Condition
Gall Stones
Gallstones are hardened deposits that form within the gallbladder from components of bile such as cholesterol or bile pigment.
Overview
Aetiology
Cholesterol Stones
Approximately 80% of gallstones are made of cholesterol deposits. High cholesterol concentrations in bile can reduce its solubility and cause it to fall out of solution. Cholesterol then builds up over time and forms clumps, which can aggregate and eventually fuse to form larger deposits.
Causes may include:
- High cholesterol concentrations in the bile
- Incomplete gallbladder emptying
- High bilirubin levels in the gallbladder (bile pigment stones)
Bile Pigment Stones
Bile pigment stones account for about 20% of cases. They form when bile pigments become too concentrated, or fall out of solution due to the presence of other compounds, causing them to crystallize into solid deposits.
Presentation
Symptoms
Many gallstones are asymptomatic. When symptoms occur, they typically include episodes of steady, severe pain in the upper right abdomen (biliary colic), often after fatty meals, which may radiate to the back or right shoulder. Nausea, vomiting, and bloating are common, and obstruction can lead to jaundice, fever, and pale stools.
Assessment
Diagnostic Considerations
- Ultrasound or CT scan
- Bilirubin
- Alkaline Phosphatase (ALP)
- Gamma Glutamyl Transferase (GGT)
- Alanine Aminotransferase (ALT)
- Aspartate Aminotransferase (AST)
- Lactate Dehydrogenase (LDH or LD)
- BUN/Urea
- Uric Acid
- Creatinine
- Urea/Creatinine Ratio
- Total Protein
- Albumin
- Functional Liver Detoxification Profile (FLDP)
- WCC (Elevated?)
Assessment
Differential Diagnosis
- Gallbladder cancer
Comorbidities/Complications
- Gallbladder cancer
- Blockage of the pancreatic duct
- Blockage of the common bile duct
- Inflammation of the gallbladder
The Compounds
Research Compounds (1)
Individual molecules studied for gall stones. These are research findings, not supplements to take — each page states how far the evidence goes.
Diosgenin
Steroidal sapogenin (spirostanol aglycone; (25R)-spirost-5-en-3β-ol)
Diosgenin is the steroidal sapogenin at the core of wild yam, fenugreek and the whole dioscin/protodioscin family — the molecule from which progesterone and cortisone were industrially semi-synthesised in the 1940s, launching the modern steroid-drug industry and the oral contraceptive. That was factory chemistry. The human body has no enzyme that performs it, and the belief that wild yam converts to progesterone is the most durable false claim in herbal medicine. What diosgenin does do — cholesterol absorption, oestrogen-receptor binding, NF-κB suppression — is real, separately evidenced, and unrelated to that history.