Jackson asked
If I have problems with my Gallbladder, I assume is probably because of Gall stones. My stomach constantly growls and I am usually very hungry. Also from time to time there is slight pain. Is there really a method to remove gall stones without surgery? I have heard about these different methods, but wanted to get your advice. I do know that most doctors recommend surgery.
Answer
Aside from surgery, there are only two FDA approved medications for gallstones and they are Ursodiol (also known as Actigall and ursodeoxycholic acid) and chenodiol.
A Gallstone formation that stays in the biliary tract is know as cholelithiasis. They are a formation of a small amount of bile with the majority of composition usually attributed to cholesterol. Treatment of these gallstones is typically through surgery but these drugs can help on occasion. Bile acids and related substances are essential components of bile. Bile acids help with bile flow, cholesterol synthesis, excretion of cholesterol and absorption of fats. After bile acids are secreted into the biliary tract, they are mostly reabsorbed in the intestine, make their way back to the liver, and then secreted again in bile. There are many reasons gallstones can form including low concentrations of bile acids, diet, body weight, genetics, altered bacterial flora and liver function.
The bile acid agents I mentioned (Ursodiol and chenodiol) are a type of bile acid. They are actually natural products that our bodies produce. They are formed in the gut by intestinal bacteria. When administered orally, these agents alter the concentrations of bile acid and can decrease fat secretion, reduce the cholesterol content of the bile and increase cholesterol solubility so that gallstones are less likely to form.
It is important to note that patients MUST have a functioning gallbladder in order for these agents to work as the modified bile must enter the gallbladder to interact with the gallstones. Also, your doctor will take a close look at the actual gallstones. They must by composed of a specific type of cholesterol and they usually must be a certain size in order to the medications to work. Unfortunately, due to these conditions, therapy with drugs like ursodiol is not always effective and the results can be disappointing. It has been reported that partial break up of the gallstones happen in about 50% of patients and complete dissolution of the stone only happens in about 30-35% of people. In addition, ursodiol and related products can cause side effects such as liver problems and GI discomfort. In the past, both ursodiol and chenodiol were given together, but that is very rare to see nowadays. The danger of side effects is just too great.
Unfortunately, surgery is the primary option for many patients. Ursodiol it has been found, is much more effective when it is used as prophylaxis for gallstone formation, as opposed to treatment.
