Gall Stone Dissolving Plants: History
View Latest Version
Please note this is an old version of this entry, which may differ significantly from the current revision.
Contributor:
Salman Ahmed

Medicinal plants have been known for thousands of years and are highly esteemed throughout the world as a rich source of therapeutic agents for the prevention and cure of diseases. There is large number of population suffers from gall stone. Gall stones problem is now being increased significantly due to changes in living style and conditions i.e. industrialization and malnutrition. Medicinal plants are used from centuries due to its, cultural acceptability, efficacy, safety and lesser side effects as compared to synthetic drugs.

  • Gall stone
  • anticholelithiatic plants
  • ethnomedicine

1. Introduction

Gallstone is a worldwide problem. Its pervasiveness gives off an impression of being higher in Western countries (>10%) than in Asian countries (3 – 10%). Female sex, older age, higher body mass index (BMI), hyperlipidemia, alcohol consumption, and diabetes mellitus have been accounted for as danger factors for gallstone problem [1][2][3]. Cholelithiasis (gallstone formation) is generally found in adults as compared to children. The frequency of gall stones among children is 1.9%. About 10 - 20% adult population of Western countries suffers from gall stones and its predominance in India is 3 - 6 % [4].

The gallbladder is a sac situated under the liver. It stores and concentrates bile produced in the liver. Bile acids play an important role in the assimilation of fats and are delivered from the gallbladder into the upper small digestive tract (duodenum) in response to food, especially fats Development of stones inside the gall bladder is known as cholelithiasis. In this condition, hard stones composed of cholesterol or bile pigments are formed in the gallbladder. If stones are present in the common bile duct, the condition is called choledocholithiasis. Most of the stones are composed of chole[4]sterol [5].

Bile is composed of bile salts, cholesterol, and lecithin, is present in solution by a delicate harmony. The proportion between bile salts to cholesterol is the most significant, in light of the fact that the bile salts are acid, and without this acid the cholesterol would form crystals and stones. In other words, sufficient bile acids are needed to keep the cholesterol from forming stones in the gallbladder. In bile, cholesterol is in equilibrium with bile salts and with phosphatidylcholine. When the cholesterol in the bile becomes too concentrated, it saturates the bile acids and begins to form crystals. Then a sludge containing cholesterol, mucin, calcium salts and bilirubin is formed and ultimately stones are developed [6].

Cholesterol stones are mainly causes due to difference in the production of cholesterol or the secretion of bile. The most ideal approach to forestall and eliminate gallstones is to bring down the body's general cholesterol level, which lessens the cholesterol in the gallbladder, and in this way makes a healthy bile-to-cholesterol proportion. When this proportion is restored, the bile acids can disintegrate the cholesterol crystals and stones and reestablish the healthy gallbladder. Pigmented stones are chiefly made out of bilirubin, which is an element formed because of the ordinary breakdown of red blood cells [7]. Among various variants of gall stones about 70% patients have cholesterol stones and 30% have pigmented gall bladder stones. The prevalence of Bilirubin or brown pigment stones is highest in East Asia and Africa [4]. Western countries, gallstones are composed mainly of cholesterol as cholesterol monohydrate crystals in 75–80% of the cases. The staying 20% are pigment stones, comprised basically of calcium bilirubinate [8][9].

The significant reasons for gallstones are elevated cholesterol diet, low bile salt levels, decreased gall bladder motility etc. Obesity, female gender, family history, rapid weight loss sharp, and vitamin B12 or folic acid deficiency are considered as significant danger factors in the advancement of gall stones. Gallstones can cause intense pain in the upper right part of the abdomen. This pain may radiate to back and up to the shoulder blade. Other symptoms include nausea, vomiting, light-colored or gray stool, and diarrhea. The clinical presentations include acute cholecystitis and febrile illness with pain and tenderness in the right upper quadrant (Murphy sign: In this condition gallbladder is inflamed, the patient will hastily stop inhaling due

to the pain). This torment may emanate to back and up to the shoulder bone. Different manifestations incorporate queasiness, spewing, light-shaded or dim stool, and looseness of the bowels. The clinical introductions incorporate intense cholecystitis and febrile sickness with torment and delicacy in the correct upper quadrant (Murphy sign: In this condition gallbladder is excited, the patient will quickly quit breathing in because of the agony). Generalized body weakness and weight reduction are considered as most common symptoms of gallstones. The complications incorporate cholangitis, empyema of gall bladder, pancreatitis, abscess formation, porcelain gall bladder and gall bladder perforation [4]. 

External shock wave lithotripsy (ESWL) can be used in the treatment of gall stones [6]. When surgery is to be avoided, extracorporeal shock wave lithotripsy is a noninvasive therapeutic alternative for symptomatic patients. Although serious adverse effects (e.g., biliary pancreatitis, liver hematoma) are rare, limitations of the procedure include stone recurrence [10] ESWL is safer but inferior to laparoscopic cholecystectomy with respect to recurrence rate [11]. The most widely used conventional treatment for symptomatic gallstones is cholecystectomy (gallbladder removal). Most patients experience a resolution of symptoms after cholecystectomy, but about 10-15% of patients suffer from postcholecystectomy syndrome, which is characterized by biliary colic or persistent right upper quadrant (RUQ) abdominal pain with or without dyspepsia [12]. Non-surgical treatment for gall stones is oral dissolution therapy. The oral administration of a naturally occurring bile acid (Ursodeoxycholic acid or Chenodeoxycholic acid), may promote gradual dissolution of radiolucent gallstones over a time of a half year to two years [9]. Methyl tert-butyl ether and monooctanoin (Moctanin) are solvents that are infused directly into the bile duct or the gallbladder to dissolve stones [13]. However, these treatments can cause various gastrointestinal symptoms and other adverse effects. In addition, recurrences are seen in up to 50 % of patients after treatment is discontinued [9].

Anticholelithiatic plants are utilized since old periods before imagining current medicines for treating (dissolution or elimination) gallstones and to avoid their recurrence [14]. Various plants are utilized to fix and forestall cholelithiasis. Although medicinal plants produce slow recovery, these are affordable and less expensive, evidence based traditionally proven dissolution or elimination of gallstones, less relapse

of cholelithiasis, their successful prophylactic use, less side effects, not only revealing their therapeutic potential but encourages patient's belief and increasing their interest in traditional practices to find an herbal cure for gallstones. The use of anticholelithiatic plants in the form of decoction, infusion, juice, powder taken along with water, raw eaten are less expensive than current medication and procedures [15].  Expanding interest for restorative plants become as one of the main territories of exploration. Nonetheless, closer consideration is required for bioactivity-safety evaluation, phytochemical analysis and plant conservation. Extraction and isolation along with clinical trials may develop proactive anticholelithiatic compounds. This could be helpful in creating mass awareness about conservation of such plants to promote ethno-medicobotany knowledge within the region, besides contributing to the preservation of such medicinally important species before they are extinct [16].

2. Gall stone dissolving plants

Table 1: Medicinal plants for dissolving gall stones in different countries and cultures

Cichorium intybus L.

Flowers [17]

Cissus verticillata (L.) Nicolson & C.E. Jarvis.

Leaves decoction [18]

Citrus × aurantium L.

Essential oil from fruit peel [19]

Citrus limon (L.) Osbeck.

Fruit juice [20]

Citrus sinensis (L.) Osbeck.

Fruit juice – China [21]

Cocos nucifera L.

Fruit oil [22]

Costus scaber Ruiz & Pav.

Whole plant [22]

Curcuma longa L.

Roots - Saudi Arabia [23]

Eutrochium purpureum (L.) E.E. Lamont.

Roots decoction [24]

Galium triflorum Michx.

Plant infusion [25]

Gomphrena globosa L.

Flowers [22]

Haloxylon salicornicum (Moq.) Bunge ex Boiss.

Aerial parts - Saudi Arabia [23]

Herniaria hirsuta L.

Whole plant [20]

Hordeum vulgare L.

Seeds - Nepal [26]

Hydrangea arborescens L.

Roots [27]

Juniperus communis L.

Berries [28]

Lycopersicon esculentum Mill.

Fruits [29]

Macrotyloma uniflorum (Lam.) Verdc.

Seeds [30]

Magnolia officinalis Rehder & E.H. Wilson.

Bark [31]

Malva sylvestris L.

Leaves infusion – Algeria [32]

Matricaria chamomilla L.

Flowers decoction [24][33]

Mentha × piperita L.

Leaves decoction – Azerbaijan [34]

Menyanthes trifoliata L.

Leaves infusion – Azerbaijan [34]

Nepeta cataria var. citriodora (Dumort.) Lej.

Aerial parts [35]

Orthosiphon aristatus (Blume) Miq.

Leaves – Philippine[36]

Petroselinum crispum (Mill.) Fuss.

Roots [37]

Phyllanthus amarus Schumach. & Thonn.

Leaves [38]

Pinus sylvestris L.

Needles (Leaves) oil - Germany, Slovenia and Poland [39]

Plantago major L. / Plantago asiatica L.

Seeds[40]

Portulaca oleracea L.

Leaves [22]

Raphanus sativus var. niger (Mill.) J. Kern.

Root juice[41]

Rhamnus purshiana DC.

Bark[42]

Rubia cordifolia L.

Roots[43]

Ruscus aculeatus L.

Roots[44]

Scutellaria baicalensis Georgi.

Roots [45]

Sorbus americana Marshall.

Fruits without seeds [46].

Trianthema monogyna L.

Leaves [29]

Taraxacum officinale (L.) Weber ex F.H. Wigg.

Roots decoction [47][48].

Vaccinium macrocarpon Aiton.

Berry juice[49]

Vitis vinifera L.

Fruits [29]

Zea mays L.

Cobs and corn silk [50]

Zingiber officinale Roscoe.

Rhizome [40]

This entry is adapted from the peer-reviewed paper 10.22271/phyto.2020.v9.i6a.13006

References

  1. Chen CH et al. Prevalence and risk factors of gallstone disease in an adult population of Taiwan: An epidemiological survey. Journal of Gastroenterology and Hepatology 2006;21(11):1737-1743.
  2. Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. The Lancet 2006;368(9531):230-239.
  3. Chen YC et al. The prevalence and risk factors for gallstone disease in Taiwanese vegetarians. Plos One 2014;9(12): e115145. doi: 10.1371/journal.pone.0115145
  4. Iqbal MN, et al. Gall stones: A fundamental clinical review. International Journal of Research in Medical Sciences 2019;7(7):2869.
  5. Bateson MC. Gallstone Disease and its Management. Springer Netherlands 1986. doi:10.1007/978-94-009-4173-1
  6. Dowling R. Pathogenesis of gallstones. Alimentary pharmacology & therapeutics 2000;14(S2):39-47. doi:10.1046/j.1365-2036.2000.014s2039.x
  7. Kim IS et al. Classification and nomenclature of gallstones revisited. Yonsei Medical Journal 2003;44(4): 561-570.
  8. Di Ciaula A, Wang DQH, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Current Opinion in Gastroenterology 2018;34(2):71-80.
  9. Gaby AR. Nutritional approaches to prevention and treatment of gallstones. Alternative Medicine Review 2009;14(3):258-267.
  10. Abraham S et al. Surgical and nonsurgical management of gallstones. American Family Physician 2014;89(10): 795-802.
  11. Darzi A et al. The pros and cons of laparoscopic cholecystectomy and extracorporeal shock wave lithotripsy in the management of gallstone disease. Annals of the Royal College of Surgeons of England 1994;76(1):42.
  12. Madacsy L, Dubravcsik Z, Szepes A. Postcholecystectomy syndrome: From pathophysiology to differential diagnosis: A critical review. Pancreatic Disorders and Therapy 2015;5:162. doi:10.4172/2165-7092.1000162
  13. Allen MJ et al. Cholelitholysis using methyl tertiary butyl ether. Gastroenterology 1985;88(1):122-125.
  14. Joy JM et al. Potent herbal wealth with litholytic activity: A review. International Journal of Innovative Drug Discovery 2012;2(2):66-75.
  15. Ahmed MM, Singh KP. Traditional knowledge of kidney stones treatment by Muslim Maiba (herbalists) of Manipur, India. Notulae Scientia Biologicae 2011;3(2):12-15.
  16. Vaya RK et al. Nephroprotective Plants: A Review. Journal of Bioscience and Technology 2017;8:801-812.
  17. Street RA, Sidana J, Prinsloo G. Cichorium intybus: Traditional uses, phytochemistry, pharmacology, and toxicology. Evidence-Based Complementary and Alternative Medicine 2013; 2013: 579319. doi: 10.1155/2013/579319
  18. Alok S et al. Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review. Asian Pacific Journal of Tropical Disease 2013;3(6):496-504. doi: 10.1016/S2222-1808(13)60107-3
  19. Schiller C, Schiller D, Schiller J. The Aromatherapy Encyclopedia: A Concise Guide to Over 385 Plant Oils. Basic Health Publications, Inc 2008.
  20. Chekroune M, Benamara S. Gallstones-dissolving capacity of lemon (Citrus limon) juice, Herniaria hirsuta L. extract and lemon juice-based natural vinaigrette in vitro. Indian Journal of Traditional Knowledge 2017; 16(2): 197-202.
  21. NI, MAOS. The Natural Health Dictionary: Your comprehensive A-to Z guide for healing with herbs, nutrition, supplements, and secret remedies. Ask Dr. Mao 2011.
  22. Choubey A et al. Potential of medicinal plants in kidney, gall and urinary stones. International Journal of Drug Development and Research 2010;2(2):431-447.
  23. Al-Asmari AK et al. A review of hepatoprotective plants used in Saudi traditional medicine. Evidence-Based Complementary and Alternative Medicine 2014. doi: 10.1155/2014/890842
  24. Page L. Healthy Healing's Detoxification: Programs to Cleanse, Purify & Renew. Healthy Healing Inc. 2008.
  25. Paudyal R, Singh N. Ethno-medicinal uses of animals and plants among the migratory tangbetons of Pokhara, Nepal. Journal of Institute of Science and Technology 2014;19(1):145-149. doi: 10.3126/jist.v19i1.13840
  26. Quattrocchi U. CRC World Dictionary of Medicinal and Poisonous Plants: Common Names, Scientific Names, Eponyms, Synonyms, and Etymology. CRC Press 2016.
  27. Crellin JK, Philpott J, Bass ALT. Herbal Medicine Past and Present: A reference guide to medicinal plants. Duke University Press 1990.
  28. Tshiteya RM. Herbal Medicines for Common Ailments: A Quick Reference Guide. Natural Remedies, Incorporated 2007.
  29. Das I, Verma S. Human Stones: Dissolution of calcium phosphate and cholesterol by edible plant extracts and bile acids Journal of Scientific and Industrial Research 2008; 67: 291-294.
  30. Bigoniya P, Bais S, Sirohi B. The effect of Macrotyloma uniflorum seed on bile lithogenicity against diet induced cholelithiasis on mice. Ancient Science of Life 2014; 33(4):242-251. doi : 10.4103/0257-7941.147433
  31. MacLean W, Taylor K. Clinical Manual of Chinese Herbal Patent Medicines. Pangolin Press 2000.
  32. Amoura NB et al. Évaluation de la capacité de dissolution des calculs biliaires de Malva sylvestris L. Evaluation of the dissolving capacity of gallstones of Malva sylvestris L. Bulletin de la Société Royale des Sciences de Liège 2018;87:56 - 61.
  33. Sharifi-Rad M et al. Matricaria genus as a source of antimicrobial agents: From farm to pharmacy and food applications. Microbiological Research 2018;215:76-88. doi : 10.1016/j.micres.2018.06.010
  34. Ibadullayeva S et al. Medico-ethnobotanical inventory (liver and gallbladder ducts illnesses) of Nakhchivan AR, Azerbaijan. International Journal of Science 2015;4(6):80-88.
  35. Balz R, Dandrieux B. The Healing Power of Essential Oils: Fragrance Secrets for Everyday Use. Dehli: Motilal Banarsidass Publishers Private Limited 1999.
  36. Chai TT et al. Orthosiphon aristatus: A review of traditional uses, phytochemical profile, and pharmacological properties. In: Traditional and Folk Herbal Medicine: Recent Researches, Gupta VK. Daya Publishing House: New Delhi 2014, P153-187.
  37. Kilham C. The Whole Food Bible: How to Select & Prepare Safe, Healthful Foods. Inner Traditions / Bear & Co 1996.
  38. Meena J, Sharma R, Rolania R. A review on phytochemical and pharmacological properties of Phyllanthus amarus Schum, and Thonn. International Journal of Pharmaceutical Sciences and Research 2018;9(4):1377-1386. doi: 10.13040/IJPSR.0975-8232.9(4).1377-86
  39. Mercier B, Prost J, Prost M. The essential oil of turpentine and its major volatile fraction (α-and βpinenes): A review. International Journal of Occupational Medicine and Environmental Health 2009;22(4):331-342. doi: 10.2478/v10001-009-0032-5
  40. Joy J et al. Potent herbal wealth with litholytic activity: A review. International Journal of Innovative Drug Discovery 2012;2(2):66-75.
  41. Castro-Torres IG et al. Antilithiasic and hypolipidaemic effects of Raphanus sativus L. var. niger on mice fed with a lithogenic diet. BioMed Research International 2012:161205. doi: 10.1155/2012/161205
  42. Harris P, Nagy S, Vardaxis N. Mosby's Dictionary of Medicine, Nursing and Health Professions - Revised 3rd Anz Edition. Elsevier Health Sciences 2018.
  43. Verma A et al. Rubia cordifolia - A review on pharmaconosy and phytochemistry. International Journal of Pharmaceutical Sciences and Research 2016;7(7): 2720-2731. doi: 10.13040/IJPSR.0975-8232.7(7).2720-31
  44. Mantle F, Tiran D. A-Z of Complementary and Alternative Medicine E-Book. A guide for health professionals. Elsevier Health Sciences 2009.
  45. Zhao T et al. Scutellaria baicalensis Georgi. (Lamiaceae): A review of its traditional uses, botany, phytochemistry, pharmacology and toxicology. Journal of Pharmacy and Pharmacology 2019;71(9):1353-1369. doi: 10.1111/jphp.13129
  46. Rayburn D. Let's Get Natural with Herbs. Ozark Mountain Publishing 2007.
  47. Capasso F et al. Phytotherapy: A Quick Reference to Herbal Medicine. Springer Science & Business Media 2003.
  48. Hechtman L. Clinical Naturopathic Medicine. Elsevier Health Sciences 2012.
  49. Ensminger ME, Ensminger AH. Foods & Nutrition Encyclopedia. 2nd Edition, Volume 1, CRC Press, 2019.
  50. Owoyele B et al. Analgesic and anti-Inflammatory effects of aqueous extract of Zea mays husk in male Wistar rats. Journal of Medicinal Food 2010;13:343-347. doi: 10.1089/jmf.2008.0311
More
©Text is available under the terms and conditions of the Creative Commons-Attribution ShareAlike (CC BY-SA) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
This entry is offline, you can click here to edit this entry!
ScholarVision Creations
Feedback