Cholelithiasis 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 short material.
Definition and stages of the disease
What is gallstone disease? This is a metabolic disease in which stones form in the gallbladder and liver ducts. 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, which are substances that dissolve gallstones.
- The second stage is defined asstone carrier, 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 that gradually fill the gallbladder and its ducts.
- The third stage is exactly that calculous cholecystitis that makes a person go to the doctor. In order to dissolve gallstones at this stage without surgery, it is necessary to adhere to a whole scheme of medical recommendations. Only a specialist can give them.
Disease symptoms
The first two stages of gallstone disease are asymptomatic. Clinical manifestations occur when:
- Inflammation of the gallbladder and its ducts.
- Clogging, congestion.
- Filling the organ completely with stones and violating its function of deposition.
The most characteristic symptom of the disease is colic. It is characterized by severe pain in the right hypochondrium or in the center under the ribs. The pain may radiate to the left hypochondrium, lower abdomen, back, right shoulder blade or the area between them. The pain can go on for hours. In addition to painful sensations, there are various vegetative 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 restless, the pain does not allow sleep.
When body temperature rises, acute cholecystitis or cholangitis is suspected. Yellowness of the skin, sclera, indicates that the stoneobstructs the outflow of bile.
Disease diagnosis
Whether it is possible to dissolve gallstones in the gallbladder by various methods depends on what stones formed in the bladder and ducts.
Stones are of the following types:
- Cholesterol, containing up to 75% cholesterol, as well as pigments, lime s alts, proteins and mucins. Meet most often (from 70 to 90% of all cases). They are found in the gallbladder and much less frequently in the ducts.
- Brown pigment stones contain up to 30% cholesterol, as well as calcium bilirubinate. Appear in the common bile duct after surgery, rarely in the bladder itself.
- Black pigment contains black pigment, mucin and proteins. Occur mainly in the gallbladder, extremely rare in the common duct.
- Mixed complex stones contain less cholesterol, as well as lime s alts, proteins, mucin and pigment substances. Occurs in about 20% of cases.
Dissolve gallstones without surgery if they are cholesterol. These stones are not visible on x-rays. The main diagnostic method is ultrasound. Stones and their shadows are visualized, as well as a thickened wall of the gallbladder.
On plain radiographic images of the abdominal cavity, stones are seen much less often if they contain lime s alts, radio-positive formations.
Fibrogastroduodenoscopy is performed to examine the exit site of the common bileduodenal duct to detect stone blockage.
In a biochemical blood test, the amount of cholesterol and the lipid spectrum are studied, as well as the functioning of the liver based on bilirubin and enzyme substances.
Complete blood count diagnoses the presence or absence of an active inflammatory process by the number of leukocytes and erythrocyte sedimentation rate.
Diet for gallstone disease
At any stage, medical nutrition should be aimed at lowering cholesterol levels, 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.
Food should be taken fractionally - from four to six times a day, distributing food evenly over the hours so that there is no stagnation of bile in the bladder. Portions should be small, gluttony is prohibited, as it will cause spasm of the bile ducts and painful sensations of varying intensity.
Diet 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 taken into account. This applies to dairy products, which must be bought with a low percentage of fat. Meat should be low-fat varieties (chicken, turkey, rabbit, beef). Fish river or low-fat (bream, perch, cod, pike perch, hake). Meat and fish should be steamed orcook.
Eating about 100 grams of raw vegetables or fruits three to four times a day is helpful. You need to eat them before the main meal. Apples and pears, as well as juices from them, help dissolve gallstones well, which has earned the love of many nutritionists. For the same purposes, carrots, sauerkraut, celery will be used. Food rich in fiber 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. Bran brewed with boiling water and added to the main dish helps to dissolve gallstones and improve bowel function.
Half the fats should be plant-based. Vegetable oils (sunflower, linseed, olive, corn and soybean) help lower cholesterol, enrich the body with tocopherol, dilute bile with the help of prostaglandins in their composition.
Neutral and alkaline bile contributes to 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 sour-milk 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, it is 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 medical methods under certain conditions:
- The gallbladder contains only cholesterol calculi, which are visible on ultrasound and absent on radiographs.
- Size - no more than two centimeters in size.
- The gallbladder functions correctly and fully, accumulating bile.
- Stones in the body occupy no more than half of its volume.
- The duct leaving the gallbladder must be passable.
- There are no stones in the common duct.
- The term for the appearance of stones is less than three years, since later they accumulate a large amount of mineral s alts that are difficult to dissolve.
Contraindications for drug dissolution of stones
Know conditions that prohibit lysis medication and which gallstones can be dissolved with medication.
Contraindications are:
- Acute inflammatory reaction in the gallbladder wall and ducts.
- Large stones over two centimeters in diameter.
- Pathology of the liver of any etiology.
- Diabetes mellitus.
- Chronic pancreatitis.
- Peptic ulcer of the stomach and duodenum.
- Exacerbation of chronic pathology of all parts of the intestine.
- Calcium carbonate stones seen on x-rays.
- Disabled gallbladder with no signs of functioning.
- Pregnancy andbreastfeeding.
What drugs dissolve gallstones
For medical lysis, preparations of bile acids - chenodeoxycholic and ursodeoxycholic, are used, which compensate for the lack of these substances in patients prone to stone formation. When using these drugs, the absorption of cholesterol from food and its synthesis in the liver is inhibited, which leads to its decrease in bile. Without cholesterol, which is the basis of the stone, its formation becomes difficult. In addition, with cholesterol stones and crystals already present in the bladder, fatty acids create liquid compounds that dissolve bile conglomerates.
The drug of chenodeoxycholic acid is "Chenofalk", produced in capsules by the German company Doctor Falk Pharma GmbH. A medication is prescribed before going to bed every evening, since cholesterol stones form at night with prolonged stagnation of bile (since a person does not eat at night).
Dose depends on the weight of the person at the rate of 15 mg per kilogram. Overweight people should be aware that the maximum dose is 1500 mg per day.
It is necessary to take the drug for a long time. Six months later, a follow-up ultrasound examination is performed, which evaluates the result of therapy. In the absence of positive dynamics, the medication is stopped. The maximum period for taking "Chenofalk" is considered to be three years. There is a method of taking the drug for the prevention of subsequent stone formation in personsprone to this pathology, provided that the previous stones are completely dissolved. Reception is carried out within a month with breaks of 60 days.
Henofalk's tolerance is good. You should be afraid of allergic reactions in the form of itching and rash. With long-term multi-month intake, it is necessary to monitor liver parameters (ALAT and ASAT), and if they increase, reduce the dosage.
Pain in the abdomen can occur when moving stones. Loose stools are possible at high doses due to increased fat in the stool.
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 control of ultrasound. Cancel "Ursofalk" in the absence of dynamics within a year and a half.
There is a technique for combining "Chenofalk" and "Ursofalk" with taking half dosages at night. This treatment is more effective and leads to the dissolution of stones in 70% of cases, in contrast to monotherapy, where success accompanies only half of the patients.
Clarify all contraindications before dissolving gallstones with acid preparations. In addition, one must remember that their conventional medicines cannot.
Herbs that dissolve gallstones
The use of herbal medicine to dissolve stones should be carried out only afterpermission from the attending physician. So, the remedies that dissolve gallstones are found in the following herbs.
Use milk thistle, peppermint, tansy, rose hips, beetroot decoction, lingonberry leaves, lavender flowers, mountain thyme. They are used in the form of tablets, infusions, teas. Remember that each remedy has its own list of contraindications.
It is possible to dissolve gallstones in the gallbladder with folk remedies, including herbal medicine, with their very small diameter and cholesterol composition. The use of herbs during an acute inflammation process is contraindicated.
Non-drug treatments
How can you dissolve stones in the gallbladder without resorting to surgical treatment, you should find out after consulting with a gastroenterologist and surgeon.
The method of shock wave cholelithotripsy allows crushing large stones (up to 3 cm) into small fragments. Stones must be cholesterol. The gallbladder must perform its function. The method will be especially effective if you start using fatty acid preparations two weeks before it. Stone fragmentation is successful in 95% of cases.
The percutaneous transhepatic cholelitholysis technique is an invasive procedure performed under local or general anesthesia. It consists in introducing a thin probe into the gallbladder through the skin and liver tissue and infusing a solution through this probe to dissolve stones. This dissolves up to 95% of the stones.
Prevention
Prevention measures are aimed at preventingthe formation of primary stones and new stones after therapy with the above-described means.
Prevention measures include:
- Proper nutrition in compliance with all of the above activities.
- 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.
- Chronic care.
We discussed how to dissolve gallstones. With competent treatment, the outcome is favorable.
