Anyone know about gallstones?

[Gordo]

Since changing to a plant based whole foods diet with mild CR I never get sick anymore, haven't had a missed day of work, a runny nose, a fever, cough, flu, or sore throat.  But I have been having "upset stomach" type incidents every 3-6 months that can sometimes be very painful, this actually started years ago back when I was on the standard american diet.  More recently I was thinking all the fiber, beans/broccoli/Brussels sprouts were just creating a lot of gas, which was causing this.  I kind of just brushed it off.  But recently it got so bad I went to see my doc, the doc sent me to get an ultrasound, and the ultrasound showed a distended gallbladder with stones.  I am guessing I formed these stones long ago when my diet was terrible because based on my research, my current diet is pretty much IDEAL for avoiding gallstones.

 

After some more research I also found that turmeric causes the gallbladder to contract, which may have contributed to these stones causing me more problems since changing my diet (I take turmeric every day).  But I doubt cutting off the turmeric is going to make the problem go away.  

 

Also I discovered I have a family history of this sort of problem.  I've got 5 close blood relatives (2 aunts, 2 uncles, and a grandmother) who ALL had their gallbladders removed.

 

Anyway, my doc referred me to a surgeon, whom I have not seen yet, but I'm sure he or she is going to recommend gallbladder removal.  From what I've read this is pretty routine surgery, done laparoscopically with relatively fast recovery.  My concern is the long term consequences of not having a gallbladder.  It is not a useless "bonus" organ, it serves an important role in digestion.  I could not find any studies though on life expectancy changes due to gallbladder removal. From what I've read, the bile from the liver that would normally be stored in the gallbladder goes directly into the digestive tract, which can result in health problems and damage, digestion of fats also becomes a problem, nutrient absorption is affected, etc.  There are lots of reports of people having long term health issues after gallbladder removal.

 

Unfortunately it seems the profession no longer removes gallstones surgically, or by shock wave therapy, even though they used to.  I guess there were such high rates of recidivism that the insurance companies will not pay for this, and the docs think its a waste of time.  I think in my case, the stones are less likely to come back, so I wish this was an option for me.  I looked at a bunch of "suspect" home remedy type stuff out there on the web/youtube, which looks like a waste of time/snakeoil.  I started researching gallstone dissolution methods, there are some things there that look promising like:

 

Optimum bile acid treatment for rapid gall stone dissolution.

 

Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial

 

I'm not sure if, or where, I could obtain: CNU®; (Myungmoon Pharmaceutical Company, Seoul, Korea) but it looks like Ursodiol is available (in cheap generic form) and FDA approved in the US, it may be the only FDA approved treatment for dissolving gallstones, it seems about as effective as CNU.  I guess I'll try to see if my doc will prescribe it.

 

That's all I have for now.  Just thought if anyone has been down this road, it would be useful to swap notes.

 

Regards,

Gordo

[mccoy]

Gordo, I don't know if you searched 'liver flush'. I have not had this problem, nor known people who did that. I read the book on Ayurvedic medicine by Andreas Moritz, who developed a pretty elaborated liver flush strategy. I remember that he suggests apple juice to dissolve the gallstones, also his enema is not a simple one. But it all beats going under the surgeon's irons.

 

[TomBAvoider]

Do you happen to know if you have pigment or cholesterol stones? Different treatment for each (unless you simply remove the gallbladder) - for example, on cholesterol stones, you can use chenodiol/ursodiol, and in pigment stones, if you have access to your blood tests throughout the years, you might check on your bilirubin levels.

[TomBAvoider]

There's also this:

 

https://www.sciencedaily.com/releases/2017/03/170313192505.htm

[Gordo]

Mccoy, I am quite familiar with him.  I'm almost embarrassed to admit, I tried his "amazing flush" despite my better judgement, only because it didn't seem like it could cause any harm, and I have a lot of EVOO I wanted to consume anyway, haha.  There are LOTS of anecdotes out there suggesting it works.  But this stuff has been thoroughly debunked, see:

The Truth about Gallbladder and Liver "Flushes"

 

Regardless, here is a pic of some of my results of the flush, just taken TODAY:

 

Yea I pooped that stuff, wow, its almost half convincing isn't it?  Haha, there is NO WAY these "stones" came out of my gallbladder.  If you take the same ingredients (EVOO, citrus juice, bile, epsom salts) and mix them around in a beaker you will get the same result.  A waste of time, and false hope for a lot of people...

 

Ursodiol is cheap and proven, so I hope to at least give it a shot, although even it doesn't have a great long term record (for many successfully treated, the stones come back within 5 years).  I kind of wish I could combine shock waves and Ursodiol, but I'd have to find someone with that equipment who was willing to do it...

[Gordo]

Do you happen to know if you have pigment or cholesterol stones? Different treatment for each (unless you simply remove the gallbladder) - for example, on cholesterol stones, you can use chenodiol/ursodiol, and in pigment stones, if you have access to your blood tests throughout the years, you might check on your bilirubin levels.

 

I don't know, but I've read in Westerners, 80% of gallbladder stones are of the cholesterol variety.

4 years ago bilirubin = 0.4

2 years ago bilirubin = 0.6

0 years ago bilirubin = 0.5

 

Pretty much smack in the middle of the normal range.  I've read that both fasting and rapid weight loss can cause the stones to form, I started my CR journey with both fasting, and rapid weight loss, so I'm sure that couldn't have contributed, but I'm also fairly confident I had these stones even before that time.   My current blood cholesterol levels are extremely low, and dietary intake of cholesterol is extremely low.

[TomBAvoider]

Given your bilirubin levels, it's highly probable you have cholesterol stones, which is good news I guess (relatively), because you can use those drugs. The other good news, is that you are a good candidate, becuase the odds of recurrence are lower because of your diet and lifestyle. But as with any drug, the shorter course of treatment, the better, so it may pay to look into shattering the stones, that way the smaller stones will have a larger aggregate surface area and should dissolve faster than fewer large stones. Is you insurance company giving you trouble with regard to breaking the stones apart?

[Gordo]

Given your bilirubin levels, it's highly probable you have cholesterol stones, which is good news I guess (relatively), because you can use those drugs. The other good news, is that you are a good candidate, becuase the odds of recurrence are lower because of your diet and lifestyle. But as with any drug, the shorter course of treatment, the better, so it may pay to look into shattering the stones, that way the smaller stones will have a larger aggregate surface area and should dissolve faster than fewer large stones. Is you insurance company giving you trouble with regard to breaking the stones apart?

 

I'm new to this level of self help.  I'm not actually sure what my insurance will cover, the first step is finding a place that is even willing to do non-surgical options.  After more research, it seems like this is the latest and greatest:

New technique spares patients time consuming surgery by blasting painful gallstones with powerful shockwaves

 

https://youtu.be/5XyrghtGWO4

SpyGlass Cholangioscopy is pretty amazing.  I don't think they can use this to go into the gallbladder itself though.

[tasbin]

Hi Gordo,

I do know one thing about gallbladder removal. That is big businness here in Morocco (North of Africa)
Every adult in Morocco know at least 5 people with no gallbladder.

Could it be a widepread genetic issue? In France, there is a lot of moroccans(same population) and I know no one with such medical problem under the french healthcare.

Almost if not every time someone complain about something related to digestion in Morocco, they will recommend gallbladder removal.
A sick surgeon admitted in private to a journalist that it was easy to do and very lucrative and most of the time not related to the real issue.

My father in law had been suggested to remove it until he asked for a second opinion in France. well, well, the last opinion contradicted the 1st one
It would be inetresteding to find some statistics of % of gallbladder removal per country to compare.

[TomBAvoider]

I asked about insurance, because getting any treatment outside of insurance and paying out of pocket has gotten well nigh impossible due to insane costs in the U.S. - if insurance doesn't cover it, you might consider medical tourism. Depending on the procedure, it can be a very good and cost effective rout. Meaning, if the procedure does not entail having to stay for weeks on end for mulitple components of care - sometimes it's not about the cost, but the fact that you can't take off from work to spend weeks/months elsewhere. But if it's one of those in-and-out type things, then it's a matter of flying in, staying at a hotel for 1-3 days and getting out. This might be the case here, because you probably don't need a lot of post-operative care, just do the procedure and then come back the next day/week to see if it's successful, and you're out. There are a lot of facilities in what are called developing countries which are really at top notch level of education and technology. So, if for example you manage to locate a good reputation facility in say, Mexico, it might be more affordable to do it that way than try to pay out of pocket here in the U.S. But talk to your doc first and then your insurance, and only then you can cross that bridge when you get to it. Just something to keep in mind as an option.

[Todd Allen]

A gallbladder isn't useless but one can still eat plenty of fat without one.  There are many people without gallbladders who have successfully adopted a keto diet, though they need to take some care not to eat too much fat too fast.   I'd try hard to avoid the need for removal but if it has to go I doubt you'll have much trouble with your diet. 

[Gordo]

Just wanted to report back that I'm alive and well post surgery (yay).  Here's a pic of my actual disgusting gallbladder:

To my layman's eye, it doesn't seem like this thing has been functional for a long time, those big stones (one was the size of a quarter) take years to form from what I've read, and even where there weren't stones, it was packed full of sludge, definitely wasn't holding much bile.

 

For the benefit of anyone who stumbles upon this thread in the future (and the google bots that archive the forum for the world to find).

If you need surgery, the first thing you might want to figure out is how to find a good surgeon. I didn't know until recently that there is a data driven way to do this now at least in the US!  A non-profit group put together a site that analyzes all of the medicare data on surgeons and hospitals, so you can find both the hospital and surgeon in your area with the best outcomes: surgeonratings.org

They also run surveys of docs themselves, to see what surgeons docs recommend the most.  Using that site I found a really great surgeon, working out of a hospital I would never have thought to go to, but not that far away for me.

 

Finally, for recovery, there are a few things the docs may not tell you, like to avoid constipation from all the drugs they use for the surgery, drink some milk of magnesia (but don't overdo it).  And if you want to rapidly improve your healing time and lessen your pain, take a turmeric/curcumin supplement (these guys showed fantastic results with 2000mg curcuminoids per day):

 

Efficacy of turmeric (curcumin) in pain and postoperative fatigue after laparoscopic cholecystectomy: a double-blind, randomized placebo-controlled study

(Curcumin was given at dosage of one 500 mg cap once every 6 h per orally.)

 

My personal anecdote is that this stuff worked as well for me as was reported in the above double blind study, with rapid reduction in inflammation, and no need at all for pain meds after the 2nd day of recovery (what to do with all that leftover oxycodone?   ).

 

For what its worth, I opted for the da Vinci robotic surgical technique (since I figured one surgical site is better than 4 which is what you'd get without the robot):

https://youtu.be/wQnKG2J4lZA

 

Regards,

Gordo

[mccoy]

Good recovery, Gordo, it seems you are not just alive, but kicking big time!

[TomBAvoider]

That's great news, Gordo, very happy you had such a problem-free experience! And thank you for the update about turmeric. From this I guess in the end you opted for removal of the entire gallbladder, rather than trying to break/flush the stones. If you don't mind - could you please take us through the reasoning you went through in order to come to that decision? I imagine doctors must have had input in your decision-making and you took all of the information before you made your final determination. I ask, because I was diagnosed a few years ago, with "small gallstones" - I went in for something else, and they performed an ultrasound and by the way noticed that I had "small gallstones"... so far completely asymptomatic for me all my life - BUT my father had to have his gallbladder removed when he was in his 30's, so while I'm a lot older now and never had an issue or any symptoms, I want to prepare in case that day comes...

[Thomas G]

Glad to hear you are doing well Gordo.

[Gordo]

Hey TomB, at first it was looking like a tough choice, but then it wasn't really. First, no one around me does any "break up the gallstones" procedures, even if they did, I would not have qualified since my stones were too large. I asked my doc if I could try ursodiol, and he acted like he had never heard of it and instead suggested that I don't wait to talk to a surgeon. The surgeon himself argued rather persuasively that despite some of the things you may read, we really don't need a gallbladder, especially so if you eat a lot of fruits and vegetables. So all of that, plus my mounting and continuous pain was easily enough for me to schedule the surgery.

 

In your case I'd consider a preventive 12 month course of ursodiol (it's available as a cheap generic, was only going to cost me $80 for a whole years supply via mail order, low incidence of side effects). Perhaps in a few years the tech will be approved for a non-surgical cleaning like that spyview from Boston Scientific (which is currently only for duct stones and not for inside the gallbladder). That said, if indeed you don't get much value from a gallbladder (especially someone that doesn't consume a lot of saturated fat) I'm not sure why anyone should go to great lengths to avoid removing it. I guess the general risk from surgery is probably far higher though from say the risk of developing gallbladder cancer. I'm guessing at some point you will want to get yours removed, and probably the younger you are when you do it, the more optimal the outcome and recovery is likely to be.

[TomBAvoider]

Hey Gordo, thanks for this. Certainly a lot of food for thought, many considerations.

[Mechanism]

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