Gallstone disease is a common problem affecting the digestive system due to malnutrition and metabolic disorders. How to dissolve stones in the gallbladder, which can bother a person for years, we will tell in our small material.
Definition and stages of the disease
What is gallstone disease? This is a metabolic disease in which calculi form in the gallbladder and ducts of the liver. Do gallstones dissolve? It all depends on the stage and composition of them.
The pathological process goes through three stages, which can be influenced in various ways.
- The first stage does not manifest itself clinically and is characterized by an increase in the amount of cholesterol in bile, up to cholesterol flakes and crystals. In addition, it contains less phospholipids, bile acids and lecithin, that is, substances that dissolve gallstones.
- The second stage is defined as stone carriage, does not manifest itself in any way and is characterized by an aggravation of changes in the properties of bile. Flakes and crystals of cholesterol turn into stones, which gradually fill the gallbladder and its ducts.
- The third stage is precisely the calculous cholecystitis that makes a person go to the doctor. In order to dissolve stones in the gall bladder without surgery at this stage, it is necessary to adhere to a whole scheme of medical recommendations. They can only be given by a specialist.
Symptoms of the disease
The first two stages of gallstone disease are asymptomatic. Clinical manifestations occur with:
- Inflammation of the gallbladder and its ducts.
- Blockage, stagnation.
- Filling the organ with stones completely and violating its deposit function.
The most characteristic sign of the disease is colic. It is characterized by severe pain in the right hypochondrium or in the center under the ribs. Pain can be given in the left hypochondrium, in the lower abdomen, back, right shoulder blade or the area between them. The pain can last for hours. In addition to painful sensations, there are various autonomic reactions: sweating, redness or pallor of the skin, an increase in blood pressure and a rapid heartbeat. Nausea and vomiting are frequent companions of biliary colic. In addition, the appetite decreases, the patient is anxious, the pain does not allow sleep.
With an increase in body temperature, acute cholecystitis or cholangitis is suspected. Yellowness of the skin, sclera, indicates that the stone impedes the outflow of bile.
Diagnosis of the disease
Is it possible to dissolve stones in the gallbladder by various methods, depends on what calculi formed in the bladder and ducts.
The stones are of the following types:
- Cholesterol containing up to 75% cholesterol, as well as pigments, lime salts, proteins and mucins. Meet most often (from 70 to 90% of all cases). They are located in the gallbladder and much less often in the ducts.
- Brown pigment stones contain up to 30% cholesterol, as well as calcium bilirubinate. Appear in the common bile duct after surgical treatment, rarely in the bladder itself.
- Black pigment contains black pigment, mucin and proteins. They occur mainly in the gallbladder, are extremely rare in the common duct.
- Mixed complex calculi contain less cholesterol, as well as calcareous salts, proteins, mucin and pigment substances. Found in about 20% of cases.
Dissolve gallstones without surgery is possible if they are cholesterol. These stones are not visible on x-rays. The main diagnostic method is ultrasound. The stones and their shadows are visualized, as well as the thickened wall of the gallbladder.
On panoramic radiographic images of the abdominal cavity, stones are much less visible if they contain calcareous salts, X-ray positive formations.
Fibrogastroduodenoscopy is performed to examine the exit site of the common bile duct into the lumen of the duodenum in order to recognize a blockage with a stone.
In a biochemical blood test, the amount of cholesterol and the lipid spectrum, as well as the functioning of the liver based on bilirubin and enzyme substances, are studied.
A general blood test diagnoses the presence or absence of an active inflammatory process by the number of leukocytes and the erythrocyte sedimentation rate.
Diet for gallstone disease
At any stage, therapeutic nutrition should be aimed at lowering cholesterol, its hypersecretion in the body. An important role here is played by proper nutrition, aimed at reducing body weight, correcting metabolic processes. Often, the pathological picture of bile is associated with endocrine pathology, which requires a specialized diet.
Eating should be fractional - from four to six times a day, distributing the food evenly over the clock so that there is no stagnation of bile in the bladder. Servings should be small, gluttony is prohibited, as it will cause a spasm of the bile ducts and painful sensations of varying intensity.
Dietary food excludes the intake of fried, fatty, smoked, spicy and high-calorie (up to 2900 kcal). Food should be rich in protein. When choosing products, their fat content should be considered. This applies to dairy products, which must be purchased with a low percentage of fat content. The meat should be low-fat varieties (chicken, turkey, rabbit, beef). River or low-fat fish (bream, perch, cod, pike perch, hake). Cook meat and fish should be steamed or boiled.
It will be beneficial to eat about a hundred grams of raw vegetables or fruits three to four times a day. You need to eat them before the main meal. Apples and pears, as well as juices from them, help to dissolve stones in the gall bladder, which earned the love of many nutritionists. For the same purposes, carrots, sour cabbage, celery are used. Fiber-rich foods should be present on the table of a patient struggling with stone formation. Eating a tablespoon of wheat bran twice a day is one of the folk remedies. The bran brewed with boiling water and added to the main dish helps dissolve the stones in the gallbladder and improve the intestines.
Half the fat should be of plant origin. Vegetable oils (sunflower, linseed, olive, corn and soybean) help lower cholesterol, enrich the body with tocopherol, and dilute bile with the help of prostaglandins in their composition.
Neutral and alkaline bile promotes the dissolution of cholesterol in it, and an acidic environment, on the contrary, causes crystallization and stone formation. This leads to the consumption of a large number of flour products and cereals. To make the environment more alkaline, you should add dairy products, cottage cheese, cheese, vegetables (except legumes), fruits and berries (except red currants) to the diet.
Soups should be cooked lean. Soft-boiled eggs are allowed no more than one per day. From seasonings, you can use parsley and dill, fruit sauces. Tea and coffee can be drunk weak, good to take juices. Strong alcohol and beer are prohibited.
Indications for drug dissolution of stones
It is possible to dissolve stones in the gallbladder by folk and drug methods under certain conditions:
- In the gallbladder, there are only cholesterol calculi, which are visible during ultrasound and are not visible on radiographs.
- Size - no more than two centimeters in size.
- The gallbladder functions properly, accumulating bile.
- Stones in an organ occupy no more than half of its volume.
- The duct exiting the gallbladder must be passable.
- There are no stones in the general duct.
- The appearance of stones is less than three years, since later they accumulate a large amount of mineral salts that are poorly soluble.
Contraindications for the medical dissolution of calculi
You should know the conditions that prohibit taking medications for lysis, as well as which stones in the gall bladder can be dissolved medically.
Contraindications are:
- Acute inflammatory reaction in the gallbladder wall and ducts.
- Large stones more than two centimeters in diameter.
- Pathology of the liver of any etiology.
- Diabetes.
- Chronic pancreatitis.
- Peptic ulcer of the stomach and duodenum.
- Exacerbation of chronic pathology of all parts of the intestine.
- Calcium carbonate stones visible on x-ray.
- A disconnected gallbladder without signs of functioning.
- Pregnancy and lactation.
What drugs dissolve gallstones
For medical lysis, preparations of bile acids are used - chenodeoxycholic and ursodeoxycholic, which make up for the lack of these substances in patients prone to stone formation. With the use of these drugs, the absorption of cholesterol from food and its synthesis in the liver is inhibited, which leads to its decrease in the composition of bile. Without cholesterol, which is the basis of the stone, its formation becomes difficult. In addition, with stones and crystals of cholesterol already present in the bladder, fatty acids create liquid compounds that dissolve bile conglomerates.
The product of chenodeoxycholic acid is "Henofalk", produced in capsules by the German company Doctor Falk Pharma GmbH. A medication is prescribed before going to bed every night, since cholesterol stones form at night with prolonged stagnation of bile (since a person does not eat at night).
The dose depends on the weight of a person at the rate of 15 mg per kilogram. Overweight people should be aware that the maximum dose is 1,500 mg per day.
Take the drug for a long time. Six months later, a control ultrasound is performed, on which the result of therapy is evaluated. In the absence of positive dynamics, the medication is stopped. The maximum period for receiving Henofalk is three years. There is a method of course taking the drug to prevent subsequent stone formation in people prone to this pathology, provided that the previous stones are completely dissolved. Reception is carried out during the month with interruptions of 60 days.
Henofalk's tolerance is good. Fear should be allergic reactions in the form of itching and rash. With prolonged months-long intake, it is necessary to monitor liver parameters (ALaT and ASaT), and if they increase, reduce the dosage.
Abdominal pain can occur when stones move. Stool relaxation is possible at high doses due to increased fat in the feces.
The drug "Ursofalk" based on ursodeoxycholic acid is used at a dosage of 10 mg per kilogram of body weight per day in the evening. The maximum amount is 1250 mg. The drug is considered more effective for dissolving stones, and its tolerance is good. Reception is carried out under the supervision of ultrasound. Ursofalk is canceled in the absence of dynamics for a year and a half.
There is a combination technique of “Henofalk” and “Ursofalk” with half dosage taken at night. Such treatment is more effective and leads to the dissolution of stones in 70% of cases, unlike monotherapy, where only half of the patients are successful.
All contraindications should be clarified before dissolving the stones in the gallbladder with the help of preparations containing acids. In addition, you need to remember that their usual medicines can not.
Herbs dissolving gallstones
The use of herbal medicine for the dissolution of calculi should be carried out only after the permission of the attending physician. So, tools that dissolve gallstones are found in the following herbs.
Milk thistle, peppermint, tansy, rose hips, beetroot decoction, lingonberry leaves, lavender flowers, mountain thyme are used. They are used in the form of tablets, infusions, teas. Remember that each remedy has its own list of contraindications.
Dissolve gallstones with folk remedies, including herbal medicine, can be done with their very small diameter and cholesterol composition. The use of herbs during the acute process of inflammation is contraindicated.
Non-drug treatments
How can you dissolve stones in the gallbladder without resorting to surgical treatment, you should find out by consulting a gastroenterologist and surgeon.
The shock wave cholelithotripsy method allows crushing large stones (up to 3 cm) into small fragments. Stones should be cholesterol. The gallbladder must fulfill its function. The method will be especially effective if you start using fatty acid preparations two weeks before it. It is possible to fragment stones in 95% of cases.
The technique of percutaneous transhepatic cholelitolysis is an invasive procedure performed under local or general anesthesia. It consists in the introduction of a thin probe into the gallbladder through the skin and liver tissue and the infusion of a solution for dissolving stones through this probe. Thus, up to 95% of calculi dissolves.
Prevention
Preventive measures are aimed at preventing the formation of primary stones and new calculi after treatment with the above means.
Preventive measures include:
- Proper nutrition in compliance with all of the above activities.
- The use of mineral waters containing sulfate ion ("Essentuki", "Borjomi", "Truskavets", "Narzan").
- Spa treatment.
- Rejection of bad habits.
- Regular physical activity, including exercises that develop the muscles of the diaphragm and the press.
- Body weight control.
- The treatment of chronic diseases.
We discussed how to dissolve gallstones. With competent treatment, the outcome is favorable.