By Penelope A. Domogo, MD

“Gallstones can be as small as a grain of sand to as large as a pingpong ball. You see, the gallbladder is stretchable so it could accommodate this size. I’ve seen one that big!”

Like the other diseases of the modern world such as high blood pressure, diabetes and rayuma, gallstones were unheard of in the Cordillera until the 1990s. When I was a medical student in the 1970s, we were taught that chances for developing gallstones were much higher if you were female, fat and forty. It was easy to memorize those 3Fs. Although these risk conditions may still apply today, we are seeing patients now right here in the Cordillera who are male, slim or young. Well, way back in the early 1980s I could count the number of fat women with my fingers.
What are gallstones, by the way? Perhaps if these were gold or silver or pearls, I am sure people won’t mind growing them. But these are hardened deposits in the gallbladder from gooey digestive fluid containing a lot of sticky mucus and fat. The gallbladder is “akgo” or “apdo” and in the indigenous Igorot culture, this is a very important part of the ritual pig or chicken. The gallbladder is part of our digestive system. It stores a digestive fluid called bile which is produced by the liver and releases it into the small intestine. Those from my generation would remember the “green rice” served in the evening of dadawak. This is called “bugay” – boiled rice mixed with bile and we enjoyed eating it.
The most common type of gallstone in the world is cholesterol gallstone. Cholesterol is a kind of fat coming exclusively from animals. Plants don’t contain cholesterol. Again, plants don’t contain cholesterol. So avocado does not contain cholesterol. Our bodies (homo sapiens are classified under the animal kingdom) manufacture enough cholesterol so we don’t need any to take in any extra.
Cholesterol gallstones are often yellow in color. Another type of gallstone is pigment gallstone which is dark brown or black. One theory is that this type of stone develops when there is too much bilirubin in your bile. Bilirubin is a chemical that is produced when the body metabolizes red blood cells. I have seen green gallstones, too, that look like tiny green sago or the seaweed “ar-arrosep”.
Gallstones can be as small as a grain of sand to as large as a pingpong ball. You see, the gallbladder is stretchable so it could accommodate this size. I’ve seen one that big!
What causes gallstones to form? Western and eastern scientists agree that these form when the bile (which inside your gallbladder) contains too much cholesterol or fat. Macrobiotic experts add that gallstones are formed when the bile also contains a lot of sticky mucus AND “when the intake of yin, such as cold foods or beverages, crystallizes these formations into stones” (Natural Healing Through Macrobiotics by Michio Kushi). Sounds logical isn’t it- try putting the soup bones in your refrigerator and you will see the curdled fat coating the bones. This theory is evidenced by the increase of people developing gallstones (and kidney stones for that matter) with the coming of the refrigerator. This also explains why in Bontoc, gallstones became popular with the coming of 24-hour electricity in the mid 1980s.
“Gallstones that don’t cause any signs and symptoms typically don’t need treatment.” (Mayo Clinic staff). But you need to change diet. There are also cleansing treatments available but just make sure you understand the process very well and get expert advice. If there are symptoms like intense pain or fever and chills, then these usually require surgical removal of the gallbladder.
The logical path, then, to preventing gallstones are the following 1) avoiding or limiting fat, 2) avoiding food and drink that produce mucus and 3) avoiding or limiting iced and cold food and drink. Avoid drinking or eating anything straight from the refrigerator. You see a lot of these images on TV or in movies and I see a lot of local people mimicking this behavior – a man or woman enters the house, goes straight to the refrigerator and pulls out a cold drink straight to his or her mouth. That is actually an advertising ploy and we are behaving as expected, much to our detriment. And so, careful with that icy cold soft drink, beer, ice-candy, halo-halo and ice cream. The regular milk commonly used contains a lot of fat because those are cheaper than non-fat milk. Be careful also with iced or chilled water because those have a chilling effect inside just the same.
Modern science is still deciphering the effect of removal of the gallbladder. But I know that in Igorot culture, we call a coward “maid akgo na.”***
“My boundaries enclose a pleasant land, indeed I have a goodly heritage.” Psalm 16:6


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