To Your Good Health: Examining the common and available treatments for gallstones

What advice do you have for the treatment of gallstones?

Gallstones are common — 6% of men and 9% of women will get one over a lifetime — and are mostly composed of bile salts and cholesterol.

The goal of treatment is to reduce symptoms and the risk of complications. Depending on the size and composition of a person’s gallstones, there are different therapies available.

The most common treatment for symptomatic gallstones is surgery. Surgery is highly effective, although there are complications such as bleeding, infection and leaks.

About 10% of people will develop diarrhea after surgery, which tends to get better over weeks to months but sometimes requires treatment with a bile-acid-binding drug like cholestyramine. Surgery is performed laparoscopically, which means faster healing times.

For people who are not good candidates for surgery — such as those with significant medical illnesses — or people who do not want surgery, there are other options.

Medications given by mouth, such as ursodiol, or Actigall, can dissolve gallstones, but this can take a long time, usually several years.

People with smaller stones that are mostly made of cholesterol can be good candidates for this treatment. However, it is not 100% effective.

Another option is a tube placed into the gallbladder through the abdominal wall to drain bile, which is also sometimes done to remove stones, but I have seldom seen it done.

Similarly, shock-wave treatment, which is commonly used for kidney stones, is rarely used but can be a reasonable option in people with only one or two stones.

I am an 83-year-old woman with a question about excessive hair shedding. I’ve always had very thick, good hair, and in fact, I get a lot of compliments on my beautiful hair. I get my hair cut every four to five weeks, and my hairdresser always thins my hair at each visit. On my last visit, she asked me if I had been ill. While my hair was not coming out in clumps, she said it was shedding more than she has ever seen before with my hair. I, too, have noticed during the past month that there is more hair on my brush, shower drain and clothes. With my hair being so thick, I’ve always had some shedding that appears on my clothes, but nothing to this extent. I’m not on any new medicines. What could be causing my hair to shed so much? This is the last thing I thought I would be a problem for me. Is it something serious? Can it be treated and reversed?

The most common cause of hair loss I see in older women is female pattern hair loss, but your story sounds more like acute telogen effluvium, which means the loss of hair during the resting phase.

This condition is sometimes but not always associated with a stressful event. There are other medical causes, but in a third of cases, no underlying cause can be identified.

The good news about telogen effluvium is that the hair usually comes back, often around six to 12 months.

However, I know how important hair can be to both men and women, so I always recommend a visit with a dermatologist, especially one who has expertise in hair disorders as they have additional tools to evaluate patients for other causes.