Ox Gallstones Central Africa

A cattle byproduct, Ox Gallstones are in high demand as Chinese herbal medicine. They are highly sought after as an aphrodisiac in Hong Kong.

The aetiology of gallstones is complex and depends on multiple factors, including diet, age, sex, lifestyle and genetics. Symptomatic gallstones develop in most people and can lead to severe complications.

Prevalence

Gallstones are a common health problem worldwide. They are formed in the biliary tract, mainly in the gallbladder and the common bile duct. They can form solitary stones or mixed stones. There are two major types of gallstones: pigment (bilirubin) and cholesterol stones.

Pigment stones are composed of calcium carbonate and phosphate, whereas cholesterol stones consist of a large amount of calcium soaps and fatty acid salts. In both cases, the stones are surrounded by a framework of mucin glycoproteins secreted by the biliary epithelium.

Cholesterol stones are formed when bile contains excessive amounts of cholesterol. They can also be caused by bacterial infection of the bile ducts. Patients with hepatic disease such as cirrhosis or chronic haemolysis are at risk of developing cholesterol stones.

Most symptomatic gallstones are treated with cholecystectomy, the surgical removal of the gallbladder. Other treatments include extracorporeal shockwave lithotripsy and oral dissolution therapy, which involves ingesting a medication that gradually softens and dissolves cholesterol gallstones.

The aetiopathogenesis of gallstones is complex and involves multiple physiologic and pathological processes that result in the formation of stones. Genetic factors are important, as they may control the synthesis of enzymes that contribute to the formation of gallstones.

Some studies have shown that genetic variants in the genes ABCG5 and ABCG8 may be associated with gallstone disease. These variants are commonly found in European and American populations and have been linked to higher prevalence of gallstones.

Another study suggests that obesity is a key factor in the development of gallstones. This is because overweight and obese people tend to have slower intestinal transit, increased levels of triglycerides, and an enhanced risk of gallstone formation [56].

Gallstones are a major cause of morbidity in both developed and developing countries. They are associated with an increased risk of gastrointestinal cancers and cardiovascular diseases, as well as an increase in mortality.

Ox gallstones are in high demand as a precious Chinese herbal medicine. They are harvested from cattle and are sold at the retail level in either their natural, unprocessed state or as a proprietary Chinese medicine mixed with other ingredients. The price of a kilogram of ox gallstones can be as high as HK$19,000, or US$65 per gram.

Symptoms

Gallstones are hard deposits of bile components that form in the gallbladder or in the bile ducts, which transport bile from the liver to the small intestine. They are caused by an excess of cholesterol, bile acids, or both, or by a combination of these factors.

A gallstone can vary in size from a microgram to a golf ball. They may be composed primarily of cholesterol, or they may contain other substances such as phospholipids and bile acids (Zakko 2018; Ibrahim 2018).

The most common symptom is a dull, ache in the right upper abdomen, which is usually related to an obstruction of the cystic duct (Byrne 2006). A large stone can cause a painful “attack” that typically results in cholangitis, which can result in jaundice.

Generally, patients with symptomatic gallstones are treated by surgery. However, for those with asymptomatic gallstones, most physicians recommend that the stones be left alone unless symptoms occur.

The most likely cause of gallstones is cholesterol and bile acid malabsorption (Lombardo 2012; Zakko 2018). Cholesterol modifying medications, such as statins, are not known to decrease the rate of gallstone formation, but may reduce the risk of gallstones by blocking the synthesis of cholesterol from bile acids. Similarly, bile acid supplementation is thought to have a positive impact on the development of gallstones. The most important factor in preventing gallstones is maintaining a healthy weight, which helps keep bile acids balanced and prevents the formation of stones.

Diagnosis

Gallstones can be a difficult condition to diagnose. Many people develop gallstones without symptoms, and some asymptomatic or “silent” stones can cause serious complications (Stinton 2012; Ibrahim 2018).

The most common type of gallstone is cholesterol-rich, which forms in the gallbladder and bile ducts (cholesterol stones) [1,3]. Pigment gallstones, which are made of bilirubin, are also a cause of problems.

There are several risk factors for gallstones, including obesity, hypercholesterolemia, and a high-calorie diet. Surgical treatment for symptomatic gallstones is available, including cholecystectomy, which removes the gallbladder, and laparoscopic cholecystectomy, a procedure that is performed through the abdominal wall. In addition to conventional medical treatments, patients can also improve their chances of preventing gallstones by improving their diet and lifestyle choices, including physical activity and avoiding smoking.

In the United States, about 38 million Americans have gallstones, and one million new diagnoses are made each year (Zakko 2018; Stinton 2012). A significant number of asymptomatic gallstones are discovered accidentally during tests for other reasons.

The diagnosis of a gallstone is typically made by taking a sample of the gallbladder and bile. The doctor will then order an ultrasound exam to determine the location and size of the stone. A MRI or CT scan may be necessary in some cases to confirm the diagnosis and identify any underlying disease or other conditions that can increase the risk of gallstone formation.

Once the location and type of stone have been determined, the doctor can determine the best approach to treat it. Surgery is usually recommended, but a ursodeoxycholic acid solution may be used instead to dissolve smaller, more difficult-to-treat gallstones.

Cholesterol gallstones are typically asymptomatic, but they can cause pain or discomfort in the upper abdomen, back, or under the right shoulder. They can sometimes cause inflammation of the gallbladder, called cholecystitis. This condition can progress to blockage of the common bile duct, which can cause jaundice and indigestion.

Moreover, gallstones that are too large to pass through the bile duct can block the small intestine and cause bloating, cramping, and intestinal obstruction. This can be a life-threatening condition.

Treatment

Gallstones are formed when cholesterol, bilirubin (a substance produced in the body that is normally removed from the blood), and calcium form crystals in the gallbladder. These crystals can cause a blockage in the gallbladder and bile duct. This condition can be life-threatening if left untreated.

People with diabetes, high blood pressure, or abdominal obesity are more likely to develop gallstones than those without these risk factors. Having low HDL cholesterol levels may also contribute to the development of these stones.

The most common treatment for gallstones is surgery, called cholecystectomy. This is usually performed after a patient has suffered an episode of acute cholecystitis (inflammation of the gallbladder). However, this surgery is not always necessary and should only be recommended if other options are not available.

Other possible medical treatments include ursodeoxycholic acid (Actigall), which decreases the amount of cholesterol produced by the liver and lowers the saturation of cholesterol in the bile; and urokinase, a drug that helps to dissolve small, cholesterol-rich stones. These treatments have been reported to relieve symptoms within two to three months, although it may take years for the gallstones to be completely dissolved (Zakko 2018; Jones, Ghassemzadeh 2018; Sinha 2002; Portincasa 2012).

In addition, certain medications can also affect bile production and cause the formation of gallstones. These drugs include some NSAIDs, such as aspirin and ibuprofen; and the drug propofol, which can help to relax the muscles of the gallbladder.

Another potential gallstone-related disease is peptic ulcer disease. This condition causes severe upper-abdominal pain that often occurs after eating. It can lead to a serious infection of the pancreas, called pancreatitis.

A third potential diagnosis is cirrhosis of the liver, a chronic disease that involves the breakdown of red blood cells and may increase cholesterol in the bile. Patients with cirrhosis have increased cholesterol secretion, which can increase the risk of gallstones in the bile ducts.

Some studies have suggested that a compound from milk thistle, known as silymarin, could help to prevent the development of gallstones by reducing bile secretion. This treatment option is not currently used in the United States but has been shown to work in animal models.

Ox Gallstones Central Africa