Choleretic drugs for gallstones

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.

1. The first stage does not manifest itself clinically and is characterized by an increase in the amount of cholesterol in the bile, up to cholesterol flakes and crystals. In addition, it contains less phospholipids, bile acids and lecithin, that is, substances that dissolve gallstones.
2. The second stage is defined as stone-carrying, does not manifest itself in any way and is characterized by worsening changes in the properties of bile. Cholesterol flakes and crystals turn into stones, which gradually fill the gallbladder and its ducts.
3. The third stage is precisely that calculous cholecystitis that forces a person to 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.

Symptoms of the disease

The first two stages of gallstone disease are asymptomatic. Clinical manifestations occur when:

1. Inflammation of the gallbladder and its ducts.
2. Blockage, stagnation.
3. Filling the organ completely with stones and disrupting its deposition function.

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 can radiate to the left hypochondrium, lower abdomen, back, right shoulder blade, or the area between them. The pain may last for hours. In addition to painful sensations, various autonomic reactions are present: sweating, redness or paleness of the skin, increased blood pressure and rapid heartbeat. Nausea and vomiting are frequent companions of biliary colic. In addition, appetite decreases, the patient is restless, and pain prevents sleep.

If the body temperature rises, acute cholecystitis or cholangitis is suspected. Yellowness of the skin and sclera indicates that the stone impedes the flow of bile.

Diagnosis of the disease

Whether it is possible to dissolve gallstones using various methods depends on what kind of stones have formed in the gallbladder and ducts.

Stones come in the following types:

1. Cholesterol containing up to 75% cholesterol, as well as pigments, lime salts, proteins and mucins. They occur most often (from 70 to 90% of all cases). They are found in the gallbladder and much less often in the ducts.
2. Brown pigment stones contain up to 30% cholesterol, as well as calcium bilirubinate. They appear in the common bile duct after surgical treatment, rarely in the bladder itself.
3. Black pigmented ones contain black pigment, mucin and proteins. They occur mainly in the gallbladder; they are extremely rare in the common duct.
4. Mixed complex stones contain less cholesterol, as well as lime salts, proteins, mucin and pigment substances. Occurs in approximately 20% of cases.

It is possible to 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 X-ray photographs of the abdominal cavity, stones are visible much less frequently if they contain calcareous salts, X-ray positive formations.

Fibrogastroduodenoscopy is performed to examine the exit site of the common bile duct into the lumen of the duodenum in order to recognize blockage with a stone.

A biochemical blood test examines the amount of cholesterol and lipid spectrum, as well as the functioning of the liver based on bilirubin and enzyme substances.

A general blood test diagnoses the presence or absence of an active inflammatory process by the number of leukocytes and erythrocyte sedimentation rate.

Is this technique right for you?

Answer yourself a few simple questions:

1. Your stones are less than 2 cm in size, your gallbladder is functioning (not disabled or fibrotic), the stones are not calcified (i.e. not visible on x-ray), and there are no frequent attacks?

If you answered “Yes,” then it makes sense to think about dissolving stones with herbs and there are very real hopes.

2. Is your entire bladder filled with small stones or are they calcified?

If you answered “Yes,” then they probably won’t be able to dissolve completely))) But you can improve the functioning of the liver and the quality of bile, which means that digestion in general and your general condition will improve. If in any case you are not planning an operation in the near future, try taking the course. There are exceptions.

3. Do you have to regularly take antispasmodics because of pain in your right side?

If you answered “Yes,” then it’s more likely that you’ve already missed the point where natural remedies are effective.

Diet for gallstone disease

At any stage, therapeutic nutrition should be aimed at reducing cholesterol levels and its hypersecretion in the body. An important role here is played by proper nutrition, aimed at reducing body weight and correcting metabolic processes. Often the pathological picture of bile is associated with endocrine pathology, which requires a specialized diet.

You should eat meals in small portions - four to six times a day, distributing the food evenly over the course of an hour, 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.

Dietary food excludes fried, fatty, smoked, spicy and high-calorie foods (up to 2900 kcal). Food should be rich in protein. When choosing products, you should consider their fat content. This applies to dairy products, which must be purchased with a low fat content. Meat should be lean varieties (chicken, turkey, rabbit, beef). River fish or lean fish (bream, perch, cod, pike perch, hake). Meat and fish should be steamed or boiled.

Eating about one hundred grams of raw vegetables or fruits three to four times a day will be beneficial. You need to eat them before the main meal. Apples and pears, as well as juices from them, are good for dissolving gallstones, which has earned the love of many nutritionists. Carrots, sauerkraut, and celery will be used for the same purposes. 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 dissolve gallstones and improve intestinal function.

Half of the fats should be of plant origin. Vegetable oils (sunflower, flaxseed, olive, corn and soybean) help reduce cholesterol, enrich the body with tocopherol, and dilute bile with the help of prostaglandins in their composition.

Neutral and alkaline bile promotes the dissolution of cholesterol in it, and an acidic environment, on the contrary, causes crystallization and stone formation. This is caused by the consumption of large quantities of flour products and cereals. To make the environment more alkaline, you should add fermented milk products, cottage cheese, cheese, vegetables (except legumes), fruits and berries (except red currants) to your diet.

Soups should be cooked lean. Soft-boiled eggs are allowed no more than one per day. For seasonings, you can use parsley and dill, fruit sauces. You can drink weak tea and coffee, and it’s good to take juices. Strong alcohol and beer are prohibited.

Alternative methods

The advisability of removing stones non-surgically is justified only if they are a consequence of excess cholesterol. In this case:

1. You can dissolve the formed cholesterol stones with herbal remedies. Rovachol is the best representative of products created on the basis of plant substances. The course of treatment is 6 months. During this period, the stones dissolve by improving the secretion of bile and reducing the production of cholesterol by the liver.
2. Acupuncture. Acupuncture will neither dissolve nor remove gallstones. It is used to alleviate the condition: relieves spasms, eliminates bile stagnation and helps stabilize the functioning of the gallbladder and liver.
3. Organ cleansing. This method has not been studied enough. There is also no evidence as to whether stones actually dissolve using this procedure. And those substances that can be found in feces after cleansing are nothing more than a by-product of the cleansing procedure.

To verify the effectiveness of such methods and detect signs of stone dissolution, it is necessary to do an ultrasound. The examination is advisable if it was also carried out before treatment.

How to dissolve the stones in the gall bladder and whether it is possible to remove them without surgery is decided only by a doctor.

Massage

Massage has a positive effect on the functioning of the organ. It not only makes him work more actively, but also relaxes him well. The exercises are quite simple:

1. While lying on your back, bend your legs and feel the painful point under the right rib. Massage it with your thumb and forefinger in a circular motion for 5-6 seconds.
2. Sitting on a chair, you should lean forward and lightly press your fist on the painful point. Straighten your back. Repeat 5 times.
3. Lie down as in the first exercise. Using your fingers, perform stroking circular movements in the area of ​​the right hypochondrium. Do this for 30-40 seconds.

If there is constant pain, a gallbladder massage should be performed twice a day (always 30–40 minutes before meals). The course is 10 days.

Use of traditional medicine

A time-tested way to get rid of gallstones is to dissolve them using folk remedies. Here are some recipes:

1. The old way. Drink 100 ml of sea buckthorn oil and the same amount of lemon juice before bed. Treatment is carried out 3-4 times a month. In the morning, you will see green clots in your stool - traces of bile and tiny grains of cholesterol.
2. Mix honey with olive oil in equal quantities - 0.5 teaspoon each. Eat 30 minutes before breakfast. The course is one week. Break – 3 days. Then 3 more courses with similar breaks.
3. Sandy immortelle, wormwood herb and dandelion root (1 teaspoon each) pour boiling water (200 ml) and leave for half an hour. Drink 50 g after breakfast. Take for a month.
4. Mix 3 lemons, minced through a meat grinder, 500 g of honey and 100 ml of sea buckthorn oil and place in the refrigerator. Take 1 teaspoon of the mixture before each meal. Course – 1 month.
5. Black radish juice is an excellent cure for stones. Use 1 teaspoon after meals, gradually increasing the dosage to 1 glass. The juice is prepared immediately from 5 kg of product. This is enough for the entire course of treatment.
6. Pour a glass of boiling water over rose hips (1 tablespoon) and leave overnight in a thermos. Drink 200 ml for 30 days.
7. Beetroot decoction. Peel 500 g of vegetables, chop, cook for an hour over low heat. Drink 50 ml three times a day.
8. Mix juices – beetroot, cucumber, carrot – in equal quantities (total volume 100 ml). This gives a good effect and cleanses the bladder. Take 3 times a day for a week.
9. An excellent choleretic remedy is tea made from the cocklebur herb.
10. There is an opinion that 1 teaspoon of soda per glass of water softens cholesterol stones, thereby promoting their dissolution.

For the purpose of cleansing, a variety of medicinal herbs and food products are used. These are strawberries, cabbage, carrots, yarrow, St. John's wort, dandelion, fennel.

They help dilute bile, soften small stones, which turn into flakes and are removed through the intestines.

Indications for drug dissolution of stones

It is possible to dissolve gallstones using traditional and medicinal methods under certain conditions:

1. The gallbladder contains only cholesterol stones, which are visible on ultrasound and are absent on radiographs.
2. Size - no more than two centimeters in size.
3. The gallbladder functions properly, accumulating bile.
4. Stones in the organ occupy no more than half of its volume.
5. The duct leaving the gallbladder must be patent.
6. There are no stones in the common duct.
7. The period for the appearance of stones is less than three years, since later they accumulate a large amount of mineral salts that are difficult to dissolve.

Indications and contraindications

Medicines for gallstones are prescribed in the following situations:

1. the formation of cholesterol stones that are present in suspension;
2. stone size – up to 20 mm;
3. free passage of bile through the ducts;
4. absence of violations of the regulatory activity of the gallbladder;
5. absence of sand and stones in the channels;
6. the filling of the organ with stones is less than 50%.

Before starting medical treatment of the gallbladder, you need to conduct a comprehensive examination. Conservative therapy lasts quite a long time.

It is worth considering that such means cannot always be used. The main restrictions on the use of such drugs include:

• dysfunction of the gallbladder;
• frequent hepatic colic;
• pregnancy;
• acute pathologies of the biliary tract;
• formation of calcium or bilirubin stones;
• presence of mixed stones.

Contraindications for drug dissolution of stones

You should know the conditions that prohibit the use of lysis drugs, as well as which gallstones can be dissolved with medication.

Contraindications are:

• Acute inflammatory reaction in the wall of the gallbladder and ducts.
• Large stones are more than two centimeters in diameter.
• Liver pathology of any etiology.
• Diabetes.
• Chronic pancreatitis.
• Peptic ulcer of the stomach and duodenum.
• Exacerbation of chronic pathology of all parts of the intestine.
• Calcium carbonate stones visible on x-ray.
• Disabled gallbladder without signs of functioning.
• Pregnancy and breastfeeding.

Contraindications to treatment

Tablets containing bile acids are allowed to be taken to cleanse cholesterol formations only if the patient is fine with the functioning of the gallbladder and there is no exacerbation of it. The bile ducts should be passable, and the stones should fill the bladder less than half. There should be no severe pain. If a person is obese, such cleansing will be less effective for him. Such drugs have a side effect - liver function decreases, because of this creatinine and urea accumulate in the blood. At risk are pregnant women, women during breastfeeding, patients with stomach and duodenal ulcers, patients with inflammation of the liver, gall bladder and tract.

Remember that cleansing stones with such means is not compatible with:

1. Hormonal contraceptives that contain estrogen.
2. Drugs that remove excess cholesterol from the body (“Cholestyramine”).
3. Medicines that provoke a decrease in stomach acidity (Almagel).

There are also warnings for cleansing with Ziflan. It is prohibited for pregnant women, as well as during lactation, people with individual intolerance to immortelle, and children under 12 years of age. For diseases such as jaundice and high blood pressure, this drug is also not used to clear stones. One of the negative effects on the body is the occurrence of allergic reactions. Considering that this is a herbal preparation that tends to accumulate in the tissues of the body, you should not drink it for more than 3 months in a row, even if the pain does not decrease.

What medications dissolve gallstones?

For drug lysis, preparations of bile acids are used - chenodeoxycholic and ursodeoxycholic, which compensate for the deficiency 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 the composition of 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 chenodeoxycholic acid is “Chenofalk”, produced in capsules by the German company Doctor Falk Pharma GmbH. The 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).

The dose depends on the person’s weight at the rate of 15 mg per kilogram. Overweight people should be aware that the maximum dose is 1500 mg per day.

The drug must be taken for a long time. After six months, a control ultrasound examination is performed to evaluate the result of therapy. If there is no positive dynamics, the medication is stopped. The maximum period for taking Henofalk is three years. There is a method of taking a course of the drug to prevent subsequent stone formation in people prone to this pathology, provided that the previous stones are completely dissolved. Reception is carried out for a month with breaks of 60 days.

Henofalk is well tolerated. You should be wary of allergic reactions in the form of itching and rash. With long-term use over many months, it is necessary to monitor liver parameters (ALaT and ASaT), and if they increase, reduce the dosage.

Abdominal pain may occur when stones move. Loose stools are possible with large doses due to an increase in fat in the stool.

The drug "Ursofalk" based on ursodeoxycholic acid is used in 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 is well tolerated. The appointment is carried out under ultrasound control. O in the absence of dynamics for a year and a half.

There is a method of combining “Henofalk” and “Ursofalk” with half the dosages taken at night. This treatment is more effective and leads to the dissolution of stones in 70% of cases, in contrast to monotherapy, where success occurs in only half of the patients.

All contraindications should be clarified before dissolving gallstones using drugs containing acids. In addition, you need to remember that they cannot be taken with conventional medications.

Options for getting rid of stones

Apart from laparoscopic surgery, which is the most common method of removing stones, there are other ways to get rid of them.

Treatment without surgery

Traditional medicine has conservative methods for treating gallstone disease. Among them, the following have proven themselves well:

Litholytic therapy

In this case, bile acid preparations in tablets are prescribed - Ursohol, Henochol, Ursosan, Henofalk. This option for dissolving stones is used when cholesterol stones no larger than 1.5 cm are detected. It is not suitable for getting rid of pigmented gallstones and for patients who are prone to obesity.

The second type of drugs used in litholytic therapy is Ziflan. The immortelle contained in it dissolves cholesterol stones.

Contact dissolution of stones

It involves injecting methyl tert-butyl ether (MTBE) directly into the gallbladder. It should be noted that this procedure is complex and unsafe. It is carried out in a clinic under the supervision of experienced specialists.

Everything goes quickly . Ether, remaining in a liquid state under the influence of the patient’s temperature, promotes the dissolution of stones in 6-10 hours. A stay in the clinic is caused by the possibility of serious side effects, which are accompanied by intense pain and burning.

Shock wave therapy

The method is used rarely and often with the simultaneous use of litholytic therapy. The second name is “lithotripsy”. During the procedure, large stones are crushed into small fragments by sound waves. The use of the method is allowed in the presence of formations no larger than 2 cm in size.

The disadvantage of such techniques is the possibility of the formation of new stones. That is why removal using laparoscopic surgery is the mainstay of traditional medicine in this case.

The described methods of crushing and dissolving gallstones are used in situations where surgical intervention is contraindicated for the patient.

Herbs that dissolve gallstones

The use of herbal medicine to dissolve stones should be carried out only after the permission of the attending physician. So, the agents that dissolve gallstones are contained in the following herbs.

Milk thistle, peppermint, tansy, rose hips, beet broth, lingonberry leaves, lavender flowers, mountain thyme are used. They are used in the form of tablets, infusions, and teas. Remember that each remedy has its own list of contraindications.

It is possible to dissolve gallstones using folk remedies, including herbal medicine, when their diameter and cholesterol composition are very small. The use of herbs during an acute inflammation process is contraindicated.

Non-drug treatments

How you can dissolve gallstones without resorting to surgical treatment should be found out in consultation with a gastroenterologist and surgeon.

The shock wave cholelithotripsy method allows you to crush large stones (up to 3 cm) into small fragments. The stones must be cholesterol. The gallbladder must perform its function. The method will be especially effective if you start consuming fatty acid preparations two weeks before. Stones can be fragmented in 95% of cases.

The percutaneous transhepatic cholelitholysis technique is an invasive procedure performed under local or general anesthesia. It consists of inserting a thin probe into the gallbladder through the skin and liver tissue and infusing a solution through this probe to dissolve the stones. In this way, up to 95% of stones are dissolved.

What to do after gallbladder removal if you read this article after the operation

If you did not read this information before surgery, it’s a pity. You can't get your gallbladder back. But even after removal of the gallbladder, it is highly advisable to take Ziflan (export formula) 3 times a year for a month. These are the recommendations of leading hepatologists, even if your doctor did not tell you this.

Why is it important? Because the cause of stone formation is not eliminated by surgery and often stones form again, but in the bile ducts. Bile, not collecting in the gallbladder, constantly flows into the duodenum, causing irritation and provoking the development of duodenitis and enteritis. Many patients continue to have the same symptoms and complaints as before surgery (heaviness in the right side, aching pain after breaking the diet, bitterness and metallic taste in the mouth). This is called postcholecystectomy syndrome.

In addition to Ziflan (export formula), periodic addition of LecithinUM to food and, of course, increasing the amount of plant fiber in the diet can be useful. This is the most natural way to maintain the correct structure of bile - changing the nutritional structure. By reducing the amount of fat and protein and increasing vegetables, you will protect yourself from many diseases that stem from problematic intestines and liver. The easiest way to eat an “extra” portion of vegetables a day is “Redi Fiber” with any fermented milk product. It’s tasty, convenient and incredibly healthy.

Prevention

Preventive measures are aimed at preventing the formation of primary stones and new stones after therapy with the means described above.

Preventive measures include:

1. Proper nutrition in compliance with all the above measures.
2. Drinking mineral waters containing sulfate ion (Essentuki, Borjomi, Truskavets, Narzan).
3. Spa treatment.
4. Rejection of bad habits.
5. Regular physical activity, including exercises that develop the muscles of the diaphragm and abdominal muscles.
6. Body weight control.
7. Treatment of chronic diseases.

We discussed how to dissolve gallstones. With competent treatment, the outcome is favorable.