GALLSTONES

THE GALLBLADDER IS A SMALL SAC that receives and stores bile after it has been secreted by the liver. It then releases this fat-digesting fluid after meals. When everything is working properly, you are not aware of it at all.

But when bile becomes oversaturated with cholesterol or, more rarely, calcium, the extra compounds may crystallise, forming gallstones. Such stones can vary in size from smaller than a pea to as large as an egg. Many times you won't even know you have them; one­third to one-half of the people with gallstones experience no symptoms.

The problem arises when a gallstone gets stuck in the bile duct - one of the tubes through which bile flows on its way to the small intestine. When that happens, you feel severe pain in the upper right section of your abdomen, often with nausea, vomiting, bloating or belching. Sometimes the pain subsides; that means the stone may have fallen back into the gallbladder or been forced into the intestines. Rarely, an infection may develop because of the obstruction, resulting in fever, chills or jaundice.

Millions of people have gallstones and thousands of new cases are diagnosed each year. Many people have their gallbladders surgically removed each year just because of gallstones.

Diet plays a major role in the development of gallstones because bile is secreted when fatty substances are digested. Eating foods high in fat, protein or sugar can make you more prone to stones. You're also more likely to get gallstones if your cholesterol is high, you have food allergies or you've experienced rapid weight loss.

Obese women over 40 who have had children are more likely to suffer from gallstones; in fact, with each pregnancy, a woman increases her chances of developing gallstones, because pregnancy upsets the balance between cholesterol and bile acids.

Doctors tend to prefer surgery rather than drug treatment for gallstones. The usual procedure is removal of the gallbladder. New laser surgery techniques involve only a small incision and allow rapid recovery. A new treatment called lithotripsy uses sonic shock waves to break up the stones. Another technique involves placing a tube into the gallbladder through which a strong solution capable of dissolving the stone is administered. Doctors and researchers are still evaluating the effectiveness and safety of these last two methods.

The gallbladder and the liver work together as an efficient team. Hence, the herbs that support the liver often help with gallstones.

SUPPLEMENTS FOR GALLBLADDER SUPPORT

You can't just take a pill to fight your body's tendency to form gallstones. But there are a few nutrients that can be solid allies.

1. Vitamin C. Deficiencies in vitamin C have been linked to gallstone formation; taking C in supplements may prevent more from forming. Typical dosage: 1,000 to 3,000 milligrams per day, with meals.

2. Vitamin E. So you gave in to temptation and ordered the chips anyway. Well, vitamin E helps to scavenge free radicals, the damaging molecules that eating oxidised fats - like those fried foods - creates. Clinical studies also indicate that it may prevent gallstone formation. Typical dosage: 200 to 800 l U per day.

0. Lecithin. Some research suggests that low levels of lecithin in the bile may cause gallstones. Lecithin, a type of nutrient called a phospholipid, also helps to break up fats, which is important to proper cholesterol digestion. It may also increase the capacity of bile to dissolve cholesterol. Typical dosage: 1,000 milligrams three times per day with meals.

1. Essential fatty acids. These wonder chemicals help the body control cholesterol and digest other fats. Look for a product that offers a combination of omega-3 and omega-6 fatty acids; you'll find both in fish, flaxseed, borage seed, blackcurrant seed and evening primrose oils. Typical dosage: 1,000 to 4,000 milligrams per day. Keep these oils refrigerated.

0. Taurine. Studies of people who took supplements of this amino acid found that they secreted more bile - the magical fat-digesting fluid - and that the bile they secreted was able to dissolve more cholesterol. Typical dosage: 500 to 3,000 milligrams per day.

1. Hydrochloric acid. Think it's odd for this dangerous acid to appear on a list of supplements? This hydrochloric acid is the kind that your stomach uses to digest food. People who lack sufficient amounts of this acid maybe prone to developing gallstones. Typical dosage: 1 to 5 capsules with meals; start with one and build up, following the recommendations of the manufacturer or your doctor.

0. Fibre. Psyllium, pectin and guar gum can decrease cholesterol levels and keep the bile acid pool active, which discourages disease and stone formation. In studies on animals, the ones who ate the least fibre had the highest incidence of gallstones. New evidence suggests that non-obese women whose digestive systems move slowly are prone to gallstones. So they need to be sure of getting enough fibre, especially if they have a family history of gallbladder disease. Follow manufacturer's recommendations for dosage.

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THE STONE-ZAPPING DIET

If you have gallstones, you've probably heard people urging you to change your diet. They're right: minimising your intake of saturated fat (cutting out fatty red meats, fried foods and hydrogenated fats) does work wonders. Here's what else you can do:

0. Emphasise a low-fat diet high in raw foods. Eat plenty of grilled fish, carrots, apples, lemons, oranges, grapes, celery, garlic, onions, tomatoes, dates, melons and fibre-rich foods.

1. Learn to love beetroot. Seriously. In addition to the foods mentioned above, beetroot is a great food for cleansing the blood and liver. Try beetroot juice, or a carrot-apple-beet mixed juice.

2. void fried foods, fatty foods, animal fat, margarine, commercial oils, chocolate and coffee. Minimise your consumption of sugar and refined carbohydrates.

DRUG TREATMENT

Bile Salts

Ursodeoxycholic acid (Destolit, Urdox, Ursofalk, Ursogal). Function: dissolve gallstones by dilution. Side effects: diarrhoea, nausea, vomiting.

HERBAL REMEDIES

Dandelion (Taraxacum officinale)

The root of this common lawn weed has traditionally been used to treat both liver and gallbladder obstructions, improve overall liver function and promote bile production. More bile means there's less chance of it becoming oversaturated with cholesterol or calcium, and that means it's less likely gallstones will form.Typical dosage: 1,000 to 2,000 milligrams of powdered root per day.

Milk Thistle (Silybum marianum)

A superior herb for liver support, cleansing, repair and protection, milk thistle also reduces the concentration of cholesterol in the bile; result: fewer gallstones. Typical dosage: 200 to 400 milligrams of product standardised to 80 per cent silymarin per day, in divided doses.

Turmeric (Curcuma longa)

Curcumin, which gives turmeric its yellow pigment, is antioxidant, anti-inflammatory and, most important, cholesterol-lowering. Studies have shown that it also increases the ability of bile to dissolve cholesterol and calcium. Again, the bottom line is less likelihood that gallstones will form. Typical dosage: 300 to 1,000 milligrams of capsules standardised to 95 per cent curcumin per day.

Artichoke (Cynara scolymus)

This herb is one of the group known as bitters, because that's how they taste. Bitters jump-start the whole digestive system before a meal; they prime the bile pump, so to speak. Studies have shown that artichoke leaf can effectively lower cholesterol; it especially helps facilitate the digestion of fats. Typical dosage: 800 to 1,200 milligrams per day.

Peppermint (Mentha x piperita)

Several studies suggest that this essential oil, when taken in an enteric-coated capsule, may dissolve gallstones. An enteric coating is one that passes through the stomach's digestive fluids intact to deliver its healing properties lower in the digestive tract. Studies suggest peppermint oil can help keep gallstone blockage from occurring. Typical dosage: 0.2 to 0.4 millilitre in enteric-coated capsules two times per day between meals.