Low fat or high fat diet to control gallstones? Ursodeoxycholic acid? Not asking about surgery.

CorneliusPhoton

Has anybody used Ursodeoxycholic acid or Ursodiol for gallstones instead of having the surgery?

I have a load of gall stones, found on a CT scan for another issue. Likely because of all of the weight I've carried and yo-yo-ing I've done with my weight in my past (I am not doing that anymore!!!). No family history that I know of. I have not had any serious issues with them, but I have felt what I would call a threatening pain on occasions that I go much above 20g or so of fat in a meal. Surgery is not an option for me at this time, and even if it becomes an option, I would prefer to avoid it. It looks like an ursodiol prescription is effective for the reduction and prevention of gallstones, but you have to take it for a long time, if not forever.

I would really like to eat more healthy fat in my diet, but conventional practice seems to advocate eating a very low fat diet when you have gallstones. Which doesn't make sense to me, because the more fat you eat, the more your gall bladder pushes bile (and gallstones) out. Similar to kidney stones, where the advice is to keep flushing them out, even though you might have an "attack" while doing so, gallstones should be able to be pushed out. Seems that a low fat diet would just let them sit there and gather more mass since the gall bladder isn't emptying as much. Is the low fat diet simply advised due to fat phobia and lingering mainstream low fat diet promotion? I have found a decent amount of information from keto and paleo friendly websites that advocate the high fat diet, sometimes seeing reports of gallstone problems disappearing, but the sites that seem to be acceptable to cite (Mayo, etc.) advocate low fat.

I plan on talking to my doctor about taking the drug when I see him next week. Last time we talked, he said that they do not treat unless it is a problem. I don't want to be a walking timebomb! Seems to me that taking the drug and maintaining good flow out the gallbladder would be a logical solution, especially since I am mostly without symptoms at this time. FWIW, I found one paper reviewing random controlled trials of just this: https://www.ncbi.nlm.nih.gov/pubmed/24321208.

Looking for people's experience with the drug and thoughts on the low/high fat diet debate.

ETA: OTC supplement form: https://www.amazon.com/Nutricology-Bile-500-Vegetarian-Capsules/dp/B0002JIUDS?th=1

Macy9336

My husband had his gallbladder removed due to a very large gallstone. The attacks happen when the gallstone(s) block the flow of bile to the stomach, get stuck and cause pain. You don't produce any more or less bile based on you diet being high or low fat. What happens is with gallstones, the amount of bile getting to your stomach is less than if you had no gallstones because they act like a dam...cutting down the flow of bile so it stays stored up in the gall bladder. This is why they recommend a low fat diet because you won't have enough bile getting to the stomach to help digest the fats. It's the same if you get the gallbladder removed. Instead of having a store of bile to be released, it's released in a constant trickle. So you don't have ability to digest high fat any more and have to stick to low fat. I agree you want to get rid of the stones but eating high fat won't cause floods of bile to be generated to flush out the stones...bile is produced prior to you eating, it's not produced as a reaction to what you just ate.

CorneliusPhoton

Macy9336 wrote: »

My husband had his gallbladder removed due to a very large gallstone. The attacks happen when the gallstone(s) block the flow of bile to the stomach, get stuck and cause pain. You don't produce any more or less bile based on you diet being high or low fat. What happens is with gallstones, the amount of bile getting to your stomach is less than if you had no gallstones because they act like a dam...cutting down the flow of bile so it stays stored up in the gall bladder. This is why they recommend a low fat diet because you won't have enough bile getting to the stomach to help digest the fats. It's the same if you get the gallbladder removed. Instead of having a store of bile to be released, it's released in a constant trickle. So you don't have ability to digest high fat any more and have to stick to low fat. I agree you want to get rid of the stones but eating high fat won't cause floods of bile to be generated to flush out the stones...bile is produced prior to you eating, it's not produced as a reaction to what you just ate.

But it is released via gall bladder contraction in response to what you eat, fat in particular.

The gall bladder stores and concentrates bile salts during fasting and releases them into the duodenum in response to gastric emptying of a meal. The flow of bile into the duodenum is controlled by gall bladder muscular contraction, gall bladder tone, hepatic secretory pressure and relaxation of the sphincter of Oddi. This process is mostly regulated by the hormone cholecystokinin (CCK) that is released by the proximal intestine in response to products of macronutrients digestion, particularly fat. Source

I am pretty sure that gallbladder emptying in response to fat is fairly well studied, along with how stones are normally passed via that mechanism, but I am happy to go back and look for more supporting information about passing them. As for preventing them in the first place, It is believed that one of the reasons that gall stones form (other than from too much cholesterol or bilirubin) is because the gall bladder does not empty frequently enough or completely enough, both of which could be caused by a low fat diet, among other things.

Fuzzipeg

I know I'm being controversial here.

Looking at this from a functional aspect, if you can increase and/or dilute your bile flow this might help you pass the smaller stones. If you can have the juice of half a lemon in a glass of water with your meals or as a simple drink this could assist your digestive acid. You could take HCI and pepsin, the pepsin is important some manufactures make it without. Poor bile secretions can be influenced by low thyroid function, which impacts many aspects of dietary elimination. Its convoluted but it is something general medicine is loathed to admit and often may not be taught in med school. One on line thyroid support site gives 300 possible symptoms including Gaul stones.

I've just found, by doing a simple search, 'reasons for poor bile flow'. I discovered many of the symptoms attributed to Gaul stones echoes those for thyroid problems! The search results I found, give explanation of the possible causes as well as dietary interventions which can aid bile flow. Please try your own search using my terms above. I really hope you will be able to read with interest. I hope fine some relief in a few days if you are able to institute some of the suggestions. May be you could keep your Gaul bladder and not face a life with the problems of continuous bile flow.

What ever you decide, I wish you all the very best.

CorneliusPhoton

Appreciate your response and willingness to help. I am not having any significant problems digesting foods right now, and not necessarily looking for relief from anything (thankfully). I just want to get rid of the gallstones that are sitting there, growing larger, waiting to hurt me. So far what I have found related to increasing bile flow (as I have termed improved gallbladder emptying) is increase fat. My thyroid hormones are controlled with medication, but due for rechecking next week.

kommodevaran

I'm sure it's more complicated than this, but in short - gallstones build up when your diet is lacking in sufficient fat (preventing the gall bladder from emptying completely), and when they are formed, you need to eat low fat to prevent attacks. After gall bladder is removed, some patients are adviced to "limit" fat, others aren't. I have had random attacks, though very rarely, similar to before I had mine removed. I eat a diet pretty high in fat now, and the attacks seem to come more and more rarely. Couple of years since the last one, I think.

Before I had the operation, I read about and got tips about home remedies to parse the stones, I don't rememeber all of it, but it included large amounts of olive oil, dry bread and black coffee

Now I've heard that you can remove the gallstones surgically and leave the gallbladder intact. I wish that had been an option back in 2000.

ronjsteele1

Easiest way to both get rid of them and prevent future stones - Stonebreaker by Herb Pharm. it takes two 30mL bottles. Cheap as anything on amazon. Dosing is 30 drops twice a day for 15 days. I highly recommend putting the drops in purple grape juice. It doesn't taste great and that's the only stuff we've found tolerable. After the 15 days you can take it once a week for prevention if you want to (I know one person that does this because she's so prone to stones. The others I know do not do this).

This stuff works for gallstones and kidney stones. It breaks them down and you pass them with no pain because they are so broken down. I've had several friends scheduled for surgery that did this prior to surgery and ended up canceling the surgery for removal. Ultrasounds showed their gallstones were gone.

It's a cheap $22 for two 30mL bottles which is way easier and cheaper then surgery or the drug you mentioned. You don't have much to lose by trying it. If it doesn't work for you, the drug is always available (as is surgery).

ronjsteele1

Forgot to add, my husband uses the stonebreaker for kidney stones. My friends have used it for gallstones.

CorneliusPhoton

Never heard of that, @ronjsteele1. Thank you!

Missjulesdid

My gallstone was the size of an egg and could never be pushed out. Attacks were because it got in front of the duct. I didn't want surgery either but had to have it out when it became infected and gangrene. I hope you have a different outcome. Many people live fine with stones and never need surgery.

comptonelizabeth

Just want to say that when I had gallstones it made no difference whether the fat I consumed was "good" or "bad " Your gall bladder can't tell the difference!
Mine caused me a lot of pain so I was happy to have surgery but still have to be careful with fatty food. If you can manage without surgery ,great.
I don't know what the cause is. I've never been overweight neither have I done yo yo dieting (often said to be the cause)