in the common bile duct. If this happens, serious health complications can result, such as to ascending cholangitis (inflammation of the bile ducts), sepsis, and even death. So I can't recommend gallbladder flushes even if I wanted to. Although such complications are rare, I choose the conservative route and most patients do too when they see it from that perspective.

The best solution for gallstones and other gallbladder problems is the same solution for other health problems: Prevention! In this case, prevention starts with a healthy diet. If possible, eat organically raised foods and try to increase your intake of fiber-rich foods, especially vegetables, and cut down on red meat. You'll also want to limit your overall fat intake to about 20 percent of the total amount of foods you eat. (Don't cut out fat completely however, as healthy fats are essential for good health and a complete lack of fat can actually cause gallstones to form.) In addition, try to avoid overeating, as eating too much food at meals places stress on the gallbladder. Don't skip meals, however, as this can also cause gallbladder stress, along with other health problems.

In addition to a healthy diet, various nutritional supplements can also help to prevent and ease gallstones and other gallbladder problems. These include vitamin B complex, vitamin C, choline, acidophilus, and lecithin. Taking a digestive enzyme formula before each meal can also be helpful.

Finally, be sure to get regular exercise throughout each week. If you are overweight, work with your physician to create a healthy weight-loss program, but avoid losing weight too quickly, because, as I said above, this can cause gallstones to form.

Should your Health Coach determine that your gallbladder needs to be removed two surgical approaches are available. Ideally, you will be able have laparoscopic surgery, which involves the use of lasers to make small incisions in the abdomen, after which the gallbladder is cut away and suctioned out. This procedure typically takes no more than an hour to perform and very often patients are able to go home the same day. If laproscopy is not possible, due to complications, then a surgical procedure known as open cholecystectomy may be performed. In this procedure a larger surgical cut is made just below the ribs on the right side of the abdomen, and then the gallbladder is cut and extracted. Patients who receive this surgery usually need to stay in the hospital for observation for two or three days, and their recovery time is usually longer as well. I recently reviewed a scientific article describing an oral (through the mouth) endoscopic (incision-less) procedure that requires only local anesthesia with little or no downtime. That may be the future of gallbladder surgery.

Read more answers from Ask our Health Coach