What are gallstones? Can you tell me the foods preventing them?

Bile, made in the liver, is stored in gallbladder and it contains water, cholesterol, fat, bilirubin and bile salts. Bile is released from the gallbladder into the small intestine to digest fat. If the bile has too much of bile salts, fats, bilirubin and cholesterol, it can harden into stones.

There are two types of stones, one is cholesterol stones which accounts for about 80% and the rest is bilirubin stones. The stones can be very tiny or as big as a plum and there may be one big stone or hundreds of tiny stones and almost in each possible combination. About 80% of the stones are harmless and not at all detected. Gallstones come with age; obese women get it three times more often than men and are also hereditary.

Gallstones can prevent the flow of bile in the small intestine by blocking the ducts. Other ducts like pancreatic duct, opens in the common bile duct to bring its enzymes to the small intestine. The problem here is the trapped digestive enzymes of the pancreas cause an extremely painful inflammation. If it is blocked for a considerable time, severe damage is possible for liver, gallbladder or pancreas.

The symptoms of this serious problem include:

• Fever
• Jaundice
• Continuous heavy pain.

Diet plays a vital role here because it can influence the amount of cholesterol in the bile, thus preventing the formation of the gallstones. Certain foods can keep cholesterol in solution at the same time they can expel stones into the duct, causing a very painful gallbladder attack.

Increase the intake of water soluble fibre by eating fruits and vegetables. The recommended foods are apples, artichokes, grapefruit, lemon, watermelon, beet roots, broccoli, spinach, celery, carrots, fennel, radish, garlic, barley and olive oil. The non-vegetarian can take fish, turkey without skin and chicken without skin in very small quantities, but they should not forget to take enough fruits and vegetables. This is the best way to treat gallstones is to prevent them.

Whole grains and products and healthy plant oils must also be the part of the food.

The foods to avoid include:

• Meat or meat products,
• Red meat
• Pork
• Egg
• Milk
• Oily or fatty foods
• Spicy foods
• Fast foods
• Junk foods
• Processed foods
• Corn
• Beans
• Nuts
• Onions

If we take less fibre but a lot of sugar, then it is a risk factor. You need not avoid sugar but eat very moderately and take more fruits and vegetables to get enough fibres.

Coffee directly, with no milk or sugar and with or without caffeine, can stimulate the gallbladder to contract, probably bringing a gallbladder attack. It is better to avoid coffee if you are prone to gallstone attacks.

Avoid smoking and tobacco products.

The skipping of breakfast or not eating for a long time may lead to gallstones. We need food so that bile acids keep cholesterol in solution to prevent the formation of gallstone.

Overweight is a risk in women for gallstones and it is better to reduce the weight. But, do not forget, losing weight very quickly gives only the adverse result. It is better to reduce less than three kilos per month.

Physical activities are important. Select according to your time and health. It is better to consult with your doctor before you start.

Can you tell me what causes gallstones?

The gallbladder is a small pear shaped organ located just below the liver in the upper right part of the abdomen. The bile produced in the liver is stored in the gallbladder until the body needs it. Bile is secreted from the gallbladder into the small intestine during the process of fat digestion and absorption from the food. Bile has water, bile salts, fats, cholesterol, protein and bilirubin. We all produce small gallbladder stones which we never notice. When bile crystallizes into big stones the problem starts. Bile can harden if there is too much of bile salts, cholesterol or bilirubin in it. Gallstones are stones that form in the gallbladder or bile ducts.

There are two main types of gallstone and they are:

• Cholesterol stones – 80% are cholesterol stones. They are made mostly of hardened cholesterol and are usually yellowish – green in color.

• Bilirubin stones – 20% are bilirubin stones and are also called as pigment stones. They are made of biliruben, usually small and have a dark color.

Very rarely calcium is also present in bilirubin stones.

Gallstones can be very small or can be as big as a golf ball. Many people who have gallstones do not have any symptoms. The ducts can be blocked and this can cause excess pain and inflammation. Liver, gallbladder and pancreas can be affected.

The causes or risk factors for gallstones include:

• Diabetes – the increased triglycerides are the risk factor here.

• Crohn’s disease – the patients have less bile acids to keep the cholesterol in the solution and these results gallstones.

• Other diseases - cirrhosis of the liver, sickle cell disease and thalassemia are also risk factors of bilirubin gallstones.

• Cholesterol-lowering drugs – these can reduce the cholesterol level in the blood. But, actually it increases the amount of cholesterol in bile.

• Age – people above 60 years are more likely to develop gallstones.

• Obesity – it is a main risk factor in women. Overweight is also a risk factor.

• Rapid weight loss – crash diet to weight loss can produce more cholesterol.

• Estrogen – excess estrogen is a risk factor. Oral contraceptives, pregnancy and hormone replacement therapy can be the reason.

• Ethnicity – for example, the American Indians have higher risk because of the higher levels of cholesterol in their bile. Scandinavians and Mexico-Americans are also in this group.

• Hereditary – can run in the families

• Gender – women has double the risk than men.

There are surgical as well as non-surgical methods of treatment and you doctor can decide which is right for your problem.

Ginger

Ginger is the underground stem of the ginger plant. India and China produce most of the ginger.

The active components of the ginger are the volatile oils and pungent phenolic compounds, such as, gingerols and shogaols. The volatile oils are of 3% and it is the gives volatile oil that the fragrance to ginger.

Ginger is mainly used as a spice in Asian and other countries. In Western countries, ginger is used only in sweet food. But in other countries, the uses are diverse, from sweets to several food preparations. Ginger tea, ginger pickles, spicy seafood or mutton, ginger ale, an aerated sweet beverage and spicier ginger beer are well known ginger products.

In India, ginger spice tea is well known and ginger is used in vegetarian as well as in non-vegetarian foods. In Tamil Nadu it is used to make a candy, called ‘inji murappa’.

Ginger root is widely used as a digestive aid for mild stomach upset and is also recommended by doctors and other health professionals to help prevent or treat nausea and vomiting pregnancy, cancer chemotherapy and motion sickness. Ginger is also a good support in inflammatory conditions such as arthritis and can even be used in heart disease or cancer.

It is safe for children over two years old because of side effects. Normally four grams per day are used for an adult. The dose is calculated for a person weighing 70 kg. Children may weigh 20 to 25 kg and the amount of ginger must be adjusted to their weight. If you want to use ginger for a child below two years old, consult your doctor always. The dose makes the poison.

Allergic reactions have been reported rarely. If you experience a side effect, talk to your doctor immediately. Here the interactions with other medicines should be taken into consideration.

What are the interactions of ginger with other medicines?

Do not use ginger if you take the following medicines:

- any heart medicine
- any medicine including insulin to control blood sugar values
- any medicines to thin the blood such as aspirin or warfarin or heparin

If you take any other medicines consult your doctor or herbal specialist.

Who should not take ginger?

You must consult your doctor before you take ginger if you have the following health problems:

- have gallstones and any other disease of the gallbladder
- have any heart problems or if you take medicines for these
- have diabetes and take medicine to control your blood sugar levels
- have blood clotting or bleeding disorders
- Do not take ginger without first consulting your doctor if you are pregnant or could become pregnant
- Do not take ginger without first consulting your doctor if you are breastfeeding a baby

Why should not be given to children before two years?

There are no scientific studies about this and therefore, we must be careful. Your grandmother can have the fine feeling to use it from her experience with many children but, we cannot expect this from a modern lady who knows better in several other things! Remember always, the dose only makes the poison.