Gallstones

1 What are Gallstones?

Gallstones occur as hardened or crystallized deposits of the digestive fluids which form in your gall bladder.

A gallbladder is a pear-shaped body organ located on the right-hand side of the abdomen and just below the liver. The gall bladder stores the digestive juice called bile which is released in the small intestine.

Gallstones range in size from small as a grain crystal grain of sand to as large as a golf ball or hockey ball.

It may also appear just as one gall stone. Others may develop many of the gall stones.

This is a condition that is common in the UD. It is mainly managed by the removal of the gallstones through surgery. However, gallstones that have no signs and symptoms may not require any form of treatment.

2 Symptoms

Gallstones may be present with no signs or symptoms. However, when they form in a duct, they may cause a blockage and this present a few signs and symptoms.

This may include sudden and rapid pain in the upper section of the abdomen, the central region of the abdomen and even below the breastbone.

Back pain may also be felt in between the shoulders. But the pain on your right shoulder may last several minutes to some hours.

See a doctor when this pain starts to present. Also, seek immediate care when the symptoms present serious complications: such as abdominal pain, yellowing of the skin and whites of your eyes coupled with high fever chills in the body.

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3 Causes

The exact cause of gallstones is not known. But, scientist and medical doctors equally believe that it is formed when the bile contains too much of the cholesterol.

Bile has several chemicals that dissolve the cholesterol released by the liver. However, sometimes, the liver can release more cholesterol than the bile can manage.

This may be converted to crystals in the gallbladder, which eventually becomes stones. Moreover, bile contains bilirubin. This is a chemical that is produced by the breakdown of the red blood cells.

Sometimes, too much of the bilirubin may be formed by your liver, especially in diseased liver states such as cirrhosis, biliary infections, blood disorders. It is known that excess bilirubin causes gallstone formation.

More especially when the gallbladder does not empty correctly and completely. This may lead to bile becoming very concentrated leading to a formation of gallstones.

There are several types of gallstones such as:

  • Cholesterol gallstone which is the most common. It appears as a yellow crystal. They are mainly composed of undissolved cholesterol, but may contain other components.
  • Secondly, pigment gallstones; they occur as dark brown or black stones, they are formed from excess bilirubin.

4 Making a Diagnosis

A diagnosis of Gallstones will be made by your Gastroenterologist and depends on any symptoms you exhibit and report.

When the signs and symptoms of gallstones present, see a doctor or general practitioner.

If the doctors suspect gallstones, you may be referred to a specialist of the digestive system (gastroenterologist) or an abdominal surgeon. These appointments are often brief and a lot of the information may need to be covered. Therefore, good preparation will be required.

During the appointment, seek to know if there is any diet that is restricted. Look for any of the symptoms that is not related to gallstones. Jot down a few key personal information such as stress or life changes. List all the medications, vitamins and supplements in use or previously used. Take a friend who knows you well with you for the appointment. Note down some of the questions the doctor asks.

Always list the questions from most important to the least important. Some key questions may include:

  • Is there any likelihood of abdominal pain?
  • What are the symptoms?
  • Will I need surgery to remove gallstones?
  • What are the risks involved in surgery?
  • Are there any alternative forms of treatments?
  • How much time will it take to heal from surgery?
  • Do I need a specialist?
  • How much does it cost?
  • Are there any insurance covers?
  • Where can I get brochures for this condition?
  • What websites can I visit for this information? 

The doctor may also ask you several personal questions such as:

  • When did you feel the first pain?
  • Have you felt fever during this time?
  • How long does the pain last? 
  • How have you managed the pain? 

The doctor may send you to the labs for disease diagnosis. 

The test and the procedures for gallstones will include:

  • An abdominal ultrasound,
  • Computerized tomography (CT) scan for pictures of your gallbladder to check for a presence of gallstones.

Tests may also be done to check for ducts of gallstones. This tests uses a dye to mark your bile duct on images which help your doctor to make a diagnosis as to whether the gallstones are responsible for the blockade. 

The test may also include hepatobiliary iminodiacetic acid (HIDA) scan, Magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP).

The gall stones are discoverable using the ERCP will then be removed using the surgical procedures.

Blood tests may also be done to look for the natural body complications. This may also reveal the presence of an infection, jaundice, pancreatitis or and other complication which may lead to gallstones.

5 Treatment

Gallstones which do not come with signs and symptoms may not need any form of treatment. This may be determined by their detection using CT or ultrasound.

Your doctor will, however, recommend that you be alert for the signs and symptoms of complications of the gallstones such as excessive pain at the upper right hand in the abdomen.

When the gallstone signs and symptoms occur, seek for treatment. The treatment options may include surgical removal of the gallbladder (Cholecystectomy). This is recommended since the gallstones recur. However, this will make the bile flow directly from the liver to the small intestines without being stored. One can survive without a gallbladder.

It will also not affect your digestive processes, but will cause diarrhea. Some of the medication for gallstones, when taken orally, are intended to dissolve the gallstones. This may take a few months and years to dissolve the gallstones. This drugs may not also work sometimes.

Medication for gallstones are also not commonly used and often reserved for people that may not afford surgery.

6 Prevention

Gallstones can be prevented when you do not skip your meals and sticking to your usual mealtimes every day. Also, skipping meals may increase the risk of gallstones.

It is recommended that one loses weight slowly. Rapid weight loss poses a risk for weight loss. The target for weight loss is about 1-2 pounds a week (0.5-1Kg).

Try to also maintain a healthy weight. Being obese and overweight increases the risk for gallstones. Work to achieve a healthy weight by reducing the calories one eats daily and increase involvement in physical activity. Maintain the weight and continue to eat a healthy diet.

7 Risks and Complications

There are several factors that may increase the risk of gallstones:

  • Being female Being age 60 or older
  • Being an American Indian
  • Being a Mexican-American
  • Being overweight or obese
  • Being pregnant
  • Eating a high-fat diet
  • Eating a high-cholesterol diet
  • Eating a low-fiber diet
  • Having a family history of gallstones
  • Having diabetes
  • Losing weight very quickly
  • Taking some cholesterol-lowering medications
  • Taking medications that contain estrogen, such as hormone therapy drugs. 

Serious complications may be presented as an inflammation of the gallbladder, gallbladder blockage with gallstones at the neck of the gallbladder causing inflammation of the gallbladder (cholecystitis), cholecystitis may also lead to severe pain, and fever.

Blocking of the bile duct, Jaundice and bile duct infection may also present as a complication.

Blocking of the pancreatic duct which runs from the pancreas to the common bile duct which transports the pancreatic juice leading to the inflammation of the pancreas (Pancreatitis). Pancreatitis leads to the intense, constant pain which requires treatment. People exposed to cancer of the Gallbladder have an increased risk of gallstones and vice versa. Cancer of the gallbladder is very rare and 

People exposed to cancer of the Gallbladder have an increased risk of gallstones and vice versa. Cancer of the gallbladder is very rare and the likelihood of its development is very small.

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