Treatment of gallstones with 'cleanse' not shown to be effective

June 10, 2013|Medical Edge from Mayo Clinic | Tribune Media Services

DEAR MAYO CLINIC: I've been diagnosed with gallstones. I read about a gallbladder "cleanse" that may get rid of gallstones. Is this safe? If it doesn't work, what are the treatment options? I would like to avoid surgery if possible.

ANSWER: A variety of remedies that claim to treat gallstones by cleansing the gallbladder are sold without a prescription. None of them have been shown to be effective. Several prescription medications are available that may dissolve gallstones in some patients. This treatment typically is reserved for people who cannot tolerate surgery, and it is not always effective. For gallstones that are causing symptoms, the most reliable treatment choice usually is gallbladder removal.

Your gallbladder is a small organ on the right side of your upper abdomen, just beneath your liver. The gallbladder contains a digestive fluid called bile that's released into your small intestine. Gallstones are hardened deposits that form in your gallbladder.

If gallstones are not causing symptoms, they usually don't need treatment. Gallstones can lead to problems, though. The most common is pain in your abdomen after you eat -- a symptom called biliary colic.

If left untreated, gallstones that cause symptoms can lead to inflammation of the gallbladder, a condition known as cholecystitis. Gallstones also may pass out of the gallbladder and into the bile duct, blocking the duct. When that duct is blocked, enzymes from the pancreas cannot flow to the small intestine. Instead, they are forced back into the pancreas where they can cause inflammation, a serious condition known as pancreatitis. Because of these potential symptomatic complications, it's important to consider treating gallstones.

The gallbladder cleanse you mention is touted as an alternative remedy for getting rid of gallstones. In most cases, a gallbladder cleanse involves eating or drinking a combination of olive oil, herbs and fruit juice over several hours. Proponents claim that gallbladder cleansing helps break up gallstones and stimulates the gallbladder to release them in the stool.

People who try gallbladder cleansing may see what looks like gallstones in their stool the next day. But what they're really seeing is globs of oil, juice and other materials. None of these cleansing treatments have been shown to be effective for gallstones.

Gallbladder cleansing is not without risk. For some people, it may cause nausea, vomiting, diarrhea and abdominal pain. In addition, some components of the herbal mixtures used in a gallbladder cleanse may present their own health hazards.

Prescription medications that dissolve gallstones may be an option for some people. They can only be used in specific situations, though. The stones must be made up of mostly cholesterol, and they have to be small. Even if they are the right type of stone, it can take months or years for gallstones to dissolve completely with medication. For the medication to be effective long-term, your gallbladder must be functioning correctly. If not, stones are less likely to respond to dissolving medications and new stones are more likely to form.

As long as you don't have an underlying medical condition that makes surgery dangerous, removing the gallbladder usually is the best treatment for gallstones. Gallbladder removal -- a procedure known as cholecystectomy -- can often be performed using a minimally invasive, or laparoscopic, technique. Many people who have laparoscopic cholecystectomy go home the same day.

Side effects from gallbladder removal usually are minor. The most common problem after surgery is mild diarrhea. It may last for several days to several weeks, but it usually goes away without treatment.

Discuss the treatment options for gallstones with your doctor. Together you can review the choices available to you and decide on the best one for your situation. -- Michael Picco, M.D., Gastroenterology, Mayo Clinic, Jacksonville, Fla.

