August 24, 2018 at 6:48 am #735
Dr. Tranchitella highlighted a very important point regarding specific gallbladder cleanses and the potential for a gallstone to become lodged within the biliary/common bile duct. I have a patient who has been diagnosed with gallstones, via ultrasound, and I wondered what you have found effective for dissolving these stones? I know phosphatidylcholine can prevent stones, but what would actually eliminate them?
In addition, if the patient is dx with SIBO would it not be more prudent to address bowel and bile function first prior to incorporation of antimicrobials?
August 28, 2018 at 8:18 am #739
In SIBO, the quickest way to symptom reduction is antimicrobial therapy. People will feel better fairly quickly which gives them some relief. However, working on bile flow and bowel function concurrently is a good idea if possible, but this can depend on who sensitive your patient is. The use of binders, e.g. GI Detox+ are typically well tolerated and help with symptom reduction too with or with antimicrobials because they help to bind up some of the toxins being generated in the small intestine.
In an ideal situation working on the bile flow, digestion, motility, etc. first is preferred prior to treating with antimicrobials, but if you have an individual who is extremely symptomatic, e.g. excessive bloating, gas, loose stools because of bacterial overgrowth than treating with antimicrobials to provide some relief (even if its temporary) may be preferred. Many times getting them started on a SIBO reduction diet is enough to provide symptom relief so that other supportive supplements can be started.
The attempt to to dissolve already created gallstones, depending on how large they are, is controversial. I don’t know of any full proof measures to get this done. There are lots of articles online that discuss different options. Here are some different examples:
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