Apparent resolution of 27-mm Gallstones after traditional Persian medicine-based interventions: A case report

Gallstones are commonly managed surgically, particularly in symptomatic patients or those with large stones. Pharmacological treatment options for large gallstones remain limited. Although increasing interest exists in Traditional Medicine and herbal therapies, robust clinical evidence supporting their efficacy in gallstone management remains insufficient. This report presents a case of gallstone resolution following Traditional Persian Medicine (TPM)-based interventions.

A 34-year-old woman presented with right upper quadrant and epigastric pain, nausea, and constipation. Ultrasonography revealed multiple gallstones with a total diameter of 27 mm and an enlarged heterogeneous hypoechoic pancreas suggestive of pancreatitis. Because of the size of the stones and the risk of complications, cholecystectomy was recommended; however, the patient declined surgery and sought treatment from a TPM specialist. The patient underwent a 3-month treatment course consisting of continuous dietary modifications and herbal remedies, with adjustments made at each follow-up visit according to clinical status. In addition, a traditional dietary cleansing regimen similar to commonly promoted liver-cleansing protocols was prescribed, consisting of fruit juice, vegetables, olive oil, and lemon juice for one day weekly, together with administration of 5 g magnesium sulfate (Epsom salt) for two consecutive days once monthly. Follow-up ultrasonography at 10 weeks demonstrated disappearance of the gallstones with only residual sludge remaining, along with normalization of pancreatic size and echogenicity. A subsequent ultrasound at 14 weeks showed complete disappearance of the sludge. The patient remained asymptomatic and experienced no complications during the 3-month follow-up period.

This case may suggest a potential role for TPM-based interventions in the non-surgical management of gallstones. However, further rigorous clinical studies are required to establish their safety and efficacy.