Gallstones

Psyllium Husk Fibre/Oat Bran Fibre

Diets that are low in fibre are positively correlated with the development of gallstones. Indeed fibre appears to be one of the most important dietary factors, with gallstones being a rare condition among populations with high fibre intake. On the other hand diets that are low in fibre and high in fat and sugar lead to reduced bile synthesis and low bile acid concentration. Fibre also reduces the impact of deoxycholic acid, a compound made from bile by the action of intestinal bacteria. Deoxycholic acid reduces the solubility of cholesterol in bile, making gallstones more likely.

Dandelion

Dandelion has a long history of use as a tonic to the liver. It has been shown to enhance bile flow, thus improving conditions such as liver congestion, bile duct inflammation., hepatitis, gallstones, and jaundice. Dandelion increases bile flow by affecting the liver directly to cause an increase in bile production and flow to the gallbladder, and by causing contraction of the gallbladder resulting in the release of stored bile. In this manner it acts as a lipotropic agent (reduces the accumulation of cholesterol and fat in the liver). The high choline content of dandelion combined with various bitter principles are thought to be the primary reasons for this action.

Phosphatidylcholine (PC)

Phosphatidylcholine, found in lecithin, acts as a lipotropic agent (i.e. prevents accumulation of fat and cholesterol in the liver). Fat and cholesterol build-up can compromise the liver’s capacity to function in detoxification, metabolism & bile production, and can also lead to the development of gall bladder and bile duct disorders (e.g. gallstones). Higher phosphatidylcholine in the bile ensures that cholesterol remains in solution, rather than being deposited in the bile duct. However, whilst there is evidence to support the protective role of PC against the development of gall stones, there is no firm evidence that PC can reduce the size of existing stones.

Lipotropic Nutrients

Choline, methionine and inositol are most common among a group of nutrients known as lipotroic factors, that hasten the removal and decrease the deposition of fat in the liver. These nutrients are particularly helpful in any liver or gallbladder condition related to poor fat removal, including gallstones.

Milk Thistle

Milk thistle has wide ranging liver-supportive properties and may offer benefits in relation to gallstones. Recent studies suggest that Milk Thistle may help prevent new, and dissolve existing gallstones via its ability to increase the solubility of cholesterol in the bile.

Gallstones Summary

Nutrient/Herb Typical intake range

Psyllium husk fibre

Dandelion root extract (4:1 ) (1)

Phosphatidylcholine (2)

Lipotropic nutrients (inositol, choline, methionine)

Milk Thistle extract (80% silymarin) (3)

2-6g per day with large glass of water

250 – 500mg per day

250 – lOOOmg per day (elemental PC)

1 0OOmg of each per day

1 75 – 525mg per day

Reduce/avoid Increase

Caffeinated beverages

Sugar

Refined carbohydrates

Saturated and trans fats

Allergen

Animal proteins

Fried foods

Vegetarian proteins

Complex carbohydrates

Vegetables

Fruit

Nuts and seeds

Oily fish

Whole grains

Water

Lifestyle Factors

• Vegetarian diets are associated with lower incidence of gallstones

Prevention of gallstones is best action – high fibre, vegetarian diet could be key

Footnotes

1. Do not use during pregnancy or lactation. May potentiate the effects of blood pressure medication, diuretics and anti-diabetic medication. Concrrcnt use under medical supervision only.

2. May cause deepening of depressive symptoms in clinical (non-bipolar) depression – use under medical supervision only.

3. Not to be used in pregnancy or lactation. Drugs metabolised by the P450 enzyme system may interact with Milk thistle. Check medication with GP before concurrent use.