dietary guidelines
eating principles:
Increase fiber and avoid refined carbohydrates.
(New Scientist Vol. 14, March 21, 1985; Thorton, J. Gut 24:2-6, 1983)
Decrease animal fats and fats in general.
Eat as little as possible or short fast
Increase foods rich in Vitamin C
Increase fluids
Vegan diet
Elimination/rotation diet, rotation diet, rotation diet expanded
therapeutic foods:
Dandelion greens, horseradish, mustard greens, black radish (Jensen, p. 61)
Water chestnuts, beet tops, pearl barley, watermelon, grapefruit, radish, apple, tomato, olive oil, celery (Ni, p. 158)
Liver-cleansing foods: beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root
Foods high in water-soluble fiber: flax seed, pectin, guar gum, oat bran, mucilage
fresh juices:
Radish, prune, black cherry, and celery (Jensen, p. 51)
Carrot, beetroot, and cucumber (Jensen, p. 51)
Prune, black cherry, celery, and radish (Jensen, p. 51)
Beet
Carrot (Walker, p. 137)
Carrot and spinach (Walker, p. 137)
Carrot, beet, and cucumber (Walker, p. 137)
Carrot, celery, parsley (Walker, p. 137)
Watermelon (Ni, p. 158)
specific remedies:
Take 120 g of walnut kernels and deep fry in oil until crisp. Add sugar and grind into a paste. Use over a period of 1-2 days, a little at a time (Yin-fang and Cheng-jun, p. 79)
Grind together into a powder, equal quantities of black pepper and Sodium sulfate crystals. Infuse 3 g in water and drink per day (Chao-liang, Qing-rong, Bao-zhen, p. 88)
avoid:
Allergies and food intolerances (Breneman)
Alcohol, nuts, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, heavy protein foods, vinegars, cow's milk and other dairy products, white bread, refined foods, processed foods, sugar and sweets; catarrh-forming foods: tofu, meat, ice cream, shellfish
supplements
Bile salts (Tooli, J., Jablonski, P., Watts, J. Lancet (2):1124, 1975)
Vitamin C (especially with cholesterol gallstones) (Jenkins, 1977, p. 1616ff)
One study suggests that vitamin C supplementation can reduce the lithogenicity of bile. 500 mg of vitamin C was given four times per day to sixteen patients with gallstones who were scheduled for surgery during the two week period prior to surgery. A control group of 16 cholecystectomized patients did not receive vitamin C. Bile was then taken from the gallbladder of each patient during surgery. There was a significant increase in the concentration of phospholipids in the bile of those who had received the Vitamin C. Further, it took 7 days for the bile from vitamin C-treated patients to form cholesterol crystals, compared with just two days in the control group. Another recent study of 384 women (8%) and 107 men (3%) reported a history of gallstone disease, and 347 women (7%) and 81 men (2%) reported a history of cholecystectomy. found an inverted U-shaped relation between serum ascorbic acid level and clinical gallbladder disease among women but not among men.
(Gustafsson U, et al. Eur J Clin Invest 1997:27:387-391; Simon JA, Hudes ES. Am J Public Health 1998 Aug;88(8):1208-1212..)
Vitamin E: 400-800 IU per day, esp. with cholesterol gallstones (Dam, 1956, p. 329)
Essential fatty acids (Bell, Doran. Brit. Med J. 1:24, Jan 6, 1979)
Hydrochloric acid and other digestive enzymes
Lecithin: 100 mg three times daily up to 4-6 g per day, supplementation may normalize the abnormally low phospholipid to cholesterol ratio associated with cholesterol gallstones. (Tuzhilin, Dreiling, Narodetskaha, Lukash. Am. J. Gastroenterol. (65):231, 1976)
Methionine: In 1984 Frezza and colleagues discovered that intrahepatic cholestasis could be reversed in women by giving 800mg of SAM (S-adenosyl-methionine) per day. It has been useful in the treatment of cholestasis in pregnancy by inhibiting the action of estrogen. However, researchers are not exactly clear how it works. (Marz, p. 370, 1997)
Taurine (Yamanaka, 1985, p. 226)
Antioxidants (Marz)
Bile salt drug therapy: Gallbladder calculi may sometimes be dissolved in vivo by giving bile acids orally for many months. The bile salt usually given is Chenodiolchenodiol 15mg/kg/day, which acts in part by reducing hepatic synthesis and biliary secretion of cholesterol. Cholesterol saturation of bile is reduced and cholesterol-containing stones may slowly dissolve. Gallstones may dissolve completely in 30-40% of patients at this dose, but recurrence of stones and colic after cessation of drug is usual. Urodeoxycholic acid (an investigational drug) may be used (10mg/kg/day) with similar clinical expectations, but without the diarrhea or disturbed liver function seen in occasional patients on the earlier drug.
Treatment is contraindicated when:
1) Stones are calcified, very large, or made up of bile pigment
2) During pregnancy
3) If liver disease is present
4) The gallbladder is nonfunctional
5) If patient is very obese
(Marz, p. 370, 1997)
footnotes
Bell, Doran. Gallstone dissolution in man using an essential oil preparation. Brit. Med J. 1:24, Jan 6, 1979. Abstract: 23 patients took Rowachol, an EFA preparation, for 6-12 months. 3 patients had complete, and 4 had partial, dissolution of gallstones.
Breneman, J.C. Allergy elimination diet-gallbladder diet. Ann. Allergy 26:83-89, 1968.
Abstract: 69 patients with either x-ray or surgical evidence of gallstones were placed on an elimination diet to determine if there were certain guilty foods not generally suspected of causing gallbladder symptoms. All 69 patients were free from all gallbladder symptoms while they were on the basic elimination diet. Gallbladder symptoms recurred in the following % of patients when each of the following foods were added back into the diet:
Food Patients whose
symptoms returned
# %
Egg 64 92.8%
Pork 44 63.8%
Onion 36 52.0%
Fowl 24 34.8%
Milk 17 24.6%
Coffee 15 21.7%
Orange 13 18.8%
Corn 10 14.5%
Beans 10 14.5%
Nuts 10 14.5%
Apple 6 8.7%
Tomato 6 6.0%
Peas 4 5.8%
Cabbage 4 5.8%
Spices 3 4.3%
Peanut 3 4.3%
Fish 2 2.9%
Rye 1 1.4%
Medications 14 20.3%
Other 29 42.0%
(Breneman, James. Basics of Food Allergy.)
Gustafsson U, Wang FH, Axelson M, Kallner A, Sahlin S, Einarsson K. The effect of vitamin C in high doses on plasma and biliary lipid composition in patients with cholesterol gallstones: prolongation of the nucleation time. Eur J Clin Invest 1997 May;27(5):387-391.
Abstract: Vitamin C deficiency in guinea pigs leads to cholesterol supersaturation of bile and formation of cholesterol gallstones. It has been suggested that there may also exist an association between vitamin C and cholesterol gallstones in man, but such a relationship has not been studied in gallstone patients. In order to study the possible effects of vitamin C on gallstone disease in humans, plasma lipid levels, hepatic cholesterol metabolism, biliary lipid composition, cholesterol saturation and nucleation time of gallbladder bile were analysed in 16 consecutive gallstone patients, who were planned for laparoscopic cholecystectomy and were treated with vitamin C (500 mg, four times a day) for 2 weeks before surgery. The plasma concentration of vitamin C increased by 42% in the treatment group. The concentrations of plasma lipids did not differ before and after vitamin C treatment; nor did the plasma levels of lathosterol and 7 alpha-hydroxy-4-cholesten-3-one, reflecting cholesterol and bile acid synthesis respectively. The relative concentrations of cholesterol, bile acids and cholesterol concentration of bile did not differ significantly between the two groups, but the relative concentration of phospholipids was slightly higher in the treated group. The bile acid composition was changed; the percentage of cholic acid being lower and those of deoxycholic acid, ursodeoxycholic acid and lithocholic acid higher in the vitamin C-treated patients compared with the untreated group. The nucleation time was significantly longer in the treatment group (7 days) compared with the untreated group (2 days). Our findings indicate that vitamin C supplementation may also influence the conditions for cholesterol gallstone formation in humans.
Report: How sugar can get you stoned? New Scientist Vol. 14, March 21, 1985. Abstract: Gallstone formation in young people was correlated with and increased intake of soft drinks and sweets as well as an increased energy or fat intake, suggesting that sugar may increase cholesterol synthesis by stimulating insulin secretion.
Simon JA, Hudes ES. Serum ascorbic acid and other correlates of gallbladder disease among US adults. Am J Public Health 1998 Aug;88(8):1208-1212.
Abstract: OBJECTIVES: This study examined the correlates of clinical gallbladder disease among US adults and whether serum ascorbic acid levels are associated with a decreased prevalence of gallbladder disease. METHODS: Cross-sectional analyses of data from the Second National Health and Nutrition Examination Survey were conducted. RESULTS: A total of 384 women (8%) and 107 men (3%) reported a history of gallstone disease, and 347 women (7%) and 81 men (2%) reported a history of cholecystectomy. An inverted U-shaped relation was found between serum ascorbic acid level and clinical gallbladder disease among women but not among men. CONCLUSIONS: Ascorbic acid, which affects the catabolism of cholesterol to bile acids and, in turn, the development of gallbladder disease in experimental animals, may reduce the risk of clinical gallbladder disease in humans.
Thorton, J. Diet and gallstones: Effects of refined carbohydrates on bile cholesterol saturation and bile acid metabolism. Gut 24:2-6, 1983.
Abstract: 13 patients with radiolucent gallstones ate refined or unrefined carbohydrate diet for 6 weeks each, in random order. While the unrefined carbohydrate diet averaged 27gms of fiber, the refined carbohydrate diet averaged only 13 gms/day. The bile saturation index was higher in 12/13 during the refined carbohydrate period.
Tooli, J., Jablonski, P., Watts, J. Gallstone dissolution in man using cholic acid and lecithin. Lancet (2):1124, 1975.
Abstract: Cholic acid 750mg/day and soybean lecithin 2250mg/day were given to 7 patients with radiolucent gallstones and 2 patients with radiolucent stones in the biliary tree. The treatment period was 6 months. In 2 patients the stones disappeared, in one the stones the lithogenic index of bile decreased during the treatment.
Tuzhilin, Dreiling, Narodetskaha, Lukash. The treatment of patients with gallstones by lecithin. Am. J. Gastroenterol. (65):231, 1976.
Abstract: 8 patients ages 38 to 58, with gallstones, took lecithin 100mg three times daily for 18-34 months. There were significant increases in bile phospholipid content and a significant decrease in bile cholesterol after lecithin treatment. In one individual, gallstones decreased in size and changed in shape. The stones of the other 7 were not affected by lecithin treatment.