The job of the gallbladder is to store the bile produced by the liver and to release it on an as-needed basis for digestive purposes. However, it isn't easy to keep this complex mixture of chemicals in liquid form. The various elements of bile have a natural tendency to form sludge, lumps, and hard deposits called gallstones. The body uses several biochemical methods to prevent such condensation from occurring, but this natural chemistry does not always succeed. More than 20% of women and 8% of men develop gallstones at some time in their lives.
You could have gallstones in your body for many years without experiencing any problems. However, sooner or later, a gallstone will likely plug the duct that leads out of the gallbladder, causing pain.
Generally, gallbladder pain starts in the form of occasional minor attacks that subside rapidly, separated by weeks without discomfort. During this phase, the stones block the duct temporarily and then move out of the way. Eventually, continuous obstruction may develop, causing the gallbladder to become inflamed and perhaps infected. This condition is called cholecystitis. Cholecystitis is a potentially life threatening situation because an inflamed, blocked gallbladder can rupture. Another risk is that a stone may escape the gallbladder's own duct and move along to the duct that carries away secretions from both the liver and the gallbladder (the common bile duct). When this happens, the liver cannot unload the bile it produces, putting it at risk of permanent injury and creating a true surgical emergency.
The most reliable symptom of cholecystitis is intense pain beneath the right lower rib cage, often occurring from midnight to 3 AM. Typically, pain radiates to the right shoulder and is accompanied by a loss of appetite and sometimes nausea. Removal of the gallbladder immediately solves the problem. Gallbladder surgery can usually be carried out laparoscopically, resulting in a quick and easy procedure that requires little recovery time needed.
Living without a gallbladder does not seem to bring any long-term consequences. However, many people are opposed on general principle to removing an organ that nature has placed there. Medications that dissolve gallstones may be another option.
The only time it is appropriate to use alternative treatments for gallstones is during the interval before cholecystitis develops. Once the gallbladder has become completely blocked, surgical treatment is urgent.
However, during the initial period in which pain is only occasional or intermittent, the risks incurred by postponing surgery are slight. If your doctor feels that a trial of stone-dissolving medications might be appropriate, some of the agents described here could present alternate possibilities. Unfortunately, none are well established as effective. Medical supervision is definitely essential.
Preliminary clinical trials suggest that formulas containing
peppermint and related terpenes (fragrant substances found in plants) can dissolve gallstones.1
milk thistle, standardized to its silymarin content, has been shown to improve the liquidity of bile,2
although its actual effects on gallstones in real life are unknown.
Several herbs are prescribed in Germany for gallbladder pain, including
root, fumitory, greater celandine, and
These herbs are thought to work by causing the gallbladder to contract and thereby expel its stones. However, such an effect is a mixed blessing: expelled stones might become lodged in the duct of the gallbladder, or, worse, the common bile duct. Furthermore, if the duct is already blocked, gallbladder contraction will lead to increased pain and perhaps rupture. Finally, some of these herbs are potentially toxic to the liver. The bottom line: consult a qualified physician before trying these treatments.
There is some evidence that regular coffee drinking can reduce the risk of developing gallstones, at least in men aged 40 to 75. In an
observational study that tracked about 46,000 male physicians for a period of 10 years, those who drank 2 to 3 cups of caffeinated coffee daily had a 40% reduced risk of developing gallstone disease.4
Those who drank more coffee had an even greater reduction of risk.
It may be the caffeine in coffee that helps, as other sources of caffeine were also associated with reduced risk of gallstones, while decaffeinated coffee didn't seem to help. Caffeine is known to increase the flow of bile, so this connection makes sense. However, it is also possible that people who drink more coffee have other unknown characteristics that make them more likely to have gallstones, and that caffeine itself is an innocent bystander. Observational studies, in other words, do not show cause and effect.
Similarly weak evidence suggests that regular use of
vitamin C supplements might help prevent gallstones in women.5
Somerville KW, Ellis WR, Whitten BH, et al. Stones in the common bile duct: experience with medical dissolution therapy.
Postgrad Med J. 1985;61:313-316.
Nassuato G, Iemmolo RM, Strazzabosco M, et al. Effect of silibinin on biliary lipid composition: experimental and clinical study.
J Hepatol. 1991;12:290-295.
Schulz V, Hansel R, Tyler VE.
Rational Phytotherapy: A Physicians’ Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:173-177.
Leitzmann MF, Willett WC, Rimm EB, et al. A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men.
Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among US adults.
Arch Intern Med.
Last reviewed December 2015 by EBSCO CAM Review Board
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