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From:
Kim Kline <[log in to unmask]>
Reply To:
Paleolithic Eating Support List <[log in to unmask]>
Date:
Thu, 3 Sep 2009 14:40:03 -0600
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I have heard from several people that this flushes are false.  See below.  I
was given my stones when I had my gallbladder out and they are literally has
hard as stones.

Kim

Gallbladder and liver "flushes" are widely advocated as a way of treating
gallstones and helping with medical conditions ranging from allergies to
cancer [1-4]. In the usual “flush,” half a cup or more of a vegetable oil is
consumed together with citrus juice and Epsom salts (magnesium sulphate),
usually after a brief fast. Many green, brown, yellow or black blobs of
various sizes may later appear in the bowel movements. Some bear a slight
resemblance to gallstones, but they are not stones. They are merely
bile-stained "soaps" produced by partial saponification (soap formation) of
the oil. A recent demonstration found that mixing equal volumes of oleic
acid (the major component of olive oil) and lemon juice produced several
semi-solid white balls after a small volume of potassium hydroxide solution
was added. After air-drying at room temperature, these balls became quite
solid and hard. When formed in the intestine, these objects absorb bile and
become green <http://curezone.com/upload/liver_flush/debate/soapstones.jpg>[5].
It has also been shown that red dye will appear in the interior of the
“stones” if consumed with the oil [1].
  The fact that the material is due to some kind of transformation of the
oil is clear from user descriptions and ultrasound images. The most obvious
evidence is that the alleged “stones” float on the toilet water [2,3,6], as
might be expected of a largely oil-based substance. Gallstones sink.
Patients with medically diagnosed gallstones may be able to confirm this for
themselves by looking at their own ultrasound scans.The stones, if free to
move, will settle at the lowest part of the gallbladder, even though bile is
much denser than water. The picture to the right shows a cross-section of
the gallbladder (the oblong black area) with three moderately large stones
in the lowermost area.

Supporters of the flushes claim that although some kinds of stones sink in
water, cholesterol stones, being composed of lighter material, will float
[2,3].That's not true. Cholesterol stones can display some buoyancy while in
the gallbladder, but only by floating between the older, concentrated bile
lying in the lowest part of the gallbladder and the fresher, less
concentrated bile above. Radiologists can use this “layering” effect to
determine whether the stones are likely to be mainly cholesterol and thus
suitable for gallstone dissolution using bile salts such as ursodeoxycholic
acid. The same stones will sink in water and also in the slightly denser
formol-saline preservative commonly used in operating rooms when saving the
stones for the patient or for laboratory analysis. This is why people
accustomed to handling real gallstones simply *know* that they always sink.
Other clues about the true nature of the "stones" include:

   - They tend to dissolve into an oily smudge in time, or with heat [5].
   Patients are advised to keep them in the freezer [1,2]. Gallstones are
   stable.
   - They have an irregular globular shape and in the many available photos
   [4] never display the sharply facetted appearance that gallstones often have
   when rubbing up against each other in an overcrowded gallbladder.
   - They are usually described as soft [7] and waxy or “gelatinous” [8].
   Real gallstones are often very hard and difficult to crack. Softer
   gallstones always have a fine, crumbly, dry texture.
   - Gallstones are thus difficult to cut cleanly with a knife, unlike the
   “stones” shown at http://curezone.com/ig/i.asp?i=7072.
   - They may be bright green and possess a translucency *never* seen in
   gallstones <http://curezone.com/ig/i.asp?i=13>.
   - They can be produced in amounts far beyond the capacity of either the
   gallbladder or the entire biliary system, as long as flushes are continued
   and regardless of whether the user still has a gallbladder.

*Could Gallstones Be Expelled?*

It seems likely that gallstones might occasionally be expelled. Small stones
are regularly expelled from the gallbladder. There is some risk that stones
over about 5mm in diameter will lodge in the bile duct, but most pass on
into the bowel and out of the body unnoticed. Gallbladders may spontaneously
empty themselves of small stones, but this is rare [9].

Also, the large oily meal would stimulate strong gallbladder contraction.
This could help expel small gallstones or even, very rarely, a whole crop of
small gallstones or sludge. Whether the whole ritual is needed is another
matter. A meal of fried fish and chips, or the “whole fat milk and a Mars
bar” sometimes used to stimulate gallbladder contraction during x-ray
examinations might serve as well.

The magnesium sulphate (Epsom Salts) could have an added effect, as it also
stimulates gallbladder contraction and relaxes the muscles controlling the
release of bile into the intestines. However, it acts in the same way as
would fat or oil, causing the release of cholecystokinin from the upper
small intestine [10]. The availability of that hormone and the ability of
the gallbladder to respond to it would be limiting factors. The chance of
success is further diminished by the fact that patients with symptomatic
gallstones often have impaired ability of the gallbladder to empty (a factor
in gallstone formation), stones that are too big to pass, or a blocked
gallbladder duct (the “non-functioning gallbladder” in contrast studies).

Moreover, it can be predicted that even if occasionally successful, most
patients would go on to form more stones. After successful dissolution of
gallstones with ursodeoxycholic acid, 30-50% of patients form new stones
within five years [11]. Despite much research, no simple, safe, or dietary
measure has been found to prevent gallstone formation. The traditional
fat-free diet has shown no consistent benefit [12], possibly because an
occasional fatty meal helps expel small stones or sludge. This may be why
patients on prolonged intravenous feeding are prone to develop gallstones.

In a popular variant, large quantities of apple juice are consumed in the
days prior to the olive oil and lemon juice (or equivalent). Its supporters
claim that apple juice is a stone solvent [13], usually offering in support
a reference to the prestigious medical journal, *The Lancet *[14]. The cited
item, “Apple juice and the chemical-contact softening of gallstones,” is
merely a brief letter to the editor stating that the writer's wife had
passed soft, brown, “fatty stones” after drinking a lot of apple juice and
then a cupful of olive oil, apparently as part of a gallbladder flush*. This
source offers no evidence that apple juice can soften gallstones*. Actually,
there is no way for apple juice or any other agent taken by mouth to come
into contact with stones in the gallbladder or bile ducts. A very effective
sphincter muscle prevents intestinal contents from leaking back into the
bile duct or gallbladder. Thus there is no logical reason to believe that
any of the materials consumed in the "flushes" (oils, fruit juices,
magnesium sulfate) could soften or otherwise affect the characteristics of
gallstones in the gallbladder or bile ducts. Bile salts such as
ursodeoxycholic acid can do so, but they must be absorbed into the blood
stream and processed by the liver before they can affect the ability of bile
to dissolve cholesterol stones—and a minimum of nine months of treatment is
usually required.

*Liver Stones*

"Flush" proponents claim that liver stones are common, and one has even
stated that 99.95% of cancer patients have them [8]. However, stones within
the small liver ducts are very rare, at least in Western communities, as
might be expected because the bile produced by the liver is 5-10 times less
concentrated than gallbladder bile. Small stones released by the gallbladder
will occasionally drift into a liver duct. Otherwise stones mainly only
develop in the liver ducts secondary to other serious biliary pathology such
as strictures, choledochal cysts or bile duct cancers. Their rarity, even in
patients known to be prone to stone formation is illustrated by a recent
study on patients with gallstones but with no other biliary problems [7].
Only 3.5% of such patients were found to have stones in the bile ducts when
imaging studies (cholangiography) were performed during their surgery. At
least 95% of such stones were in the main bile duct, usually beyond the
entrance of the gallbladder duct. Cholangiography can detect stones as small
as 1-2 mm in the narrow liver ducts.

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