But since I live in the Philippines and the apples we get are imported, they most probably have been sprayed, irradiated and probably not organic, I decided to go around the supermarket for apple juice in cartons which do not come from concentrate. You can use those bottled organic apple juices as well.
The incidence of asymptomatic cholelithiasis is on the rise due to easy availability and frequent use of ultrasonography for evaluation of most of the abdominal complaints. Laparoscopic cholecystectomy is considered as the gold standard for treating symptomatic gallstones while controversy continues to exist in managing asymptomatic cases.
However, except under some special circumstances and few well defined at-risk individuals, expectant management is considered adequate for asymptomatic gallstones AG.
The study of natural history of gallstone disease and the life time risk of complications shows, prophylactic cholecystectomy for AG may be a too aggressive treatment. The aim of this article is to make the clinician and the patient aware of the available data regarding AG and thus decision making in its management.
Asymptomatic gallstones, Prophylactic cholecystectomy. The incidence is greatly influenced by fat intake and Western type of diet. Several studies reveal rise in incidence in Saudi Arabia after adoption of Western diet where gallstones were virtually unheard 50years ago .
AG is detected incidentally during ultrasound for other abdominal conditions or occasionally by palpation of gallbladder at operation.
Symptomatic gallstones should be considered when patient gets biliary pain which is almost always episodic and infrequent [6, 7]. It develops rapidly, is severe, steady and unrelieved by change of position or gas passage.
Pain that frequently comes and goes, lasts less than 15minutes ,does not interfere with activity and symptoms of dyspepsia, epigastric discomfort, flatulence or nausea should not be attributable to gallstones as they often occur in general population with or without other gastrointestinal problems [,16].
Symptomatic gallstones may arise due to movement or impaction of stone, stasis or infection. As studies have shown dyspepsia to occur with equal frequency with presence or absence of gallstone, hence gallstone dyspepsia is a myth [16, ]. Complications due to gallstones did not occur in anyone and none died due to gallstone disease [37, 38].
Hence natural history of AG is so benign that neither they necessitate treatment nor a regular follow up [35, 39].
Spontaneous dissolution of gallstones is a possibility especially with asymptomatic biliary sludge or stones referred as pseudolithiasis encountered in postoperative paediatric patients either treated with high doses of ceftriaxone or prolonged restriction of oral diet.
Dissolution occur usually 2weeks to 4months of cessation of ceftriaxone and hence prompt cholecystectomy should be avoided [41, 42]. AG becomes symptomatic on occasions in the postoperative period possibly due to stasis of bile causing cholecystitis .
USG abdomen should be routinely done in all cases of planned laparotomy to detect silent gallstones and prior counseling the patient before surgery . Hence it is considered safe to do cholecystectomy in women with AG undergoing major gynecological surgery if it does not add further life risk .
So also concomitant cholecystectomy should be done along with laparoscopic antireflux surgery , splenectomy in sickle cell disease  and laparotomy done in patients on prolonged parenteral nutrition .
Prophylactic laparoscopic cholecystectomy can be considered for recipients of solid organ transplant on cyclosporine as frequently associated with AG  and not justified before renal and cardiac transplantation[75,76].
Essay UK - http:The history of this liver flush is my anthroposophic doctor recommended I do a liver flush and she wrote down her formula using fresh apples.
But since I live in the Philippines and the apples we get are imported, they most probably have been sprayed, irradiated and probably not organic, I . Gallstones can be as small as a grain of sand or as large as a golf ball.
” Gallstones can form when bile such as cholesterol and other waste get caught in the gallbladder. Gallstones may also form when the gallbladder does not empty all the way. Jaundice. Pancreatic cancer causes yellowing of the skin and eyes by 2 principal effects.
The first is the blockage of the bile duct by tumor and the second is the invasion and destruction of the liver.
Kidney stones are clumps of mineral that accumulate on the inner lining of the kidneys.
As long as they stay in the kidney, they do not cause any problems. However, if they move into the ureter. Below is the original essay prefixed to the King James Version in the edition of , in which the translators defend their version against criticisms they expected to be brought against it.
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