Conservative Ayurvedic Management of Symptomatic Cholelithiasis with Choledocholithiasis

Abstract

Gallstone disease is a frequently encountered disorder of the biliary system and is an important cause of right upper abdominal pain in adults. When a stone migrates into the common bile duct, it may obstruct the flow of bile and produce abnormal liver function tests with serious complications if untreated. Ayurveda describes disorders involving the hepatobiliary system under the principles of Pitta-Kapha Dushti, Pittashaya Vikara, and Ashmari, where treatment is directed towards restoring normal digestive and biliary physiology. Case Presentation: A 26-year-old woman presented with intermittent pain in the right hypochondrium, nausea, dyspepsia, and discomfort after consuming fatty meals. Ultrasonography performed on 05 June 2026 demonstrated a contracted gall bladder containing multiple calculi (largest 4.4mm), dilatation of the common bile duct (10.9mm), and a calculus within the distal common bile duct measuring approximately 5.1 mm. Biochemical evaluation revealed markedly elevated serum transaminases (SGOT 338 IU/L and SGPT 294 IU/L). Intervention: The patient underwent conservative Ayurvedic treatment with Mahashakti Detox Powder, Mahashakti Pitt Shuddhi Capsule, and Mahashakti Pittrakshak Tablet, along with dietary regulation and lifestyle modifications for approximately one month. Outcome: Follow-up ultrasonography performed after completion of treatment showed disappearance of the common bile duct calculus, normalization of the common bile duct caliber to 5mm, and persistence of only minimal gall bladder sludge with a few tiny calculi. The patient reported marked relief in abdominal pain, nausea, and digestive discomfort. Conclusion: This case highlights the potential role of an individualized Ayurvedic therapeutic approach in improving both clinical symptoms and radiological findings in a patient with cholelithiasis associated with choledocholithiasis. Further clinical investigations are required to validate these observations.