Cholelithiasis (Gallstones): Causes, Symptoms, and Ayurvedic Treatment
Gallbladder and biliary tract disorders affect a large segment of the population and in my clinical experience, almost all these cases, approximately 95%, are due to one condition: cholelithiasis, the formation of gallstones. Bile is produced by the liver and stored in the gallbladder. Abnormalities in the composition of Bile and/or biliary flow and gallbladder inflammation may lead to the formation of stones in the gallbladder and/or biliary ducts.
Gallstones can often go undiagnosed due to the fact that in many cases, patients are asymptomatic. If there are symptoms, the initial symptoms may be noted as early as feeling full in the upper abdomen. Symptoms may progress in patients to the point of discomfort and/or pain after consumption of fatty foods.
Biliary colic results when the gallstones obstruct the cystic duct or the common bile duct. Once this occurs, the patient may experience upper middle and right upper quadrant abdominal pain which can last up to five hours and may be associated with nausea and vomiting. If the obstructed duct is the common bile duct, the patient may present with jaundice.
There are 2 main types of gallstones: cholesterol stones and pigmented/calcified gallstones. 90% of gallstones are cholesterol stones. The process of formation of the other 10% of gallstones involves a different process.
Who is at Greater Risk?
The likelihood of developing gallstones increases with age. The contribution of metabolic syndrome and obesity is noticeable. This condition is more common in women. Factors that also increase risk include each of the following: family history, estrogen (from OCs or during pregnancy), gallbladder stasis, and decreased gallbladder motility. Ironically, biliary cholesterol secretion, which rapid weight loss speeds, increases the likelihood of gallstones during that period. This paradox is unfortunate because health is the goal of rapid weight loss for many patients.
Possible Problems
Gallstones that are not treated can cause many problems, including each of the following: cholecystitis, empyema, gallbladder perforation, fistula, cholangitis, obstructive cholestasis, pancreatitis, and intestinal obstruction. The many potential problems from gallstones is why evaluation and treatment should occur in a timely manner, even when patients present with what are mild symptoms.
Typical Treatment
Laparoscopic cholecystectomy (gallbladder removal) is the most common treatment. For patients who are not surgical candidates, gallbladder stones may be dissolved with medications that are gallbladder stone solvents.
How Ayurveda Treats Gallstones
Cleansing the liver and gallbladder is the focus of Ayurveda gallbladder stone treatment because Ayurveda believes the root cause of gallbladder stones is liver and gallbladder dysfunction. Ayurveda treatment uses herbal medicine that contains stone-dissolving herbs along with treatment that prevents the formation of gallstones.
To be clear, in acute or severe cases of cholelithiasis requiring surgical management, there is no role for Ayurveda. However, for non-emergency cases, Ayurveda has a role in the management of cholelithiasis and allows patients to avoid the complications described above.
Ayurvedic Formulations Used for Gallstones
Patolakaturohinyadi Kashaya, Arogyavardhini Vati, Vasaguluchyadi Kashaya, Dashamoola Haritaki Leham, Avipattikara Choornam, and Dadimadi Ghritham are some of the formulations that have shown genuine promise for the management of gallstones. These formulations have the potential to be both hepatoprotective and cleansing for the gall bladder, as well as help in the dissolution and prevention of the recurrence of gallstones. The treating Ayurvedic Physician will determine the formulation and the duration of treatment on the individual assessment of the patient.
Diet and Lifestyle for Gallbladder Health
Formulations are just one piece of the prevention and management puzzle. A diet containing sufficient fiber, hydration, fruits, and vegetables, while decreasing saturated fats and processed/junk foods, is key. Regular exercise and maintaining a healthy weight are important, and helped improve metabolic function, decrease the formation of gallstones.
Frequently Asked Questions
Owing primarily to disturbed biliary composition, biliary stagnation and inflammation of the gallbladder, there is formation of gallstones, dominantly cholesterol gallstones (90%).
Ayurveda can support the dissolution and prevention of gallstones, in appropriate non-emergency cases. However, life-threatening cases will always need surgical intervention.
Some signs of gallstones include a sense of fullness in the abdomen after eating or biliary colic that is accompanied by nausea and vomiting and consists of severe pain in the upper abdomen for as long as five hours.
The greatest population at risk of gallstones is females and specifically those that are either overweight or part of a certain ethnicity(s) known to be at a greater risk. Pregnancy and the use of oral contraceptives increase the risk as well.
Even though gallstones are an extremely common condition, they are an easily preventable and treatable condition. Kottakkal Ayurveda combines dietary and lifestyle changes with specific herbal treatments. While we believe that gallstones may require a surgery, we work to prevent the condition.
About the Author
Dr. Nasreen Thacham Poyil is an Ayurvedic Physician at Kottakkal Ayurvedic Treatment Centre. She is an alumnus of VPSV Ayurveda College, Kottakkal and is trained in treating a wide variety of conditions including, but not limited to, the gastrointestinal and the dermatological systems.
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