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‘Everyone thinks of changing the world, but no one thinks of changing himself.’

-Leo Tolstoy, Russian Writer (1828-1910).

Bile Stones

Apart from extremely rare inherited diseases, those ones are of three compositions: Cholesterol, Bilirubin and Calcium-pyrophosphate. 

First mentioned is most frequent, with a prevalence of more than 98%, some readily recognized on simple X-Rays.

 Accumulation occurs in gall bladder. Here it can occasion inflammation (Cholecystitis).

When they free themselves from this location, they travel through the bile duct, causing obstruction at Vater’s Papilla.

Common drainage with Wirsung duct evolves in Pancreatitis. Both complications are daily bread of visceral surgeons.

Long hospitalizations in Intensive Care Units are frequent, sometimes even with fatal outcomes, and severe sequelae.

Surgery

Cholecystectomy is not always without after-effects.

The gall bladder serves an important function of freeing its content on signals from proximal bowel.

Its juice rich with bile salts emulsifies fat in meal bolus, making it readily available for digestion by Lipase secreted by Pancreas.

Lack of this pulsed secretion if gallbladder is missing makes handling of nutriments by intestine more difficult.

Complaints after this operation are though exceptional.

Nevertheless, every intervention goes hand in hand with intricacies, sometimes completely unexpected.

For instance, a lady went to her surgeon asking for an appendectomy. She had no complaints whatsoever, and when the doctor asked her for the reason, she answered that she wanted to undertake a long journey in South-Amerika and did not want to have a surprise.

Well, this lady died after the operation!

Cholesterol Stones

Those appear because of faulty nutrition, with too much animal fat. Switching to a vegetarian diet, with a lot of vegetal oil, would obviate the necessity for cholecystectomy.

Saturated fat dissolves in unsaturated ones, and agglomerations can disappear. This advice serves though more prevention than therapy.

Switch vegetal oils between brands and consume them raw to preserve essential fatty acids!  

Probably a similar primum movens is at hand in alcoholism.

Nutrition rich in starches, sugar and saturated fats is the predisposing factor, and paucity of unsaturated fats serves as a trigger.

Bilirubin

This is the end-product of degradation of Hemoglobin. High levels are generated with Hemoglobinopathies and defective red blood cells.

Sickle-cell anemia and spherocytosis are two well-known entities.

For some of those, regular bloodletting can help.

Calcium-Phosphate

This one is most encountered in Hyperparathyroidism. Last ailment is frequent in chronic deficit of Vitamin D.

People who never go in the sun, or those living in cold climates are thus concerned. Substantiation with pills is one preventive measure.

Recent literature reports occurrence of some tumors with high-dose and long-term vitamin D therapy (Prostate-carcinoma).

Hence, observe discontinuation windows in such regime, as Mother Nature does it with relay of good and bad seasons!

Therapy when high Parathormone is at hand consists in taking away the Adenoma, or three out of four glands, and implanting the last one in an easily observable region, for instance the forearm, in subcutaneous location.

Alcoholism

Such abuse thickens the secretion of exocrine glands, with formation of proteinaceous plugs.

Probably a similar event occurs in lack of fats in one’s nutrition.

Pancreatitis is a frequent result.

Diagnosis

The best modality remains Ultrasound, permitting minute sand to be pinpointed in the bile duct.

Despite of this fact, this modality is extremely demanding, and needs a lot of experience and dedication on the side of the operator, and thus most cases remain out of the diagnostic grasp of modern Medicine.