From the Guidelines
Dietary changes alone cannot dissolve gallstones completely, but a low-fat diet with plenty of fiber, fruits, vegetables, whole grains, and lean proteins may help manage symptoms and potentially slow gallstone growth. The most recent and highest quality study on dietary changes for gallstone management is not directly available, but a study on kidney stone disease provides some insights into the role of diet in stone formation 1. According to this study, a diet high in calcium can actually reduce the risk of stone formation by binding dietary oxalate in the gut. However, it's essential to note that the relationship between diet and gallstone formation is complex, and more research is needed to determine the best dietary approach for gallstone management.
Some key dietary recommendations that may be beneficial for gallstone management include:
- Limiting foods high in cholesterol and saturated fats, such as fried foods, fatty meats, and full-fat dairy products
- Including healthy fats from sources like olive oil, avocados, and nuts in moderation
- Staying well-hydrated by drinking plenty of water throughout the day
- Consuming foods with vitamin C, calcium, and coffee, which have been associated with reduced gallstone risk
- Maintaining a healthy weight and avoiding rapid weight loss, as this can actually increase gallstone formation
It's also important to understand that once gallstones have formed, medical treatments like ursodeoxycholic acid (Ursodiol) may be prescribed for certain types of gallstones, but surgery (cholecystectomy) remains the definitive treatment for symptomatic gallstones, as noted in a guideline for the treatment of gallstones 1. Nonsurgical therapy, such as oral bile acids, may also be an option for certain patients, but its use is limited due to its limited efficacy and the need for long-term treatment.
From the Research
Diets to Dissolve Gallstones
- There is evidence that dietary factors influence the risk of developing cholesterol gallstones 2
- Dietary factors that may prevent the development of gallstones include polyunsaturated fat, monounsaturated fat, fiber, and caffeine 2
- Consuming a vegetarian diet is also associated with decreased risk of gallstones 2
- Identification and avoidance of allergenic foods frequently relieves symptoms of gallbladder disease, although it does not dissolve gallstones 2
- Nutritional supplements that might help prevent gallstones include vitamin C, soy lecithin, and iron 2
- A mixture of plant terpenes (Rowachol) has been used with some success to dissolve radiolucent gallstones 2
Medical Treatment of Gallstones
- Ursodeoxycholic acid (ursodiol) is a naturally occurring bile acid that can be used to dissolve radiolucent gallstones 3, 4
- Successful dissolution of gallstones with ursodiol occurs in 30-80% of subjects, depending on the size and number of the stones 3
- Calcified or pigment stones do not respond to ursodiol treatment 3
- Ursodiol is virtually free of side effects and toxicity, with less than 1% of subjects experiencing transient diarrhea 3, 4
Risk Factors for Gallstones
- Obesity is a risk factor for gallstones 2, 5
- Diets containing a high proportion of refined carbohydrates and fat increase the risk of cholesterol-rich gallstones 5
- Low-calorie diets and rapid weight loss are also associated with cholesterol-rich gallstones 5
- Women have a higher prevalence of gallstones than men, which is attributed to exposure to oestrogen and progesterone 5