Gallbladder Stone Problems?

Gallbladder Stones (Gallstones) are stones or lumps that develop in the gallbladder or bile duct when certain substances harden. If they block the bile duct, they can be extremely painful.

“Cholelithiasis” is defined as the presence of stones in the gallbladder.  The majority of gallstones are composed of cholesterol (96%) in the form of layers, calcium salts  (3%), and bilirubin (1%).  Gallstones are thought to be caused by an imbalance in the chemical make-up of bile inside the gallbladder. Bile is a liquid produced by the liver to aid digestion.

Experts are not completely sure why some people develop the chemical imbalance in their gallbladder that causes gallstones.  It is still unclear exactly what leads to this imbalance.

Gallstones can form if:

  • There are unusually high levels of cholesterol inside the gallbladder (about four in every five gallstones are made up of cholesterol)
  • There are unusually high levels of a waste product called bilirubin inside the gallbladder (about one in every five gallstones is made up of bilirubin)
  • These chemical imbalances cause tiny crystals to develop in the bile. These can gradually grow (often over many years) into solid stones that can be as small as a grain of sand or as large as a pebble

Sometimes only one stone will form, but there are often several at the same time. Gallstone disease is primarily a metabolic disease.

Its pathogenesis mainly develops as follows:

  • It starts (nucleation) with a defect in the secretion of bile lipids of which the result is biliary cholesterol oversaturation, resulting in a chemically unstable solution
  • Then, the precipitation of cholesterol crystals is produced
  • Finally, cholesterol crystals are associated with other components of bile (mucin, bilirubin, calcium) that through aggregation and growth form microscopic biliary stones
Gallstones: Causes and Risk Factors

We do know that gallstones are more common among overweight/obese people, especially women.  Obese children have a considerably higher risk of developing gallstones, compared with kids of healthy weight.

Others at risk include:

  • Women who have been pregnant
  • Family history
  • People who have recently lost lots of weight
  • Intentionally losing weight rapidly and then regaining it may increase men’s risk for gallstones later in life
  • Women taking oral contraceptives
  • Being sedentary
  • Women undergoing high-dose estrogen therapy
  • People with a close relative who has had gallstones
  • A study revealed that a gene variant significantly increases the risk of developing gallstones
  • People whose intake of dietary fat is high
  • Twice as many women get gallstones than men
  • People over 60 years of age
  • Native American Indians
  • People who take statins (cholesterol-lowering drugs)
  • People with diabetes
  • In older people, bile duct stones can also be present and comprise up to 20% of patients over 65 with kidney stone

The common bile duct lithiasis begins by a migration of small gallstones in the gallbladder (where they originated) to the common bile duct , where they continue to grow.

Symptoms

(80%) of gallstones do not cause symptoms . If symptoms occur, the most common symptom is pain in the upper right quadrant of the abdomen, which worsens after meals. Other symptoms include gas, indigestion (bloating), nausea and vomiting. In severe cases, there may be fever.

The most common complications are:

  • Acute or chronic gallbladder inflammation (cholecystitis)
  • Gallbladder infection
  • Obstruction of the bile duct
  • In extreme cases, it can cause pancreatitis

GENERAL DIETARY STANDARDS IN BILIARY PROCESSES

The diet in bile processes should serve to avoid symptoms of liver colic and biliary dyspepsia, but does not prevent the formation of new stones. The same bile diet does not work for all patients, but in general terms it is convenient to:

  • Restrict fat in the diet
  • Note that the volume by intake can cause the same symptoms as fat intake
  • Avoid flatulence (foods rich in soluble fiber) as also they cause the same symptoms
  • Avoid constipation

Any type of cocoa is not tolerated by any patient.

  • Milk and dairy products should be skimmed/low fat. There are not enough low-fat cheeses, hence their consumption is not recommended.
  • Meat and meat products: all visible fat must be removed
  • Lamb meat almost always has fat that’s not visible
  • Pork meat fat usually has invisible fat
  • Cured meats are high in fat, so they are fully advised against
  • Low-fat cooked ham exists, but you must wait for the  symptoms to disappear before consuming it.
  • Non-fat meats (with 8-10% invisible fat):
    • Veal
    • Chicken
    • Turkey
    • Horse
    • Rabbit
    • Perhaps Ox
  • Fish
    • White fish (1-2% fat) is tolerable.
    • Blue fish or fatty fish (10-12% fat) is strongly discouraged.
    • Shellfish is low in fat (a maximum of 5% fat), yet it is discouraged.
  • Eggs (6% fat): Fat is only in the yolk and its consumption is strongly discouraged because it produces a continuous contraction of the gallbladder.
  • Group of fatty foods
    • Crude oil is much better tolerated than frying oil. You must distribute the intake of crude oil throughout the day.
    • Vegetable margarines are tolerated better than butter, but are not recommended.
    • All visible animal fat should be eliminated.
    • Fatty nuts (50% fat) are discouraged.
  • Cooking methods
    • With little incorporated low fat
    • without frying
    • Do not heat fat above 100 °C
    • Crude, boiled, grilled, steamed, in papillote (wrapped in greaseproof paper or aluminum foil)

When you have been free of symptoms for a few weeks, you can have a food or use a cooking method you were used to before the problem and that you miss. It may be tolerated, but it must be done gradually and cautiously.

  1. Liquid Biliary Diet
    • Skimmed milk
    • Natural Fruit juice
    • Defatted vegetable or meat bouillon
  1. Semi-liquid Biliary Diet
    • Skimmed yogurt
    • Fruit puree, boiled apple
    • Semolina with non-fat broth
    • Mashed potatoes with skim milk (and perhaps vegetable margarine)
    • Commercial mashed meat or fish products of the baby food series
    • Puddings made with skim milk: you must be sure of its origin before ingesting.
  2. Soft Biliary Diet
    • Only boiled foods
    • No raw or grilled foods
    • Skimmed milk and yogurts
    • Boiled meat: chicken, veal (meatballs or similar)
    • Chicken
    • Veal as meatballs or similar
    • Cooked ham with no visible fat
    • Boiled hake or monkfish (whitefish)
    • No flatulent vegetables: boiled, mashed or not. Chard and tender beans
    • Boiled fruits, fruits in syrup (drained) not for the first day, quince
    • White bread, sliced bread, bread with soft crust
    • Infusions: non stimulant (no coffee, malt yes)
    • No almond cream because has a high fat concentration
    • Some jam
    • A bit of sugar
  3. Normal Biliary Diet
    • No cocoa
    • No frying
    • Methods of cooking: grilled, boiled, using double-bottomed pans
  4. Diet in simple cholecystectomy

If there are still gallbladder stones, removal of the gallbladder is usually decided. You must then follow a diet with the following characteristics, starting after surgery:

  1. Start liquids intake 24 hours after surgery.
  2. If tolerated, after 48 hours start semi-liquid, low fat biliary diet (½ portion).
  3. After 72 hours, soft biliary diet (½ portion).
  4. Continued diet: soft biliary diet.

If tolerance has been good, continue with an easily digestible diet in moderate amounts. Continue the biliary diet for 6-9 months.

Cholecystectomy

Cholecystectomy (not simple) refers to when, in addition to removing the gallbladder, the common bile duct is also opened on suspicions of finding stones in it. The sphincter of Oddi is also opened to keep it always open.

A slower progression diet should be followed in the case of simple cholecystectomy.

IMPORTANT NOTE:

DRINK DIALYTIC WATER EVERY DAY

Therapeutic diets should be personal and depend on your medical condition and specific food culture.  The specification of food (specific menus) right for you may not be right for someone else and therefore the information we provide is generic.

Please note that this information is not intended to replace any treatment or to induce self-prescription.  Always ask your doctor or specialist who knows the status of your health best, and must prescribe the diet right for you.