Nutritional approaches to prevention and treatment of gallstones.

Cholesterol gallstones are among the most common gastrointestinal disorders in Western societies. Individuals with gallstones may experience various gastrointestinal symptoms and are also at risk of developing acute or chronic cholecystitis. Cholecystectomy is the most frequently recommended conventional treatment for symptomatic gallstones. Bile acids (ursodeoxycholic acid or chenodeoxycholic acid) are also used in some cases to dissolve radiolucent stones, but these drugs can cause gastrointestinal side effects and there is a high rate of stone recurrence after treatment is discontinued. Lithotripsy is used in some cases in conjunction with ursodeoxycholic acid for patients who have a single symptomatic non-calcified gallstone. There is evidence that dietary factors influence the risk of developing cholesterol gallstones. Dietary factors that may increase risk include cholesterol, saturated fat, trans fatty acids, refined sugar, and possibly legumes. Obesity is also a risk factor for gallstones. Dietary factors that may prevent the development of gallstones include polyunsaturated fat, monounsaturated fat, fiber, and caffeine. Consuming a vegetarian diet is also associated with decreased risk. In addition, identification and avoidance of allergenic foods frequently relieves symptoms of gallbladder disease, although it does not dissolve gallstones. Nutritional supplements that might help prevent gallstones include vitamin C, soy lecithin, and iron. In addition, a mixture of plant terpenes (Rowachol) has been used with some success to dissolve radiolucent gallstones. The gallbladder flush is a folk remedy said to promote the passage of gallstones. While minimal scientific evidence supports the efficacy of this treatment, anecdotal reports suggest the gallbladder flush may be beneficial for some people.