Eat to beat gallstones

Gallstones, small hard “rocks” of cholesterol and calcium, can block the tubes that drain the gallbladder.  This blockage causes inflammation of the gallbladder or of the bile drainage tubes. Once this happens you experience terrible pain or colic, fever and even jaundice (skin turns yellow). Here’s what you can do about it.

Background to your gallbladder, bile and digestion

Bile is made in the liver and stored in the gallbladder until ready to be used to help in the process of digestion. When we eat, this signals the gall bladder that bile is needed. The gall bladder contracts and pushes the bile down into a duct that carries it to the small intestine, where it breaks down any fats eaten.

If the bile becomes too concentrated or ‘supersaturated’, substances in the bile can harden and form small stones that look like gravel. They can range in size from a tiny seed to as large as a golf ball. Generally they are made up of cholesterol (a type of blood fat) but can include calcium and/or bile pigments. Gallstones take years to form.

Symptoms

People with gallstones may experience indigestion or an upset stomach, often noticed after a rich or heavy meal. Many people, however, have gallstones but experience absolutely no symptoms at all. In fact gallstones can exist for years without causing any problems. It’s only when gallstones block the tubes that drain the gallbladder, that the problem begins. 

This blockage causes inflammation of the gallbladder (cholecystitis) or of the bile drainage tubes (cholangitis).  Symptoms then escalate to include severe pain or colic, fever and even jaundice (skin turns yellow). Symptoms are usually treated by surgery to remove the gallbladder (cholecystectomy) often done by keyhole surgery to minimise major abdominal work.

If you’ve got gallstones and are awaiting surgery:

Eating particular foods will not make gallstones disappear but can certainly lessen your pain whilst you are waiting for your operation.

• Steer clear of fatty, oily or fried foods which are most likely to cause pain or feelings of sickness. These high-fat foods ‘activate’ the gall bladder to release bile (needed to digest the fat) and so make your symptoms worse.
• Avoid concentrated fats like oil, butter, margarine, fat on meat or avocado, but you don’t have to eat completely fat-free. Often it’s a case of trial and error while you work out how low in fat you need to go.
• A low fat diet includes a wide range of foods such as vegetables, potato and legumes such as lentils and kidney beans, all varieties of bread, pasta and rice with oil free sauces, grilled or steamed fish or skinless chicken, grilled lean meat and low fat milk or soy drinks. 
• Drink plenty of water (eight to ten glasses a day).
• Avoid alcohol until after you have had your operation.
• If in doubt, make an appointment to see a dietitian.  

Once you have had your gallbladder removed: 

Once removed, bile that was formerly stored in the gall bladder will now flow directly from the liver to the small intestine rather than being stored in the gallbladder first. The gallbladder is an organ that people can easily live without.

This means you can return to your usual diet. Restricting fat is no longer necessary, however it is healthier to avoid saturated and trans fats as much as possible and eat plenty of fibre. 

Check with your doctor about when you can drink alcohol again.

How to prevent gallstones

Gallstones are estimated to effect around 10 per cent of people in Western countries, mostly older women.  The classic gallstone patient is characterized by the "4Fs": being female, fat, fair and forty. To that we could add another F namely being flatulent. 

In fact women between 40 and 60 years of age are twice as likely to develop gallstones as men.  There are 6 factors that can increase your likelihood of developing gallstones.  These are :

1. Obesity

Being even moderately overweight increases the likelihood of developing gallstones because overweight people create more cholesterol and secrete more of it into their bile which is stored in the gall bladder. They also appear to empty their gall bladders less efficiently which makes things worse.

2. Family history

Having close family members with gallstones also increases the chance of developing gallstones and so does having a large number of children.

3. Too little fibre and vegetables

Slow transit time (the time taken for food to pass through the digestive tract) and constipation encourage the formation of gallstones.  Eating more fibre and vegetables is the easiest way to improve your daily diet. This also brings with it a lower risk of bowel cancer, breast cancer and overweight.

4. Diabetes

People with diabetes generally have high levels of triglycerides (a type of fat in the blood). These increase the risk of gallstones.

5. Female hormones

Too much oestrogen from hormone replacement therapy or contraceptive pills alters the composition of the bile and decreases gallbladder movement, both of which can make you more prone to gallstones. 

6. Too-rapid weight loss and/or fasting

During rapid weight loss the body burns fat, causing the liver to secrete extra cholesterol into bile. Fasting slows down the movement of the gallbladder, which further concentrates the bile which can lead to gallstones. It also leaves you constipated which only encourages bile formation. 

What should you do to reduce your risk?

If you are a woman you are already at reasonable risk, make your priority the risk factors you can change.

• Maintain a healthy weight by following a balanced diet and keeping up an achievable exercise plan. Make sure you eat plenty of fibre (bran cereals, grains, wholemeal bread) and vegetables.
• Try to keep your cholesterol under control with diet, rather than resorting to medication
• Avoid cleansing fasts, detoxes or crash diets that cause rapid weight loss - it is impossible to maintain the weight loss in any case.