I think I may have already said this, and yet, here I go again: I am not an expert. I am more of an unwilling participant in the gallstone epidemic – one who happens to have felt the need to compile a book of recipes which might help fellow sufferers. If you are looking for more detailed information about the gallbladder, gallstones, diet or treatment, please see the following recommended reading:
Dr Sandra Cabot MD and Margaret Jasinska ND. Save Your Gallbladder and what to do if you’ve already lost it. 2013. SCB (Sarah Cabot Books) International.
Dr Sarah Brewer. Overcoming Gallstones: nutritional, medical and surgical approaches. 2014. Createspace/Medilance.
Monika Shah. The Gallbladder Diet Guide: A Complete Diet Guide for People with Gallbladder Disorders (Gallbladder Diet, Gallbladder Removal Diet, Flush Techniques, Yoga’s, Mudras & Home Remedies for Instant Pain Relief). 2017: Createspace.
Further research notes
I realise that there are those of you who would like some real facts, not just my largely uneducated opinion, though I have included excerpts from books written by people far more educated than I. (With their permission, of course).
However, in my research for this book, I did come across facts, research papers and references, which do not necessarily fit with the tone of this book but may provide some further (intelligent) information. Enjoy!
Cholelithiasis: Noun meaning the formation of gallstones.
Cholecystectomy: Noun meaning the surgical removal of the gallbladder.
To quote from the paper by Sakorafas et al: ‘About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Despite some controversy, most authors agree that the vast majority of these people should be managed by observation alone (“expectant management”). Routine cholecystectomy for all subjects with silent gallstones is too aggressive a management option. Management options should be extensively discussed with the patient; he or she should be actively involved in the process of therapeutic decision making.’
Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52(5): 1313–1325.
To quote from the abstract of Liddle et al: ‘A study was undertaken involving 51 obese subjects, who were put on calorie-controlled diets, and 26 non-dieting subjects. Over an 8 week period, the subjects (who were deemed to have no gallstones prior to the study) were scanned to investigate any formation of gallstones. Sonography performed after 4 weeks of dieting revealed new-onset gallbladder sludge in 1 subject and gallstones in 4 subjects. After 8 weeks of dieting, sludge was detected in 3 subjects and gallstones in 13 (25.5%). In contrast, none of the non-dieting subjects developed any detectable gallbladder abnormalities. During the dieting period, one of 51 subjects developed symptoms of biliary colic, necessitating cholecystectomy. On cessation of dieting with reinstitution of normal feeding, two additional subjects with stones developed symptoms severe enough to require cholecystectomy. It was concluded that this form of weight-reduction dieting predisposes to the development of gallstones and that gallstone formation is a risk of this type of prolonged calorie restriction.’
Liddle RA, Goldstein RB, Saxton J. Gallstone formation during weight-reduction dieting. Arch Intern Med 1989; 149: 1750–1753.
A study by Nakeeb et al concluded that genetic factors are responsible for at least 30% of symptomatic gallstone disease. However, the true role of heredity in gallstone pathogenesis is probably higher because data based on symptomatic gallbladder disease underestimates the true prevalence in the population.
Nakeeb A, Comuzzie AG, Martin L, Sonnenberg GE, Swartz-Basile D, Kissebah AH, Pitt HA. Gallstones: genetics versus environment. Annals of Surgery 2002; 235(6): 842–849.
To quote from the study by Wittenbury & Lammert: ‘Geographic and ethnic differences in gallstone prevalence rates and familial clustering of cholelithiasis imply that genetic factors influence the risk of gallstone formation.’
Wittenburg H, Lammert F. Genetic predisposition to gallbladder stones. Semin Liver Dis 2007; 27(1): 109-121.
Studies have shown that dietary soluble fibre inhibits cholesterol stone formation by reducing the biliary cholesterol saturation index. This protective effect is associated with a selective decrease in biliary cholesterol.
(Soluble fibre is found in oats, peas, beans, apples, citrus fruits, carrots, barley and psyllium.)
Schwesinger WH, Kurtin WE, Page CP, Stewart RM, Johnson R. Soluble dietary fiber protects against cholesterol gallstone formation. American Journal of Surgery 1999; 177: 307–310.
Yes, children can get gallstones and the occurrence of paediatric gallstones is increasing. In fact, a study conducted in 2012 concluded that there had been a three-fold increase in the incidence of paediatric cholecystectomy in England since 1997, with a particular rise among white females. Although data on BMI (body mass index) was not available, the observed effect may be a consequence of increasing levels of teenage obesity.
Khoo AK, Cartwright R, Berry S, Davenport M. Cholecystectomy in English children: evidence of an epidemic (1997-2012). J Pediatr Surg 2014; 49(2): 284-288. doi: 10.1016/j.jpedsurg.2013.11.053.