So you think you need . . . a gallbladder operation:What to do instead

* Have your cholesterol checked and switch to a low-cholesterol diet, if necessary, to avoid gallstone development.

* If you need to, lose weight – but gradually, as this will avoid the release of tissue cholesterol that occurs with rapid weight loss (Am J Surg, 1993; 165: 541-8).

* Avoid surgery if your stones are ‘silent’ or you can tolerate the symptoms. Of 135 asymptomatic patients, only 10 per cent developed symptoms and 7 per cent required an operation. Of 556 symptomatic patients, only 44 per cent had an operation because of persistent symptoms (Ann Surg, 1985; 202: 59-63).

* Drink plenty of water to avoid overconcentration of bile.

* Check for food intolerances and eliminate the offending foods from your diet.

* Take regular aerobic exercise (Med Hypoth, 2003; 60: 143-7), which also has a beneficial effect on abnormally high levels of insulin, often associated with gallbladder disease.

* Change your diet. Avoid processed carbohydrates and sugars, and fried foods, as well as foods rich in cholesterol, and monosaturated and saturated fatty acids. Eat more fibre and calcium-rich foods (Am J Surg, 1993; 165: 541-8).

* Small meals at regular intervals will reduce gallbladder storage time.

* Maintain adequate nutrient levels – through diet or supplements – of vitamins C and E, sulphur-containing amino acids, beta-carotene, magnesium, calcium and folates (Clin Chim Acta, 2004; 349: 157-65).

* Avoid the Pill, which is associated with cholesterol gallstone formation (Acta Manila Ser A, 1976; 15: 25-33).

* Take herbs such as turmeric, Oregon grape, Bupleurum and coin grass, which can reduce gallbladder inflammation and relieve liver congestion (Med Hypoth, 2003; 60: 143-7).

* Supplement with milk thistle as silymarin (its active ingredient) may help reduce gallstones. But do not self-treat – seek the guidance of a complementary health practitioner.

* Switch from animal to vegetable protein, as this can significantly lower the risk of gallstones (Am J Epidemiol., 2004; 160: 11-8).

* Eat more nuts, of any variety, as they may protect against gallstones. Women who ate at least 5 oz/week of nuts were much less likely to need a cholecystectomy than those who ate less than 1 oz/week (Am J Clin Nutr, 2004; 80: 76-81).

* If you’ve had an attack of cholecystitis, take preventative action as such an attack is an indication that you already have one or more gallstones