Dissolving gallstones without surgery. How to get rid of gallstones without surgery? Small gallstone treatment

201

Gallbladder 05/11/2013

Dear readers, today we will talk about whether it is possible to treat stones in gallbladder without surgery and get rid of them. Probably, when people are faced with this problem, the first question that arises is precisely this: “How to avoid surgery to remove the gallbladder, is it possible to do something”? I give the floor to doctor Evgeniy Snegir, who runs this column.

When is the diagnosis made? cholelithiasis and the surgeon insists on performing laparoscopic cholecystectomy , then all patients always have the same question in their heads: is it possible? Treatment of gallstones without surgery? We will try to answer this question reasonably.

At the beginning of the conversation, we will pay attention to theoretical concepts.

So, briefly. The gallbladder is a reservoir for collecting bile produced in the liver. Bile is necessary for digestion; it helps to emulsify food fats in order to make their absorption process convenient. If there are disturbances in the chemical composition of bile, it increases lithogenicity– ability to form stones. Bile salts begin to precipitate and gallstones form.

Types of gallstones.

According to their chemical composition, due to the predominance of one or another component, stones can be cholesterol, bilirubin, calcareous and mixed. For the common man without medical education this information, without much detail, is quite sufficient to understand mechanism of formation of gallstones .

A radical way to help a person once and for all is to remove the altered gallbladder with stones, i.e. execute cholecystectomy , which we have already discussed in detail in the article. If the operation is not performed and the gallbladder is left in place, then in this case the stones themselves will have to be removed from the gallbladder in some way. This is also quite understandable. In this case, the stones must either be dissolved completely or crushed into fine particles so that they can get from the gallbladder through the bile ducts into the duodenum and then in a natural way with feces leave the body. This is the situation.

Dissolution of gallstones.

Let's focus on the first method treatment of cholelithiasis without surgery - dissolution of stones . To begin with, let us immediately note that using medicines Only cholesterol stones will dissolve. If they contain calcium ions, and the majority of such options exist, then it will no longer be possible to dissolve the stones.

How to determine the composition of gallstones?

The following methods will help us in this matter.

The simplest is x-ray ( oral cholecystography ). Take a radiocontrast drug and take an x-ray. Cholesterol stones are X-ray negative – we won’t see them in the image. But all stones, regardless of their composition, are clearly visible. Those. if the doctor sees stones during an ultrasound, but x-ray If there are no stones, then we can safely conclude that the gallstones are cholesterol.
A more unpleasant method for the patient is duodenal intubation (probing of the duodenum in order to obtain different types bile). The patient swallows a special probe with olive. The end of the probe will be located in the duodenum, and the bile we collect will flow through the probe. The method allows you to accurately determine the chemical composition of bile from the bladder and draw a conclusion about the nature of the stones formed.

So, if we understand that our stones are exclusively cholesterol, their size is not very large, and the duration of the disease is short, then theoretically we can try to dissolve them - take medications for this. The most effective is ursodeoxycholic acid (a drug Ursosan) and chenodeoxycholic acid (drug Henofalk ).

But there is one very important circumstance here. Even if these medications help and it is possible to dissolve the stones, no one can guarantee that these stones will not form again. And in Once again You will need to take medications and try to dissolve the newly formed stones. Considering the rather high cost of drugs and the lack of a guaranteed recovery, it is very doubtful to recommend this method as the main one in the treatment of cholelithiasis.

A variation of this method is percutaneous transhepatic cholelitholysis , when a stone-dissolving drug is injected directly into the bladder itself through a catheter inserted through the skin and liver tissue. The method allows you to dissolve not only cholesterol stones, but also all other types of stones. But again, no one can guarantee that stones will not form again. So what, now you have to constantly “clean the bubble”? Let me note to my dear readers that the gallbladder is not the interior of a car, “mine, I don’t want it,” everything is more complicated in the body.

Well, dissolving stones is not a rewarding idea, then maybe try to crush them? They crush kidney stones and it actually helps? Of course, we will consider this method.

Crushing stones in the gall bladder.

Invented for crushing gallstones extracorporeal shock wave lithotripsy . The essence of the method is to generate shock waves in the lumen of the gallbladder and focus them on the stones, due to which crushing is achieved - dividing the stones into small fragments measuring 4-8 mm.

If, after crushing kidney stones, small fragments can leave the body on their own through urinary tract, then in the case of the biliary tract everything is much more complicated. Diameter bile ducts narrow, at the place where the common bile duct flows into the duodenum there is a special valve, which can be a serious obstacle to the passage of stones. Therefore, after crushing gallstones, their small fragments still have to be dissolved.

In addition, the method also has its contraindications - it is not used for pronounced violations blood clotting, acute inflammation gallbladder (acute cholecystitis), with heart rhythm disturbances. It will not help with calcified and bilirubin stones if there are a lot of stones and their size is more than 3 cm.

Moreover, this method is dangerous for the development of complications. No one can guarantee that perforation (rupture) of the altered wall of the gallbladder with fragments of stones or blockage of the lumen of the bile ducts with small fragments will not occur with the development of obstructive jaundice. Again, where is the guarantee that stones will not form again later? And once again you will have to go “split up” and expect possible complications and horrors.

Thus, we understand again: of course, you can take risks, but no one will give any guarantees.

From here we come to a logical conclusion. The most in a reliable way is operative - simply remove the altered gallbladder with stones, go through rehabilitation period and forget about this problem. That is why, when stones are detected in the gall bladder, surgeons advise removing the gall bladder in a way that is gentle on the body - performing a laparoscopic cholecystectomy.

201 comments

Answer

Elena
26 Mar 2018 at 20:26

Answer

Basil
18 Mar 2018 at 23:31

Answer

Nastya
18 Mar 2018 at 10:03

Gallstones treatment without surgery

What are gallstones?

Gallstones are tiny stones (hard pieces of matter) found in the gallbladder, which is a small "bag"-shaped organ that plays main role in the storage of bile produced by the liver. Gallstones (cholelithiasis) consist of particles of cholesterol, calcium deposits and other substances that are found in bile. They can vary in size, shape, composition, density and severity of symptoms, but for the most part they are all caused by the same things and are treated in much the same way.

They are formed when cholesterol, calcium and other particles bind together and enter the gallbladder, causing pain and other problems such as indigestion and back pain. Normally the gallbladder only stores liquid material, so when hard stones accumulate, it can become severe and noticeable in terms of symptoms.

Gallstones can vary in size from small and softer ones (almost like sand or sediment) to very large and dense stones that expand to almost the full size of the gallbladder. Compared to kidney stones, gallstones are usually softer because they are made primarily of cholesterol, which is not hard.

Who is most at risk for developing gallstones?

Several factors may make people more susceptible to developing gallstones, including their diet, age, gender, body composition and genetics ().

Gallstones are most common in the following populations:

women
people over 40 years old
people who are overweight or obese (especially if they have excess fat around the waist)

Other risk factors for gallstones include:

poor nutrition
too much rapid decline body weight (for example, during fasting)
pregnancy
diabetes
heredity
high level (a type of fat in the blood)
lack of physical activity
short HDL level"good" cholesterol

Why is this happening? It has been shown that gallstones are influenced by hormonal imbalances. This is the reason why women who are pregnant or taking birth control pills are more likely to experience gallstones than the general population. It is currently believed that women reproductive age, especially those aged 20 to 60 years, are the group most at risk development of gallstone disease. According to National Foundation of Diabetes, Digestive and Kidney Diseases, the female sex hormone estrogen may be the reason why gallstones are more common in women than in men.

Estrogen can increase the amount of cholesterol in bile and possibly also decrease gallbladder movement, which promotes the formation of gallstones. This is one of the reasons why preventive diet gallstones may be beneficial - it reduces the likelihood of "estrogen dominance" or excess estrogen. High estrogen levels are more common today due to the growing presence of endocrine disruptors. They are found in chemical cosmetics or cleaning products, certain water sources, and chemicals added to factory products. food products. These chemicals “mimic” the effects of true estrogen, bind to receptor sites and promote excess estrogen, which can cause fat cells to become resistant to normal breakdown.

Some medications you take contain estrogen. These include birth control pills and hormone replacement therapy, so they may increase the risk of gallstones. Taking medications that lower blood cholesterol levels can also lead to the formation of gallstones because they cause the liver to release more cholesterol into bile. It can affect everything from mood and metabolism to sleep and sexual functioning.

Causes of gallstone formation

The gallbladder itself is usually described as a soft, bag-like organ. It has the ability to expand when bile accumulates in it, which can happen when a person has not eaten for a long time, for example, if they are hungry, sick, or severely restrict themselves in food during a diet. Bile is a digestive fluid produced by the liver. It contains bile salts and other substances that help break down fats from food.

The size of the gallbladder varies among different people depending on your eating patterns and diet, but usually it ranges somewhere between the size of a small plum and a large apple. The gallbladder is attached to the liver and rests on small intestine, which is important for its proper operation. The gallbladder has the ability to drain and store bile by transporting it through a tube called the cystic duct.

To visualize how gallstones form, some experts recommend depicting the digestive organs as a “biliary tree” (). The purpose of the biliary tree is to move secretions from one organ to another, which helps with digestion, absorption nutrients and removing waste from the body. Secretions move from the liver, gallbladder and pancreas to the small intestine. Their job is to get rid of body waste in the form of bile, which the liver produces to collect waste particles and carry them to the small intestine before they are eliminated through bowel movements.

The body typically stores waste, such as bile, until it is needed, rather than continually dumping excess waste into the small intestine and wasting it. Our bodies retain these important fluids so that we can use them effectively when we eat food and must perform digestion. We have an important valve-like muscle that is our “bile duct,” the controller where bile is released in response to food intake. When we haven't eaten anything and there is no food in the small intestine, the bile duct valve is closed. Then when we eat, the valve opens so enzymes, secretions and bile can do their work.

The trick is that the liver and pancreas do not stop producing bile or other digestive substances. They have no way of knowing when we'll eat next, and no system feedback to shut down production, so they're basically always storing excess bile, whether it's needed at a certain time or not. The liver continues to produce bile, which reaches the bile duct valve, but the valve remains closed until we eat anything, so the bile has no choice but to remain in the gallbladder.

This is why the gallbladder is so important - it acts as a storehouse for excess bile, which is used when needed to aid digestion. When you eat something, the gallbladder contracts and squeezes out enough bile to keep the system running smoothly.

So, what disrupts this process and leads to gallstone disease?

When cholesterol and other substances in bile bind together and become harder, they can settle inside the gallbladder, eventually becoming cholesterol gallstones. The exact reason why gallstones form is not agreed upon by most doctors or researchers. One leading theory is that they can form when your bile contains too much cholesterol, which can be caused by a poor diet or hormonal imbalance.

Typically, bile contains the enzymes needed to properly dissolve the cholesterol released by your liver, but in some cases, the liver may secrete more cholesterol than it can dissolve, causing it to clump into solid particles. Other reasons why gallstones can form is because the bile duct valve stops working properly or because the liver begins to produce too much bilirubin (forming “pigmented gallstones”), which are chemical, used to destroy red blood cells ().

Symptoms of gallstones

It is believed that most people with gallstones do not even know they have them. Symptoms of gallstones can vary from person to person and can vary in intensity and duration. Some people with gallstones have no pain or noticeable symptoms at all, while others experience severe pain and other symptoms. Attacks of cholelithiasis often occur at night. Some people find out about their problem for the first time during computed tomography prescribed to identify another problem, and gallstones are discovered by doctors at random.

Symptoms may also vary depending on where the stone is located. Gallstones always form inside the gallbladder, but sometimes they can become dislodged and moved to different locations, such as the bile duct or even inside the small intestine.

When a stone forms in the area of the drainage tube that connects the gallbladder to the bile duct, bile can become blocked and pain can occur as the gallbladder contracts and there is nowhere for the bile to escape. As a result of this excess pressure, the normally soft gallbladder can become tense and hard. Gallstones that cause blockages can also cause inflammation of the liver or pancreas. This is another cause of pain and swelling in the abdomen, sometimes up to the back or shoulders.

In addition to pain, a person with gallstone disease may experience the following symptoms:

stomach pain and nausea
tension in the stomach, intestines and other organs, especially after meals (including those high in fat and protein)
severe pain in the upper right abdomen, usually occurring suddenly and lasting from 30 minutes to many hours
pain under the right shoulder or inside the back under the right shoulder blade

While most gallstones do not cause serious problems, in some cases they require surgical intervention. If they cause unbearable pain and problems, your doctor may recommend removing the entire gallbladder. If you suspect you have gallstones, you can talk to your doctor, who will likely order an ultrasound or x-ray. Ultrasonography counts the best method to detect them, since CT is not always able to show the presence of stones due to the fact that they may not be dense enough.

People experiencing persistent symptoms gallstones (such as severe pain), an operation called cholecystectomy may be performed to remove the stones. But this does not guarantee that they will not form again. Doctors typically wait an average of several months to recommend noninvasive surgery or medical therapy ().

How to Treat Gallstones Naturally

Nutrition and natural medicine experts recommend doing everything you can to treat gallstones without surgery and prevent stone formation with natural remedies.

1. Maintain normal body weight

If you are thinking about how to get rid of gallstones without surgery, you first need to normalize your weight. Overweight or obesity may increase the risk of gallstones (especially among overweight women), since studies show that in obese people the liver may produce too much cholesterol (). Research shows that people who do not maintain a healthy weight may experience more inflammation and swelling in the gallbladder, especially if they have a large amount of fat around the waist, which also suggests visceral fat around organs.

The healthiest thing for your body (in general) is to maintain your weight at a normal level. The constant alternation of gaining extra pounds and losing weight has negative impact on your hormones, digestion, immune system and metabolism. This is thought to increase the risk of gallstones, so if you think you need to lose weight for health reasons, do it the right way by improving your diet on an ongoing basis, increasing your exercise (especially if you are sedentary) , without using strict low-calorie diets.

2. Avoid rapid weight loss and fad diets

Obesity appears to be a greater risk factor for gallstone disease than weight loss, but rapid weight loss can cause electrolyte imbalances and other problems that increase the likelihood of gallstones. Research suggests that people who lose more than 1.5 kg per week may be at increased risk of developing gallstones compared to those who lose weight more slowly and more naturally ().

This also applies to people who have had weight loss surgery and people on a very low-calorie diet. Most experts recommend losing between 250 and 900 grams of weight per week, which is slow and steady improvement that won't lead to gallstones.

3. Follow an anti-inflammatory diet that supports liver and gallbladder health

To regulate your body's use of cholesterol, consume more anti-inflammatory foods, which have many health benefits in addition to reducing your risk of developing gallstones. An anti-inflammatory diet also reduces your intake of estrogen-rich foods, which can contribute to an increase in this hormone in the body.

To cleanse your liver, avoid eating the following foods:

hydrogenated oils (corn, sunflower, safflower)
refined sugar
semi-finished products
excess alcohol
animal products or dairy products derived from animals raised on modern large farms (they are difficult to digest and often pro-inflammatory)

Focus on incorporating new, fresher foods and vegetable juices, organic animal products, and potassium-rich foods such as, leafy greens, tomatoes, and .

4. Be physically active

People who are more physically active tend to have better protection from the formation of gallstones (). You probably already know about the many benefits physical exercise– regular physical activity not only improves your overall health, but may also be beneficial for maintaining healthy weight without the need to drastically cut calories, and can also improve digestive function.

A general recommendation for most adults who are able to be active is to aim for 30 to 60 minutes of moderate-intensity exercise each day, or a little less. If you also do high-intensity workouts, such as high-intensity interval training or explosive training, they will have the same effect. beneficial effect on the body, but in a shorter time.

5. Reconsider taking birth control pills or unnecessary medications

Birth control pills and some hormonal medications increase the amount of estrogen in the body, which affects the production and storage of cholesterol (in addition to body weight in some cases). In a study published in the journal Canadian Medical Association Journal, researchers found a "statistically significant increase in the risk of developing gallstones" in women using birth control hormonal agents ().

If you have gallstones or if anyone in your family has/has gallstones, talk to your doctor about other non-hormonal options for your medications.

Helpful Supplements for Gallstones

Several additives and natural herbs may help improve liver health and reduce inflammation, which are important for regulating the production and use of cholesterol. These include:

. Helps with digestion, fights inflammation and supports liver metabolism.
Milk thistle. Eliminates the accumulation of medications, heavy metals and others harmful substances in the liver.
Dandelion root. Helps the liver remove toxins by acting as a natural diuretic.
Activated carbon. Binds to toxins and helps remove them from the body.
Lipase (enzyme). 2 capsules with meals help improve fat digestion and bile utilization.
Bile salts or bile. 500-1000 milligrams with meals can improve gallbladder function and fat breakdown.

Means for cleansing the gallbladder from stones without surgery

Treatment of gallstones without surgery is also possible using the following remedies, but their effectiveness has not been scientifically proven.

1. Olive oil and lemon juice

Some people claim that cleaning the gallbladder can help break down and remove gallstones (). However, there is no scientific evidence to support these claims. The body is able to cleanse itself.

However, some people use a combination of olive oil, lemon juice and herbs for two or more days to cleanse their gallbladder. During this time they should not consume anything other than oil mixture. There is no standard mixture or recipe. This mixture may be dangerous for people with diabetes or those experiencing low blood sugar.

One study looked at the effects of olive oil and sunflower oil on gallstones. The researchers found that although olive oil affects the composition of bile, it does not affect gallstones ().

Talk to your doctor before starting any type of gallbladder cleanse at home. It may not be safe for all people.

2. Apple juice

Some people use apple juice to remove gallstones without surgery. They believe it can soften and remove gallstones from the gallbladder. This claim was made public by a letter published in 1999 detailing the anecdotal story of a woman who successfully cleared gallstones using apple juice(). However, there is no scientific research to support this claim.

Drinking large amounts of fruit juice may be harmful to the body if you have diabetes, hypoglycemia, stomach ulcers, or other diseases.

3. Apple cider vinegar

Natural Apple vinegar is a popular health product that is often included in cleanses to treat gallstones without surgery. Although apple cider vinegar may have positive influence on blood sugar levels, there are no studies supporting its use for the treatment of cholelithiasis (). There is little evidence that cleanses are necessary or effective.

4. Yoga

There are some claims that yoga can help you clear gallstones naturally. One study found that yoga improves lipid profile in people with diabetes (). In another study, researchers studied people with cholesterol gallstones and found that people with these types of gallstones were more likely to have abnormal lipid profiles (). However, researchers were unable to find a link between these abnormal levels and the presence of gallstones.

Although yoga can help relieve some of the symptoms associated with gallstones, there is no scientific evidence to support the effectiveness of yoga in treating gallstones.

5. Milk thistle

Milk thistle ( Silybum marianum) can help treat liver and gallbladder diseases (). It is believed to stimulate both organs, but researchers have not specifically looked at the benefits of milk thistle for treating gallstones.

Milk thistle is available in tablet form as food additives. Talk to your doctor before using milk thistle, especially if you have diabetes. Milk thistle may lower blood sugar levels in people with type 2 diabetes. Some people may also be allergic to milk thistle ().

6. Artichoke

Artichoke has been found to be beneficial for gallbladder function (). It helps stimulate bile and is also good for the liver. No studies have been conducted on the effect of artichoke on the treatment of gallstones without surgery.

The artichoke can be steamed, marinated or grilled. If you can tolerate artichokes, there is no harm in eating them. Artichoke in pill form or sold as a supplement should only be taken after you have talked to your doctor about it.

7. Loosestrife

Loosestrife is used in traditional Chinese medicine for the treatment of cholelithiasis (). Reception medicines on its basis has been associated with a decrease in the formation of gallstones. Some people recommend taking loosestrife before starting a gallbladder cleanse to help loosen the stones.

You can purchase loosestrife in powder or liquid form. These supplements can be found in stores natural products or other places where dietary supplements are sold.

8. Castor oil

Castor oil lotions are another folk remedy for treating gallstone disease without surgery. Some people choose to use this method instead of a gallbladder cleanse. Warm fabric is dipped into Castor oil, and then placed on the stomach in the area of the gallbladder. Lotions are intended to relieve pain and treat gallstone disease. There is no scientific research to support claims that this treatment is effective.

9. Acupuncture

Some people, wondering how to remove gallstones without surgery, resort to alternative medicine such as acupuncture.

Acupuncture (acupuncture) can help relieve pain from gallstones by reducing spasms, reducing bile flow, and restoring proper gallbladder function. Acupuncture has been reported to be able to treat gallstone disease, but more research is needed.

One small study was conducted to examine the effects of acupuncture on cholecystitis (inflammation of the gallbladder) in 60 participants. Acupuncture has been found to relieve symptoms and reduce gallbladder volume ().

More research needs to be done to specifically look at the benefits of acupuncture for treating gallstones without surgery.

Acupuncture is relatively safe. When choosing an acupuncturist, look for a licensed, experienced professional and make sure they use new, disposable needles.

Treatment of gallstones without surgery can be carried out only after consultation with a doctor, since in the presence of complications of gallstone disease, self-medication can lead to unforeseen consequences.

Most radical method Cholecystectomy is considered to be the cure for gallstone disease. This is an operation during which the entire gallbladder is removed. But it is not necessary to immediately agree to surgical intervention; in some cases, conservative therapy gives good results. Therefore, treating gallstones without surgery is quite possible.

Symptoms

Eating high-calorie foods rich in cholesterol low activity, diseases in which the flow of bile is disrupted, and hormonal changes in women (including pregnancy) often cause stones to appear in the gallbladder. These are dense formations that consist of bile acids, minerals and cholesterol.

Stagnation of fluid in this organ, combined with an excess of cholesterol, initially leads to the formation of sand. These are already microscopic stones in the gall bladder. The symptoms (treatment without surgery, by the way, at this stage will be very effective) inherent in cholelithiasis are not yet expressed. Over time, the grains of sand become larger, unite and form large stones called stones. The process of their formation is very long - it can last up to 20 years.

The progression of gallstone disease may be indicated by sudden attacks pain that occurs after eating fried or fatty foods. They are also observed after shaking in transport. Discomfort begins in the area of the right hypochondrium, pain can radiate to the corresponding half of the neck, shoulder blade, or arm. This colic lasts no more than 6 hours in a row.

Also, a feeling of bitter taste in the mouth, nausea, sometimes accompanied by vomiting, flatulence, stool disorders (there may be either diarrhea or constipation) are signs of the development of gallstone disease. The onset of cholecystitis may be indicated by a low-grade fever, which will remain around 37 o C.

Doctors can tell you what symptoms gallstones cause. Treatment without surgery can only be carried out if the formations in this organ are not yet too large. Their total size should be no more than 2 cm. It is also important that there is no acute cholecystitis and the bubble contracted well (this is necessary for the normal release of sand from it).

Necessary research

In order to establish an accurate diagnosis and determine treatment tactics, it is necessary to examine the patient. The main method is ultrasound of the abdominal cavity. Stones are easily visualized on the monitor screen. The doctor can determine exactly how many such formations are in the bladder and tell you about the size of each of them.

Also, such an examination allows you to evaluate the walls of the organ. If they are thickened, this indicates the onset of cholecystitis. This allows you to determine the most appropriate treatment tactics.

The diagnostic method presented above is not the only one. Despite the availability and informativeness of ultrasonography, in some cases it is necessary to conduct other examinations. If it is difficult to make an accurate diagnosis based on the results of ultrasound, then oral cholecystography may be prescribed. This special examinations bladder, in which bile contrast agents are used. Also in some cases, retrograde cholangiopancreatography is recommended. During this examination, a contrast agent is injected into the bile ducts.

Treatment methods

If stones are detected, it is necessary to discuss further tactics with your doctor. Therapy should be based on several basic principles. Regardless of the chosen treatment path, the patient must adhere to a diet. In addition, all its actions should be aimed at reducing cholesterol concentrations. But how gallstones can be treated must be understood in each case individually.

Depending on the condition, dissolving or crushing the stones may be recommended. These are non-surgical therapies. But the most common (and at the same time effective) method is removal of the gallbladder. It is used for frequently recurring liver colic, inflammation of the walls of the organ, or when too large stones are detected.

Supporters of alternative medicine also have many options for how gallstones can be treated without surgery using folk remedies. But when using them, you need to monitor your health and go to the hospital if it worsens. But these methods can be a good addition to traditional therapy.

Necessary diet

If you are afraid of surgery and want to understand how you can treat gallstones without surgery, then you need to familiarize yourself with the basic principles of nutrition. After all, if you continue to eat as you are used to, you will not be able to get rid of deposits of cholesterol, minerals and bile acids.

First of all, all fatty meats are excluded from the diet. Pork, lamb, broths are not allowed. Lard, sausages, spicy, pickled and smoked foods, eggs (yolk), liver, legumes, pastry, soft bread, chocolate, and ice cream are also prohibited. All foods must be boiled, steamed or baked.

You can eat vegetables and fruits, lean meat (rabbit, veal, beef, turkey, chicken will be healthy), river fish, dairy products low fat content, porridge. No more than 150-200 g of animal food should enter the body during the day. It is also important to avoid alcohol and stimulants. The latter include not only energy drinks, but also strong tea and coffee.

Meals should be fractional. You need to eat a little, but at least 5 times a day. This is the only way to force the gallbladder to contract. By the way, you can stimulate its activity by consuming vegetable oil (olive oil is considered the most optimal).

Conservative therapy

If during the examination it was determined that the patient has cholesterol stones, then drug treatment may be prescribed. It involves the use of chenodeoxycholic and ursodeoxycholic acids. These remedies can be used to treat gallstones without surgery.

It is also recommended to take antispasmodics. They are necessary to improve the patency of the ducts and expand them. Also, these drugs contribute to a more efficient flow of bile into the duodenum. Cholespasmolytics such as Papaverine, Drotaverine, Eufillin, No-shpa, Metacin can be prescribed.

Litholytic therapy is called conservative methods, aimed at dissolving a stone in the gall bladder. Treatment without surgery consists of taking special means. These can be “Chenofalk”, “Ursosan”, ursodeoxycholic acid. The action of these medications is aimed at reducing the concentration of substances in the bile that lead to the formation of stones. There are also contact or chemical methods for dissolving them.

If you are looking for an option on how to get rid of gallstones without surgery, then you should pay attention to extracorporeal lithotripsy. This is a method of crushing stones using increased pressure.

Chenodeoxycholic acid

If surgery is contraindicated for you, then it is important to figure out how to get rid of gallstones without surgery. For example, chenodeoxycholic acid (drugs "Chenofalk", "Chenodiol", "Chenohol", "Chenosan") promotes partial and in some cases complete dissolution of stones. It also reduces the synthesis of cholesterol in the liver and increases its solubility, thereby reducing its amount in bile. But only a doctor can prescribe these drugs if ultrasonography has shown that the size of the stones does not exceed 20 mm and they fill the bladder to no more than ½ of its volume. As a rule, chenodeoxycholic acid is recommended if it is not possible to remove the gallstone by conventional surgical or endoscopic methods.

It is worth knowing that in patients suffering from obesity, the effectiveness of treatment is noticeably reduced. During therapy, the condition of the liver should be monitored in all patients. But for cholecystitis, hepatitis, inflammatory problems with the esophagus, intestines, stomach, gastric and duodenal ulcers, kidney/liver failure, medications specified group not used.

Ursodeoxycholic acid

Also, gallstones can be treated without surgery using other means. They are made on the basis of ursodeoxycholic acid. These are drugs such as Ursohol, Ursofalk, Ursosan, Ursolizin. It is used to reduce the concentration of cholesterol in bile. They drink this remedy, as a rule, once a day, in the evening. The dose is determined individually at the rate of 10 mg/kg of patient weight.

But for liver cirrhosis, inflammatory diseases of the biliary tract and bladder, Crohn's disease, and kidney disorders, the drug is not used. You can drink the product only if the gallbladder is functioning normally, the ducts are passable, the stones occupy no more than half of its volume, and they are cholesterol (this is determined by the absence of a shadow on the x-ray).

It is worth knowing that treating gallstones without surgery with medications is Long procces. It can last from 6 months to 2 years.

Surgeons often say that such treatment is ineffective. Even if the stones dissolve, they will still appear in a few years. This really happens if the patient does not draw conclusions and continues to fill his body with cholesterol. If, after completing a successful course of treatment, you continue to adhere to the diet, then cholelithiasis will not occur.

Contact methods

Doctors are currently testing chemical methods to remove gallstones. They are also called contact. The technique has not yet become widespread and is considered experimental. It can only be used if the patient:

Exclusively cholesterol stones,

The passability of the paths is fully preserved,

The gallbladder functions normally,

There are no inflammatory processes.

This method can be used even if there is a large stone in the gall bladder. Treatment without surgery using a chemical method consists in the fact that the formations are resolved under the influence of a solvent.

A catheter is inserted into the gallbladder through a puncture under the control of X-ray tomography or ultrasound equipment. The solvent is injected into it with a syringe in small portions. It is then sucked out of the bladder along with the dissolved parts of the stones. This procedure can last up to 16 hours.

Impact lithotripsy

You should not immediately go to the operating table if you are diagnosed with gallstones. Symptoms (treatment without surgery, fortunately, is now quite possible) often indicate inflammation of this organ (in this case, surgery cannot be avoided), but if you have been diagnosed with gallstone disease only based on the results of an examination, the doctor may recommend shock wave lithotripsy.

Using this method, all stones are broken into grains of sand under the influence of ultrasound. And when taking appropriate medications and following a diet, fragments are easily removed into the duodenum.

But such therapy can be prescribed only if a number of conditions are met:

Stones should be no more than 2 cm;

The gallbladder has retained at least 75% of its functionality and is shrinking;

There are no signs of cholecystitis.

However, in some cases this method may be ineffective. He gives good results only when fragile stones are processed.

After this procedure, as a rule, medications are prescribed to dissolve cholesterol deposits: ursodeoxycholic or chenodeoxycholic acid.

The effectiveness of folk remedies

Proponents of alternative therapies will tell you how you can treat gallstones at home. But first, it is important to understand that in some cases such methods may not be effective. Moreover, some of them cause the situation to worsen.

So, some recommend taking a potent choleretic folk remedy after a period of complete hunger. It can be magnesia, black radish mixed with olive oil lemon juice and other variations. As a result of fasting, concentrated bile accumulates in the bladder. And after taking a stimulant, it begins to be intensively released. Its flow can pick up small stones and carry them into the duodenum.

But those who like to talk about how to treat gallstones at home forget to clarify the dangers of this method. After all, a compacted formation that will pick up the flow of bile may simply not pass into the duct. It can get caught at a sharp angle and turn unsuccessfully. And there are also anomalies in the development of the ducts: they can bifurcate or be too narrow.

As a result, the stone will completely or partially block the flow of bile. And this will lead to severe colic, excess bile production, or even problems with the pancreas. As a rule, such patients undergo emergency surgery. A large incision is made. Laparoscopic methods are not suitable in such situations.

Phytotherapy

When figuring out how to get rid of gallstones without surgery using folk remedies, you should not ignore advice on herbal treatment. Of course, these methods will not remove stones, but they help normalize the functioning of the organ, affect the composition of bile and stimulate its timely release.

Drinking radish juice is popular. It is recommended to consume up to 200 g per day. It is also recommended to make syrup from beet juice. To do this, it must be boiled. After this, the juice is squeezed out of it and boiled to a syrup. You should drink ¾ glass of this liquid daily.

The following recipe is also popular: honey, lemon juice and olive oil are mixed in a ratio of 4:1:2. The prepared mixture is consumed in a spoon (tablespoon) before each meal. This remedy is also beneficial for the liver.

Traditional healers know how to treat gallstones with herbs. Most often they recommend making an infusion of corn silk. It is drunk before meals, 1/3 glass (preferably half an hour before). To prepare it, you need to brew a spoonful of herbs with a glass of boiling water and let it stand for at least 30 minutes.

You can also make a decoction of birch. To prepare, you need to pour 5 tablespoons of dried leaves into a liter of boiling water and cook for 20 minutes. The decoction can be consumed an hour after it has been removed from the heat. You need to drink a glass half an hour before each meal.

These are the most famous folk methods that are recommended in cases where people are looking for ways to get rid of gallstones without surgery. Reviews about them are quite contradictory. Some talk about a noticeable improvement in their well-being, while others are disappointed in herbal medicine. But you need to know that everything alternative methods are able to improve the secretion of bile, stimulate the functioning of the bladder, slightly expand the ducts, but they are not able to dissolve stones.

Homeopathy

In search of treatment methods, many turn to specialists alternative medicine. Homeopaths are very popular now. But even they say that they can only dissolve small stones that occupy no more than 1/3 of the volume of the gallbladder.

The effectiveness of this therapy has not been officially confirmed. But despite this, some people treat gallstones with homeopathy without surgery. For these purposes, a so-called autovaccine can be used. As biological material Even the patient's urine can be used to create an autonosode.

It is sometimes impossible to assess the effectiveness of treatment. After all, homeopaths say that their medications must be taken according to a clearly established schedule for several years. In addition, these alternative medicine specialists claim that at first, the condition may worsen when taking the medicine. For most, this is a reason to refuse to continue such questionable therapy.

The gallbladder is an organ that stores bile produced by the liver. The latter is necessary for digesting food. If necessary, it is released into the duodenum. Bile represents compound, containing a large amount of bilirubin and cholesterol.

Gallstones are formed due to stagnation of bile, during which cholesterol is retained in the bladder and precipitates. This process is called the process of formation of “sand” - microscopic stones. If the “sand” is not eliminated, the stones adhere to each other, forming stones. Stones in the gall ducts and in the gallbladder itself take a long time to form. This takes 5-20 years.

Gallstones may for a long time does not manifest itself in any way, but it is still not recommended to trigger the disease: the stone can injure the wall of the gallbladder and inflammation will spread to neighboring organs (patients often also suffer from gastritis, ulcers, pancreatitis). We will look at what to do if gallstones occur and how to treat this problem without surgery in this article.

How are gallstones formed?

The gallbladder is a small sac that holds 50-80 ml of bile, a fluid that the body needs to digest fats and maintain normal microflora. If bile stagnates, its components begin to precipitate and crystallize. This is how stones are formed, which increase in size and quantity over the years.

Moreover, one of the most common causes of illness are considered:

Severe inflammation in the gallbladder.
The contractility of the gallbladder decreases, which causes stagnation of bile.
When bile contains large amounts of calcium, cholesterol, bile pigment, it is water-insoluble bilirubin.
Most often in women the disease is caused by obesity, big amount childbirth, taking hormones - estrogens.
Heredity. The formation of gallstones is caused by a genetic factor. If parents suffered from an illness, their child also has a risk of developing pathology.
Drug treatment – Cyclosporine, Clofibrate, Octreotide.
Diet. Fasting or long intervals between meals can cause gallstones. Limiting your fluid intake is not recommended.
Gallstones can occur due to, hemolytic anemia, due to Caroli syndrome, .
As a consequence of an operation in which the lower part of the intestine is removed.
Alcohol. Abuse of it provokes stagnation in the bladder. Bilirubin crystallizes and stones appear.

As you know, bile consists of various components, therefore stones may differ in composition. The following types of stones are distinguished:

Cholesterol - have a round shape and a small diameter (approximately 16-18 mm);
Calcareous – contain a lot of calcium and are quite rare;
Mixed - characterized by a layered structure, in some cases consisting of a pigmented center and a cholesterol shell.

In addition, bilirubin stones, which are small in size and localized both in the bag and in the ducts, can form in the gallbladder. However, most often the stones are mixed. On average, their sizes range from 0.1 mm to 5 cm.

Symptoms of gallstones

The clinical picture of symptoms when gallstones appear is quite varied. Symptoms depend on the composition, quantity and location of stones. Most patients with single large stones located directly in the gallbladder are often not even aware of their disease. This condition is called the hidden (latent) form of cholelithiasis.

As for specific signs, then gallstones make themselves felt with such symptoms:

(projection of the liver and biliary tract) – intensity from mild discomfort to hepatic colic;
dyspeptic syndrome - manifestations of digestive disorders - nausea, unstable stool;
an increase in body temperature is a consequence of the addition of a secondary bacterial infection.
if the stone descends along the bile duct, then the pain is localized in the groin and radiates to the femoral part.

In 70% of people, this disease does not cause any discomfort at all; a person begins to feel discomfort only when the stones have already grown and blocked the bile duct and typical manifestation- biliary colic is an attack of acute pain due to periodic blockage of the bile duct by a stone. This attack of acute pain, that is, colic, can last from 10 minutes to 5 hours

Diagnostics

Diagnosis is carried out by a gastroenterologist. The diagnosis is established using the patient's complaints and some additional studies.

First, the patient undergoes an ultrasound of the abdominal organs. – the main and most effective method diagnosis of cholelithiasis. Detects the presence of stones in the gallbladder, thickening of the walls of the gallbladder, its deformation, and dilation of the bile ducts. Its main advantages are non-invasiveness (non-traumatic), safety, accessibility and the possibility of repeated use.

If the situation is more serious, then doctors resort to cholecystocholangiography ( X-ray examination with the introduction of a contrast agent).

Consequences

The course of gallstone disease can be complicated by the following conditions:

phlegmon of the gallbladder wall;
biliary fistulas;
Mirizzi syndrome (compression of the common bile duct);
gallbladder perforation;
biliary pancreatitis;
spicy and ;
hydrocele of the gallbladder;
intestinal obstruction;
gallbladder cancer;
acute purulent inflammation (empyema) and gangrene of the gallbladder.

In general, the presence of a stone in the bladder is not dangerous as long as it does not block the bile duct. Small stones usually pass on their own, and if their size is comparable to the diameter of the duct (approximately 0.5 cm), then pain occurs with passage - colic. The grain of sand “slipped” further into the small intestine - the pain disappears. If the pebble is so large that it gets stuck, then this situation requires immediate medical intervention.

Gallstones: treatment without surgery

Detection of gallstones does not always imply mandatory surgical intervention; in most cases, treatment without surgery is indicated. But uncontrolled self-medication at home is fraught with blockage of the bile ducts and an emergency end to the operating table of the surgeon on duty.

Therefore, it is better not to consume dubious cocktails made from strictly prohibited choleretic herbs and vegetable oil, which are recommended by some traditional healers, and make an appointment with a gastroenterologist.

For conservative treatment of cholelithiasis The following medications are prescribed:

Drugs that help normalize the composition of bile (ursofalk, lyobil);
Enzyme preparations that improve digestive processes, in particular the processes of lipid digestion (Creon).
For pain caused by contraction of the gallbladder, patients are recommended to use various muscle relaxants (plataphylline, drotaverine, no-spa, metacin, pirencipin).
Stimulators of bile acid secretion (phenobarbital, zixorine).

Modern conservative treatment, which allows you to preserve the organ and its ducts, includes three main methods: dissolving stones with drugs, crushing stones using ultrasound or laser, and percutaneous cholelitholysis (invasive method).

Dissolution of stones (litholytic therapy)

Dissolving gallstones with medications helps cure gallstones without surgery. The main drugs used to dissolve gallstones are ursodeoxycholic acid (Ursosan) and chenodeoxycholic acid (Chenofalk).

Litholytic therapy indicated in the following cases:

The stones have small sizes(from 5 to 15 mm) and fill no more than 1/2 of the gallbladder.
The contractile function of the gallbladder is normal, the patency of the bile ducts is good.
The stones are of cholesterol nature. Chemical composition stones can be determined using duodenal intubation ( duodenum) or oral cholecystography.

Ursosan and Henofalk reduce the level of substances in bile that promote the formation of stones (cholesterol) and increase the level of substances that dissolve stones (bile acids). Litholytic therapy is effective only in the presence of small cholesterol stones, in the early stages of the disease. The dose and duration of medication is determined by the doctor based on ultrasound data.

Stone crushing (extracorporeal lithotripsy)

Extracorporeal shock wave lithotripsy (pulverization) is a technique based on the generation of a shock wave, leading to crushing the stone into many grains of sand. Currently this procedure used as a preparatory step before oral litholytic therapy.

Contraindications are:

Bleeding disorders;
Chronic inflammatory diseases of the gastrointestinal tract (cholecystitis, pancreatitis, ulcers).

TO side effects Ultrasound lithotripsy includes:

Risk of bile duct blockage;
Damage to the walls of the gallbladder by stone fragments as a result of vibration.

Indications for ESWL are the absence of obstruction of the bile ducts, single and multiple cholesterol stones with a diameter of no more than 3 cm.

Percutaneous transhepatic cholelitholysis

It is rarely used because it is an invasive method. A catheter is inserted into the gallbladder through the skin and liver tissue, through which 5-10 ml of a mixture of special drugs is injected dropwise. The procedure must be repeated; in 3-4 weeks, up to 90% of the stones can be dissolved.

You can dissolve not only cholesterol, but also other types of gallstones. The number and size of stones do not matter. Unlike the previous two, this method can be used not only in individuals with asymptomatic cholelithiasis, but also in patients with severe clinical manifestations diseases.

Surgery to remove gallstones

However, it is worth understanding that surgical treatment cannot be avoided if:

frequent biliary colic;
“disabled” (lost contractility) bladder;
large stones;
frequent exacerbations of cholecystitis;
complications.

In most cases, surgery to remove stones from the gallbladder is recommended for patients whose disease is accompanied by frequent relapses, attacks of severe pain, large stones, high temperature body, various complications.

Surgical treatment can be laparoscopic and open (cholecystolithotomy, cholecystectomy, papillosphincterotomy, cholecystostomy). The surgical option is determined for each patient individually.

Nutrition

Usually, a diet is prescribed as soon as the first signs of gallstones appear. It is specially designed for such patients, it is called - therapeutic diet No. 5, you must adhere to it constantly.

fat meat;
various smoked meats;
margarine;
spicy seasonings;
hard-boiled eggs;
strong coffee;
canned meat and fish;
pickled products;
broths: meat, fish and mushroom;
fresh bread and yeast baked goods;
carbonated drinks;
alcohol.

Food is prepared by boiling or baking, and you need to eat it often - 5-6 times a day. The diet for gallstones should contain a maximum of vegetables and vegetable oils. Vegetables at the expense vegetable protein stimulate the breakdown of excess cholesterol, and vegetable oils improve intestinal motility, promote contraction of the bladder, and thereby prevent the accumulation of bile in it.

Only a doctor can choose a method for removing gallstones based on tests and the patient’s health condition. Before you get rid of gallstones without surgery, you should know the main causes of their occurrence. Addiction to high-calorie foods containing a lot of cholesterol, a sedentary lifestyle, chronic digestive disorders, in which the release of bile into the intestines slows down, and hormonal imbalances in the fairer sex (during pregnancy, menopause) often contribute to the thickening of the contents of the gallbladder. Over time, stones form in it - dense formations consisting of bile enzymes. The person begins to feel heaviness in the right hypochondrium and other accompanying symptoms.

The most popular way to cure these formations is surgical, which involves cholecystectomy - removal of the entire gallbladder (GB) along with its contents. However, you shouldn’t be scared right away and prepare for surgical intervention. Under certain conditions, it is possible to get rid of mineral deposits using conservative methods.

Delay of contents in the HDD along with high level animal fats in food first lead to the appearance of grains of sand. In fact, these are the smallest stones. At the same time, the disease still practically does not manifest itself in any way. Mild symptoms typical of cholecystitis (malaise, heaviness in the right hypochondrium) may be disturbing. If a person does not change his lifestyle and does not begin treatment at this stage, the grains of sand become larger, stick together and turn into large stones. As a rule, stone formation is a rather long process that lasts for decades.

However, a large number negative factors, accession concomitant diseases can speed it up a lot. ABOUT fast current cholelithiasis is said to be harsh stabbing pains, which appear after eating foods high in animal fat. Colic can occur when shaking in transport. Sometimes the pain increases, starting with unpleasant sensations in the epigastrium, gradually intensifying, radiating to the neck, under the shoulder blade. The attack of pain goes away within 6 hours. When removing a large stone, blockage of the bile duct may occur, accompanied by severe pain.

The presence of severe stabbing or cutting pain may indicate the presence of fairly large stones in the gallbladder. If you have these symptoms, you should definitely contact a gastroenterologist or surgeon.

When pain appears in the epigastric region and suspicions of the presence of stones, many patients immediately begin to independently search for and use various recipes and medications. This is strictly not recommended. Before you start getting rid of stones in the gallbladder, you should contact medical institution and undergo examination. First of all, you need to do an ultrasound to verify the presence of stones, their size and specific location.

In some cases, when ultrasound results are not enough to diagnose accurate diagnosis, your doctor may prescribe an oral cholecystography. This is a special type of examination of the gallbladder, in which the patient swallows substances that contrast the contents of the gallbladder. The images show the entire bladder and its ducts in more detail; even small stones can be detected.

Methods of drug therapy

The stones can either be cut out ( surgical removal), or dissolve using special preparations. The latter method is called oral cholelitholytic therapy, which uses agents containing chenodeoxycholic or ursodeoxycholic acid. They help reduce the absorption of cholesterol in the intestines and its entry into bile.

You can treat with this method in the following cases:

the stones must have a cholesterol composition, which is determined during the analysis of the contents of the gallbladder, isolated during the duodenal intubation procedure;
the size of all detected objects should not exceed 1.5 cm, the ideal size is 5 mm; larger mineral formations are difficult to treat with drugs;
The gastrointestinal tract is filled with stones to a maximum of half;
the contractility of the gallbladder walls is normal, and the patency of the bile ducts is good;
body weight does not exceed average values;
The patient’s health allows him to take these medications long enough and regularly.

During the treatment period, you should avoid taking other medications that may promote stone formation (including estrogen-containing contraceptives) or prevent the full penetration of chenodeoxycholic and ursodeoxycholic acids into the gallbladder (various antacids, Activated carbon and etc.). At chronic diseases liver, stomach or intestines, it is generally not recommended to remove mineral deposits in the gallbladder using the above-described drugs.

If during treatment the patient begins to experience pain of varying degrees of intensity with a gradual increase, it is necessary to stop taking the medications and consult a doctor.

When choosing this method therapy, the doctor prescribes a course of medication from six months to two years with mandatory periodic monitoring and testing. The duration of treatment and dosage of medications will depend on the size and number of stones, the age of the patient, and the stage of gallstone disease. Efficiency can reach 80%. The dissolution of solid particles will be complete or partial.

This treatment for gallstones without surgery has side effects. These include a fairly large number of relapses after the end of the therapeutic course (up to 70%). If the factors that influenced the appearance of cholesterol deposits are not eliminated (sedentary lifestyle, poor nutrition), the quality of bile will deteriorate, which will again provoke stone formation.

Extracorporeal shock wave lithotripsy method

This method means crushing petrified pieces of bile using external influence shock wave (the main thing is to precisely focus the impulse) and their subsequent natural removal from the body. The method can be used for patients with a small number (1–4 pieces) of cholesterol stones, each no more than 3 mm in size.

The main types of lithotripsy:

the impulse is created by a spark discharge (through an elastic membrane);
the shock pulse is generated using an electromagnetic field;
piezoelectric pulse generation.

Several sessions are performed. First, primary fragmentation of the formations (cracking) occurs. Next, the stones are fragmented into small particles, which are independently excreted through the bile ducts into the intestines. This method can be combined with medication.

Shock wave lithotripsy is not suitable for diseases associated with blood incoagulability, with installed cardiac pacemakers, peptic ulcer stomach, etc. Pregnant patients cannot be treated with this method.

Side effects of this treatment method include a high probability of blockage of the bile ducts with large particles of destroyed stones. Due to the vibration of stones caused by exposure to ultrasound, the walls of the gallbladder can be damaged, followed by their inflammation.

Homeopathy, herbal medicine and alternative treatment

It is difficult to say how effective homeopathic methods are in treating gallstone disease, since homeopathy causes too much controversy in the medical community. Some representatives of this alternative medicine, promising the natural removal of mineral deposits, even recommend urine intake to their patients. One should be very skeptical about similar procedures. The risk of harm to health far exceeds the likelihood of positive dynamics when taking suspicious homeopathic medicines.

Drugs plant origin They are generally not able to get rid of stones once they have already formed. Moreover, choleretic infusions and decoctions can provoke the removal of stones. If the size of the stones exceeds the diameter of the ducts, this can lead to partial or complete blockage of the latter. For this reason, herbal medicine can only be used as a helper method and only with the permission and under the supervision of the attending physician.

There are others unconventional methods getting rid of gallstone disease. For example, treatment according to Boltov - Naumov, when chicken bile is taken orally, it is necessary to adhere to strict diet. It is assumed that the supply of bile from the outside will contribute to the softening and subsequent removal of stones from the body. GB should be treated in this way from several days to several weeks.

Patients are also encouraged to take black radish juice. It is believed that it is capable of dissolving mineral deposits in the gallbladder. The effectiveness of these techniques has also not been proven. Having decided to independently take these substances, the patient does so at his own peril and risk!

If a patient is afraid of any surgical procedures and hopes to remove cholesterol deposits in the gallbladder without any incisions, he should adhere to clear nutritional principles, without which the effectiveness of therapy will be low and the risk of relapses will be high.

Non-surgical treatment of gallstone disease involves following a strict diet. It is better to eat often, in small portions 5-6 times a day. Lard, fatty meat, smoked, salted or spicy food. Alcohol is strictly prohibited in any form!

You should eat more foods containing fiber (porridge, vegetable salads). For meat dishes, boiled or baked poultry, rabbit, lean beef, and various types of fish are best. Taking broths is not recommended. Olive oil can be used as a fat substitute in reasonable quantities.

Will have a positive effect on the patient’s condition and moderate exercise stress. Walking on fresh air, light exercise will help maintain the tone of the gallbladder and improve a person’s overall well-being. And you must follow the recommendations of your doctor.