Gallstones are hardened particles that form stones or lumps in the gallbladder or bile duct.
The gallbladder is a tiny sac positioned on the right side of the body beneath the liver. Some of the substances found in the gallbladder might harden into one large or multiple tiny stones.
The vast majority of people with gallstones have no symptoms at all. This is due to the fact that the stones remain in the gallbladder and create no complications.
However, cholecystitis, or an inflamed gallbladder, can occasionally result from gallstones.
The predominant symptom is pain that appears unexpectedly and rapidly worsens. The right side of the body may experience this discomfort in the right shoulder, between the right shoulder blades, or immediately below the right ribcage.
Additional signs include:
- Restlessness
- Nausea
- Sweating
- Vomiting
Treatment
Gallstones are only treated if they have caused gallbladder inflammation and bile duct blockage, or if they have traveled from the bile ducts into the intestines.
Gallstone treatment options include:
Ursodeoxycholic acid
Ursodeoxycholic acid reduces the cholesterol level of bile, making stones less prone to develop.
If a gallstone is formed of cholesterol, ursodeoxycholic acid can occasionally be used to dissolve it slowly. It could take up to 24 months for disintegration therapy to start working. Although it is frequently the only option for patients who cannot receive general anesthesia, it is not as successful as surgery.
Cholecystectomy
The surgical removal of the gallbladder is known as a cholecystectomy. The most common method for doing this is laparoscopic surgery. Laparoscopic surgery is not an option for approximately 10% of persons who require open cholecystectomy.
In open cholecystectomy, the abdomen is severely sliced. Open surgery patients need to heal more slowly and spend more time in the hospital. A person will typically require open surgery if their gallbladder is highly inflamed.
Gallstones recur in a substantial percentage of people who have a cholecystectomy within a year. Many people with gallstones are given ursodeoxycholic acid, which is an acid present in bile, to prevent this.
Endoscopic retrograde cholangiopancreatography
When surgery or ursodeoxycholic acid are not options for a person with gallstones, they may undergo endoscopic retrograde cholangiopancreatography (ERCP), which needs local anesthesia.
A flexible fiber-optic camera, or endoscope, is inserted into the patient’s mouth and passed through the digestive system and into the gallbladder.
The bile duct’s entrance is made wider using a wire that has been heated electrically. The doctor can then decide whether to remove the stones or let them travel into the intestine.
Lithotripsy
A doctor uses ultrasonic shock waves to break up the gallstones. Gallstones can pass safely through a person’s feces if they become small enough. This is a rare procedure that is only used when there are only a few gallstones present.
Diagnosis
The presence of gallstones in a patient is frequently discovered unintentionally while treating another ailment. A doctor may suspect gallstones following a cholesterol test, an ultrasound scan, a blood test, or even an X-ray.
Blood tests may be used to look for symptoms of infection, blockage, pancreatitis, or jaundice.
Additional diagnostic investigations consist of:
Cholangiography
Using an ERCP, a medical expert injects a dye into the circulation such that it accumulates in the bile ducts or gallbladder, or directly into the bile ducts. Ink is visible on X-rays.
The doctor will then be able to examine the X-rays and spot any gallbladder or bile duct conditions that might exist, like pancreatitis, pancreatic cancer, or gallstones. The X-rays will show the doctor whether the dye is getting to the gallbladder, intestines, liver, and bile ducts.
If the dye does not move into one of these regions, it is likely that a gallstone is causing the obstruction. The gallstone’s location will be more clear to an expert.
The ERCP procedure can be used by the doctor to find and get rid of bile duct stones.
An MRI
This non-invasive X-ray creates images of the interior of the human body in cross-section.
Cholescintigraphy (HIDA scan)
A little quantity of safe radioactive material is injected into the patient by a medical expert. This is taken up by the gallbladder, which is then induced to constrict by a medical expert. This examination may be used to identify aberrant gallbladder contractions or bile duct occlusions.
Diet
To avoid gallstone formation, doctors used to counsel people with gallstones who were not yet ready for surgery to adopt an exceptionally low-fat diet.
Recently, researchers came to the conclusion that this strategy is less effective than previously believed since quick weight loss can result in gallstones.
Instead, it is advised that those who have gallstones consume a balanced diet along with regular meals. Although it won’t remove gallstones, this can reduce any discomfort and symptoms.
Gallstones can be prevented by avoiding foods high in saturated fats, including butter, hard cheese, cakes, and cookies. Gallstone formation is hypothesized to be influenced by cholesterol.
Additionally, individuals can alter their diets in a healthy way by eating more nuts and drinking less alcohol to help prevent the illness.
Causes
Gallstones occur when the chemicals in the gallbladder, such as cholesterol, calcium bilirubinate, and calcium carbonate, are out of balance.
Gallstones come in two primary categories.
If there is too much cholesterol in the bile, cholesterol gallstones can form. They are the most common form of gallstones in the country.
When the bile contains too much bilirubin, pigment gallstones develop. People who have sickle-cell anemia, infected bile tubes, or liver illness are more likely to experience these.
The exact reason why some people experience the chemical imbalance in their gallbladder that leads to gallstones but not others is a mystery to experts.
Gallstones, on the other hand, are more common in obese adults, particularly women. A study found that a woman’s risk of acquiring gallstones and needing surgery to remove them nearly doubles if she has a waist size of 36 inches or greater.
Risk elements
The following are additional gallstone risk factors:
- having a gene mutation that considerably increases the chance of developing gallstones,
- having been pregnant,
- having a high dietary fat intake,
- being over 60,
- having a family history of gallstones,
- having recently lost a lot of weight,
- being sedentary, and receiving high-dose estrogen therapy.
- taking statins to reduce cholesterol,
- using oral contraceptives,
- having diabetes
Gallstones affect more women than men. Additionally, males who deliberately lose a lot of weight quickly and then gain it back may be at a higher risk of developing gallstones in later life.
In addition, studies have shown an increased incidence of gallbladder issues in women receiving hormone replacement therapy (HRT) during menopause
Concerns
Gallstones can obstruct the bile duct or duodenum, which can prevent the pancreas from receiving digesting fluids. Jaundice and acute pancreatitis may result from this. The gallbladder is typically surgically removed as part of treatment.
People who have had their gallbladder removed frequently feel bloated and indigestion, especially after eating a meal high in fat. Some people might urinate more frequently than usual.
Not having a gallbladder
It is possible to live without a gallbladder. A typical diet can be broken down by the bile the liver produces. If a person has their gallbladder removed, the bile is no longer retained in the gallbladder and instead travels from the liver through the hepatic ducts to the small intestine.
Because bile flows more often into the small intestine after gallbladder removal, a small percentage of people will have softer and more frequent feces for a while.
Prevention
Some of the elements, such as age, sex, and ethnicity, that can raise a person’s risk of gallstone development are unavoidable.
But it’s probable that eating a vegetarian diet will lower your risk of gallstones. Comparatively to persons who eat meat, vegetarians have a much lower risk of having gallstones.
According to many experts, a diet low in fat and high in fruits, vegetables, and dietary fiber may also assist people to avoid developing gallstones.
Additionally, a person can attempt weight management to lessen the risk of gallstone development. Crash diets, on the other hand, and quick weight loss raise the danger of gallstones.