Non surgical management of cholelithiasis using functional medicine approach: A case series

Background: Gallstone disease (cholelithiasis) is a common gastrointestinal disorder in Bangladesh, often linked to obesity, diabetes, and metabolic dysfunction. While laparoscopic cholecystectomy remains the gold standard, many patients seek non‑surgical options. Functional medicine offers a systems‑based approach targeting root causes such as diet, gut health, and metabolic imbalance.

Objective: To describe the outcomes of patients with gallstone disease managed using a functional medicine‑based personalized protocol in a real‑world clinical setting.

Methods: Three adult patients with ultrasonography‑confirmed gallstones who declined surgery were managed between April and October 2025. Interventions included dietary modification, lifestyle changes, and targeted nutraceutical support. Clinical symptoms, patient‑reported outcomes, and laboratory markers were monitored at baseline and follow‑up.

Results: Patients ranged from 13 to 50 years, predominantly female. Common symptoms included right upper abdominal pain, dyspepsia, and bloating. All patients reported marked improvement within 4–8 weeks, with complete resolution of biliary pain and sustained symptom freedom at one month. Follow‑up laboratory findings showed improved insulin sensitivity, normalized liver enzymes, and favorable stool microbiome changes. No adverse events occurred, and surgical intervention was avoided during follow‑up.

Conclusion: This case series suggests that functional medicine‑based interventions may support conservative management of uncomplicated gallstone disease in selected patients. While findings are preliminary, they highlight the potential of lifestyle‑based strategies as adjuncts to standard care. Larger studies are warranted to evaluate long‑term outcomes.