“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 . It has also been shown that red dye will appear in the interior of the “stones” if consumed with the oil .
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 . 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  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  and waxy or “gelatinous” . 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”
• 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?
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